This inspection took place on 27 April and 2 May 2017 and was announced. A previous inspection, undertaken in February 2015, found there were no breaches of legal requirements and rated the service as Good overall.

Tynedale House is registered to provide accommodation for up to 30 adults. The home is subdivided into four units. Six places at the home are designated for respite, short term care for adults with learning and/or physical disabilities. The remaining 24 places are used to provide longer term accommodation, support and personal care to older people with a learning disability, some of whom also are living with dementia. Tynedale House does not provide nursing care. At the time of the inspection there were three people receiving respite care and 23 people living permanently at the service.

The home had a registered manager who had been registered since November 2014. 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.

People and relatives told us they felt the home was a safe place to live. Staff were aware of safeguarding issues, had undertaken training in the area and told us they would report any concerns of potential abuse. The premises were effectively maintained and safety checks undertaken on a regular basis, including checks with regard to fire safety.

Appropriate staffing levels were maintained to support the changing needs of people living at the home. Proper recruitment procedures and checks were in place to ensure staff employed at the home had the correct skills and experience. Previous minor issues around the safe handling of medicines had been addressed.

Relatives told us people enjoyed access to adequate food and drink at the home and we observed this to be true. Kitchen staff had an exceptional understanding of people’s dietary needs. Staff said they were able to access the training they required and records confirmed mandatory training was up to date. Staff told us, and records confirmed there were regular supervision sessions and that they had an annual appraisal.

The registered manager had a good understanding of the Mental Capacity Act 2005 and appropriate action had been taken where Deprivation of Liberty Safeguards had been applied. Staff were aware of the need for best interests meetings to take place where decisions needed to be made and people did not have capacity.

People had access to health care professionals to help maintain their wellbeing. Decoration in communal areas of the home had been improved and bathroom and toilet areas updated.

Relatives and visiting professionals told us they felt the care was outstanding, highly personal and responsive to people’s needs. They told us the home’s dementia care was of an exceptional standard. Relatives and carer questionnaire responses rated the service highly. We observed excellent relationships between people and staff. Staff described people as being almost like family and demonstrated a genuine interest in them as individuals.

People were treated with dignity and respect. A ‘residents’ forum’ had been established to ensure people were involved in determining their care. Professionals spoke to us about the high quality end of life care provided by the service and described how the service worked cooperatively to ensure people could be cared for with compassion at this time of their lives.

People had individualised care plans that addressed their identified needs. People and relatives talked enthusiastically about activities, holidays and individual sessions they had participated in. People and relatives told us they had no reason to complain about the service. Two formal complaints, received in the previous 12 months, had been fully addressed.

The regist

People told us they were happy with the care and support they received at Tynedale House. They confirmed they were given choices in life and staff supported them to take some risks and be independent.

People we spoke with said, "I like it here", "I have just be on holiday but it is nice to get home" and "it is a nice place to live."

People said they could receive medical and specialist attention when they needed it and were helped to fulfil their social needs within the home and community. People we spoke with said "I enjoy getting out and about" and "This is my home and has been for many years."

People told us their home was clean, comfortable and warm. They said "I like my room

and it has everything I need" and "There have been good changes, it is now quite modern, which I like."

They said staff were kind and caring and seemed to be well trained. People confirmed they were given the opportunity to comment on the service, change routine or raise complaints. They said their visitors were made to feel welcome and information sharing was good.

This inspection took place on 3 and 5 February 2015 and was announced. A previous inspection undertaken in January 2014 found there were no breaches of legal requirements.

Tynedale House is registered to provide accommodation for up to 30 adults. The home is subdivided into four units. Six places at the home are designated for respite, short term care for adults with learning and/or physical disabilities. The remaining 24 places are used to provide longer term accommodation, support and personal care to older people with a learning disability, some of whom also are living with dementia. Tynedale House does not provide nursing care.

The home had a registered manager who had been registered since November 2014. 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.

People told us they felt safe and that staff treated them appropriately. Staff were aware of safeguarding issues, had undertaken training in the area and told us they would report any concerns of potential abuse. Staff were also aware of the registered provider’s whistle blowing policy. The premises were effectively maintained and safety checks undertaken on a regular basis.

Appropriate staffing levels were maintained to support the changing needs of people living at the home. Proper recruitment procedures and checks were in place to ensure staff employed at the home had the correct skills and experience. We found there to be some minor issues around the safe handling of medicines.

People told us they enjoyed access to adequate food and drink at the home and we observed this to be true. The registered manager showed us the system employed to ensure staff had regular training and updating of skills. Staff said they were able to access the training they required. Staff told us, and records confirmed there were regular supervision sessions at least four times per year and each staff member had an annual appraisal.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. Staff were aware of the need for best interests meetings to take place where decisions needed to be made and people did not have capacity to make their own decisions.

The registered manager confirmed that appropriate assessments and applications had been made, where people met the criteria laid down in the DoLS guidance. The home had been adapted to promote people’s independence with single level access and ramps available. We found the decoration in communal areas was not always homely and spoke to the registered manager about this. She told us she hoped to continue to improve the decoration at the home.

People told us they were happy with the care provided. We observed staff treated people with patience and kindness and showed a genuine interest in them as individuals. People had access to health care professionals to help maintain their wellbeing. Specialist advice was sought and acted upon where necessary and visiting professionals told us the service and support provided was good. People said they were treated with dignity and respect.

People had individualised care plans that addressed their identified needs. People talked enthusiastically about activities and holidays they had participated in. The registered manager told us there had been no formal complaints in the last year and visiting professionals told us people they were working with were happy at the home.

The registered manager showed us records confirming regular checks and audits were carried out at the home. Staff were positive about the leadership of the home, said that morale was good and felt well supported by management. People and staff all talked about the family atmosphere at the home and how they enjoyed working and being there. People who used the service told us they looked on staff as friends.