The inspection took place on 13 March 2017 and was unannounced.

The last inspection took place in February 2016. As a result of this inspection, we found the provider in breach of a regulation relating to safe care and treatment and maintenance of the premises. We asked them to submit an action plan on how they would address this breach. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found that appropriate action had been taken and the regulation had been met. At the last inspection, we found there was no specific training for staff on mental health conditions. The provider/registered manager had developed the training on offer to staff. Training had been made available so that staff had access to mental health awareness training and associated conditions. As a result of steps that the provider had taken, the overall rating of this service has improved from Requires Improvement to Good.

Touchstones is registered to provide accommodation and care for up to 19 people with a range of mental health needs and conditions such as bi-polar disorder, schizophrenia and Korsakoff’s Syndrome. At the time of our inspection, 17 people were living at the home. Touchstones is situated near to the town centre of Worthing, with easy access to the seafront and local transport connections. Communal areas at the home include a TV lounge, music and computer room, conservatory with television, garden and residents’ kitchen. There is also a larger kitchen and dining area.

The provider is also the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people were identified, assessed and managed appropriately. Risk assessments provided detailed information and guidance to staff on how to support people safely and mitigate any risks. Risk assessments relating to the premises and people’s safety were also in place. People told us they felt safe living at Touchstones. Staff had been trained to recognise the signs of potential abuse and knew what action to take. They had received safeguarding training. There were sufficient staff on duty to ensure people’s safety. Safe recruitments practices were followed. Medicines were ordered, stored, administered and disposed of safely.

Staff completed training in a range of areas in order to support people effectively. New staff followed the Care Certificate, a nationally recognised qualification. Staff were also encouraged to study for additional qualifications. They had regular supervision meetings and staff meetings were also organised. Staff understood the requirements relating to mental capacity legislation and put this into practice. No-one living at Touchstones was deprived of their liberty. People were supported to have sufficient to eat and drink and a varied menu offered people choices of what they would like to eat. Where people had been assessed as being at risk of malnourishment, advice and guidance had been sought from healthcare professionals and put into practice. People had access to a range of healthcare professionals and services and staff supported people to attend their healthcare appointments if required.

People were supported by kind, caring and friendly staff. Their cultural and spiritual beliefs were acknowledged and provided for. People were encouraged to express their views and were involved in their care planning, which was regularly reviewed. People were treated with dignity and respect. Some people had recorded their wishes for their end of life care.

Care plans contained detailed information about people’s care and support needs. Staff supported people in line with their a

The inspection took place on 2 February 2016 and was unannounced.

Touchstones provides care and accommodation for up to 19 people and there were 18 people aged 35 to 80 years living at the home when we inspected. The service specialises in the care of adults with a mental health need.

The service had 11 single bedrooms and four doubles. There were two communal lounges and a conservatory as well as two kitchens, one of which people could use to prepare their own food and drinks between meals. The home had two shower rooms and two bathrooms; two of these also had a toilet. There were also four additional toilets.

The service did not have a registered manager and was being managed by the provider who had applied to the Commission for registration as manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Whilst risks to people were assessed, and, there were care plans to mitigate those risks, we found two areas where greater detail was needed to show all relevant information had been considered.

The environment was in need of attention in certain areas and action had not been taken regarding risks from hot water, falls from first floor windows and from hot surfaces such as radiators.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

People received their medicines safely.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People at the service had capacity and the staff sought people’s consent about arrangements for their care.

There was a choice of food and people were involved in planning the menus. People’s nutritional needs were assessed so the right action could be taken if people were at risk of malnutrition.

Staff were skilled in working with people who had mental health needs although we identified staff training needed to be improved so staff had a more thorough knowledge base of specific illnesses.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular health checks.

Staff were caring and acknowledged people’s privacy. People commented that staff were understanding of people’s mental health needs and provided support during periods of distress. Staff had positive working relationships with people and offered informal counselling and listening to support people. The staff promoted people’s independence.

Care was provided to people based on their individual needs which we call person centred care. People were fully involved in the assessment of their needs and in care planning to meet those needs. Staff had a good knowledge of people’s changing needs and action was taken to review care needs.

Staff listened and acted on what people said and there were opportunities for people to contribute to how the service was organised. People knew how to raise any concerns.

The views of people, relatives and health and social professionals were sought as part a quality assurance process. The culture and ethos of the service was focussed on people being involved in the running of the service which in turn empowered people and helped build their confidence.

We found one breach of the Health and Social Care

We were informed that there were nineteen people living at Touchstones. On the day we visited some of the people were out for the day.

We looked around the building which was clean and free from unpleasant odours. Staff informed us that the kitchen was being redecorated.

During our visit we spoke with four people who used the service and five members of staff (including the registered manager and nominated Individual). We also spoke with a health care professional who visits the home regularly.

All the people we saw said they were happy living at Touchstones Lodge. One person said the staff are ok and try and help you, another told us that they liked living at Touchstones and that they felt supported by staff. This was because people were treated with respect and supported in meeting their care needs, whilst maintaining independence.

A health care professional who was visiting the home told us that the home was client centered and promoted people independence.

All the people who used the service that we spoke with said that they were happy with the care and support they received. This was because people were treated with respect and supported in meeting their care needs, whilst maintaining their independence.

The provider and staff were aware of their responsibilities regarding protecting people from abuse. Staff told us they knew how to raise concerns. There were enough qualified, skilled and experienced staff to meet people’s needs.

The provider had quality assurance systems in place to check that the quality of the service being delivered was meeting people's needs.