The comprehensive inspection took place on 11 February 2018 and was unannounced. The last inspection took place on 16 January 2016 and was rated good in all key questions. At this inspection we found the service had improved in the Well Led domain. We have rated this as Outstanding. Vane Hill is a residential care home providing care, support and accommodation for up to 32 people affected by Alcohol Related Brain Damage (ARBD) such as Korsokoff’s (an alcohol related dementia). On the day of the inspection 31 people were using the service. The home consists of two adjacent detached houses providing different levels of care for people. Vane Hill is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. We were supported on the inspection by the registered manager and the staff team.

People were at the heart of everything the service did. There was an exceptionally positive culture within the service. The registered manager had clear values about how they wished the service to be provided and these values were shared by the whole staff team. Staff talked about ‘personalised care’ and ‘respecting people’s choices’ and had a clear aim about improving people’s lives and opportunities. Staff felt very supported and valued, One staff member told us, “I've known [X] for 24 years and whilst I've been working at Vane Hill he has done so much for our residents by helping them get their life back together. [X] has taken the residents out for weekends away which this is good for them, it gets them to know other people and the residents really enjoyed this. Countless examples of people’s lives being improved were given throughout the inspection. Staff went the extra mile to ensure people mattered. A professional shared, ““Many years ago, [X] was a recent admission with some extremely disturbed behaviour. She was hard to contain her in the home and she was constantly self-harming, absconding, drinking when she managed to get out and getting into trouble with the police due to violent outbursts when she was out. Gradually over the years she has stopped self- harming, was able to travel independently without buying or consuming alcohol, was a valued member of the Vane Hill community and earned some qualifications and addressed some of her obsessive behaviours. A few years ago she seemed so much improved that she moved into Shared Lives accommodation with a family.” A relative told us, “May I praise your wonderful manager, [x] Todd at Vane Hill Road. The care he has given my brother, [X], since he became a resident in 1999, is way beyond this man's duty. “Outstanding leadership at the service benefitted people’s lives. Staff were motivated to make a difference. Feedback we received from professionals and commissioners was exceptional, “[X] (the registered manager) has taken residents who have failed in other care homes and for that he is to be commended. He is perhaps one of the most experienced ARBD managers in the UK and we believed that he should be recognised for his achievements.” Best practice in the field of alcohol related dementia was followed and people had excellent outcomes. Partnership working with charities, schools and the local community enhanced people’s lives and gave them a sense of value and worth.

Feedback received by the service and outcomes from audits were used to aid learning and drive improvement across the service. The provider,

The inspection took place on the 16 January 2016 and was unannounced.

Vane Hill is a residential care home providing care, support and accommodation for up to 32 people affected by Alcohol Related Brain Damage (ARBD) such as Korsakoff’s. On the day of the inspection 31 people were using the service. The home consists of two adjacent detached houses providing different levels of care for people.

The service had a registered manager in post. 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.

During the inspection people and staff were relaxed; the environment was clean and clutter free. There was a happy, calm and pleasant atmosphere. People confirmed staff were kind to them.

Care records were focused on giving people control and encouraging people to maintain as much independence as possible. People were involved in planning their needs and how they would like to be supported. People's preferences were sought and respected. People’s life histories, disabilities and abilities were taken into account, communicated and recorded, so staff provided consistent personalised care, treatment and support.

People’s risks were known, monitored and managed well. There was an open, transparent culture and good communication within the staff team. Accidents and incidents were recorded and managed promptly. Staff knew how to respond in a fire and emergency situation. There were effective quality assurance systems in place. Incidents related to people’s behaviour were recorded and analysed to understand possible triggers and reduce the likelihood of a reoccurrence.

People were encouraged to live active lives and were supported to participate in community life where possible. Group activities were fun and people enjoyed visiting local places of interest. People also enjoyed activities within the home such as pool, card games and chess.

People had their medicines managed safely. People received their medicines as prescribed, received them on time and understood what they were for where possible. People were supported to maintain good health through regular visits with healthcare professionals, such as GPs and dentists and the specialists involved in their specific health care needs.

People and staff were encouraged to be involved in regular meetings held at the home to help drive continuous improvement such as residents’ meetings and staff meetings. Listening to feedback helped ensure positive progress was made in the delivery of care and support provided by the home.

People knew how to raise concerns and make complaints but told us they didn’t have any. People and those who mattered to them explained there was an open door policy and staff always listened and were approachable. The registered manager informed us if any complaints were made they would be thoroughly investigated and recorded in line with the service’s policy.

People told us they felt safe and secure. People’s personal possessions and their money were kept safely.

Staff understood their role with regards to ensuring people’s human rights and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by staff. The staff made great efforts to ensure people’s human rights and liberty were respected. All staff had undertaken training on safeguarding adults from abuse; they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.

Staff received a comprehensive induction programme specific to Vane Hill and the Care Certificate (a new staff induction programme) had been implemented within the home. There were suff

We (the Care Quality Commission CQC) carried out a planned inspection of Vane Hill. We spoke with four people, three staff and the manger.

People told us that they felt involved in making decisions about their care and gave consent where appropriate. One person said “They (the staff) don’t do anything without my say so.” Another person said “I usually talk to (the manager) and we decide together. I need his help.”

People were pleased with the care and support they received and had their physical and mental health care needs met well. One person said “I can’t remember much about coming here but I like it and feel things are getting better. They (the staff) have helped me a lot. My son and daughter are pleased.”

The care staff we spoke with had a good knowledge of what people's needs were and how to meet those needs. Care was managed, provided and reviewed well.

People spoken with said they felt safe living at the home and said that they had no concerns for either themselves or their possessions. Systems were in place to deal with emergencies and protect people from abuse. People told us that they knew how to raise any concerns with the home. Any complaints were managed well.

There were enough staff on duty and people we met spoke well of the staff saying, “They (the staff) are very good”, “I like them a lot”, “We cannot grumble, they are brilliant”, and “I like X (the manager) he makes me laugh”.

We (the Care Quality Commission) carried out a visit on 11 September 2012. We observed how people were being supported, looked at four care records and other documents. We talked with seven people who used the service and talked with five members of staff.

People told us they were able to make choices about their lifestyle. People told us there was a variety of activities and events to keep them occupied.

We found that people's needs were planned and delivered or supported in a way that helped to promote independence and encourage rehabilitation. People were positive about their care. One person said, “It’s been hard for me here but I knew what I was letting myself in for. It’s been worthwhile although it took me 12 months to settle in. My health has improved and my whole lifestyle has changed for the better. I am working towards leaving here and returning to my home town and living a normal life”.

We saw that comprehensive support plans and risk assessments were in place.

People spoken with said they felt safe living at the home and liked the staff that supported them.

Staff told us they felt supported at the home. Staff said the training within the organisation was very good and that they had access to mandatory and extra training. We saw that staff were supported through a programme of supervision and new staff had completed a formal induction programme.

The provider had systems in place to formally and informally monitor the service.

One service user said they feel this is one of the better homes they had been in. It has been effective in keeping them off alcohol. ’I just grew up’ they said. We saw that people supported each other, and enjoyed social activities together in the houses.

Some service users were fully involved in training and in the life of the home. Others were not clear about their future plans. One said they thought they were well enough to move on, but did not know what the next step was, and did not want to ‘rock the boat’ by asking management.

We saw three people who had been supported to receive major health treatments since coming to Vane Hill, which improved their life chances greatly.

The houses were bright, clean and had plenty of space for people to engage in different social activities. We saw people playing pool, drafts, helping in the kitchen, and chatting in the garden. Three service users regularly attended day activities outside, while two were regularly involved in work within the houses for which they had received training, and support to seek outside employment.

Each of the two houses has a kitchen, and a different menu is prepared every day, which can give people a choice of main meal and tea time snack, as long as they are aware of this and speak up.

Some of the staff and service users had been at Vane Hill for several years, and knew each other very well, thus giving an atmosphere of informality and friendliness. ‘It’s a nice place to work’, said one Support Worker.