The inspection took place on 18 and 19 October 2016. The visit was unannounced.

Vinegar House is a residential home which provides care to people with mental health needs. It is registered to provide care for up to 13 people. At the time of our inspection there were eight people living at the home.

There was 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 and associated Regulations about how the service is run.

People using the service we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People's risk assessments had not comprehensively provided staff with information of how to support people safely.

People using the service told us they thought medicines were given safely and on time.

Staff had not always subject to robust character checks to ensure they were appropriate to work with the people who used the service.

Staff had been trained to ensure they had the skills and knowledge to meet people's needs.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives.

People had plenty to eat and drink and everyone told us they liked the food provided.

People's health care needs had been protected by referral to health care professionals when necessary.

People told us they liked the staff and got on very well with them, and we saw many examples of staff working with people in a friendly, supportive and caring way.

People and their representatives were involved in making decisions about care, treatment and support.

Care plans were individual to the people using the service and usually covered their health and social care needs, though more detail was needed to ensure specific health advice was discussed with people and included in care plans.

There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were in place to provide stimulation for people and people took part in activities in their chosen community activities.

People and their relatives told us they would tell staff if they had any concerns and were confident that proper action would be taken.

People and staff were satisfied with how the home was run by the registered manager and the management team.

Management carried out audits to check that the home was running properly to meet people's needs, though not all essential systems had been audited.

People told us they were generally happy with the care and service they received, and felt that their needs were being met. Comments received from people included ‘’I feel able to speak with staff about any problems, they listen to me and take on board what I say, we find our own activities during the day; I go out most days, I feel I have improved tenfold since being at Vinegar House and the volunteer motivates us and there is always something to do’’.

People told us that they had agreed to the care and treatment they received.

Further activities and outings were being provided to ensure that people have access to meaningful activities to occupy their day.

People told us they liked their meals, which included a choice and variety of foods. Comments received from people included ‘‘the food is cool, if I don’t like something on the menu they will cook an alternative, the food is very good, we get plenty of choice’’.

Arrangements were in place to ensure that medicines were handled appropriately, and that people received them at the times they needed them.

People told us they liked the staff that supported them and that they felt able to talk to them as they were approachable. Two people also said that they felt that the staff had the right skills to care for them.

Staff worked well together as a team. Further training had been put in place to enable staff to carry out their work effectively.

We spoke with five people who used the service. People told us they were generally happy with the care and support they received, and felt that their needs were being met.

People's care records overall provided an accurate account of the care and treatment provided to meet their needs.

People felt listened to and had a say in how the service is run. People also felt able to raise any concerns about the care and service with staff.

People told us that they were encouraged to take part in social and leisure activities of their choice. We found that further activities were needed to ensure that all people have access to meaningful activities to occupy their day.

Sufficient numbers of staff were generally available to meet people's needs. The support of a new cook and a housekeeper meant that the care staff had more time to spend with people.

Further training needs to be put in place to enable staff to carry out their work effectively.

Effective systems had been put in place to monitor the quality of the care and service that people receive, and to identify and manage risks.

We spoke with six people who used the service and three relatives.

People told us they liked living at Vinegar House as the atmosphere was relaxed and the daily routines were flexible.

People felt involved in decisions about their care and treatment. People told us they were happy with the care and support they received, and felt that their needs were being met. One person told us ''this is a good place to live; my mental health has improved since I came here.’’

People said that they received care from regular staff who knew their needs. People described staff as friendly and helpful.

People said they were encouraged to take part in social and leisure activities of their choice. Two people felt that more activities were needed to occupy their day. One person told us ‘’they enjoyed going out with the two volunteers, although there was not much to do when the volunteers were not available.’’ Another person told us ’’I rely on my friend to take me out.’’

People felt that staff treated them with dignity and respected their privacy.

People felt listened to and had a say in how the service is run. People also felt able to raise any concerns about the care and service with staff.

People told us they were supported to maintain contact with their family and friends.

Relatives told us they were generally happy with the care and support their family member received. Relatives felt able to raise any concerns about the care and service with staff.

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