This was an unannounced inspection which took place on 03 January 2017.

Watson House is a residential care home which is registered to provide a service for up to seven people with learning disabilities and other associated difficulties. Some people had developed needs relating to the ageing process. There were seven people living there on the day of the visit. The service offers accommodation in a purpose built house which offers ground floor accommodation.

There is a registered manager running the service. 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.

Staff had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Their knowledge and understanding contributed to keeping people, themselves and others as safe as possible.

People were kept safe because general risks and risks to individuals were identified and action was taken to reduce them as much as possible. There were enough staff on duty to ensure people were supported safely. The recruitment procedures were robust and made sure, that as far as possible, staff were safe and suitable to work with the people who live in the home. Medicines were given safely, in the right amounts and at the right times by trained and competent staff.

People’s health and well-being needs were well met by staff who responded very effectively to people’s changing needs. The service sought advice from and worked very closely with health and other professionals to ensure they met people’s health and well-being needs to a very high standard.

Peoples’ human and civil rights were understood, and upheld by the staff and registered manager of the service. The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who may not have capacity to do so. People were supported to make as many decisions and have as much control over their lives as they were able to.

People’s care was provided by extraordinarily kind, caring and committed staff who were exceptionally attentive and knowledgeable. Individualised care planning ensured the staff team used a highly person centred approach and people’s equality and diversity was always respected. People were provided with a lifestyle they thoroughly enjoyed because it was individually designed according to their needs, abilities and preferences.

The service was exceptionally responsive to people and met their needs in a totally person centred way. People were given the opportunity to enhance their lifestyle by participating in a wide variety of activities that they really enjoyed.

People received outstanding person centred care which was overseen by a highly thought of and exceptionally committed registered manager. She listened and responded to people, staff and others and upheld extremely high standards and values. The registered manager was described as totally approachable and always supportive. The high quality of care the service provided was assessed, reviewed, improved and developed to enhance people’s lifestyle.

We spoke with four people using the service and three staff. People living in Watson House told us they got on well with the staff and with other people living in the home. One person said “I am very well looked after here. It’s five star Watson”. Another said “the staff are very good, it’s great”.

We observed people being given choices. They were encouraged and supported to make decisions. There was evidence in people’s care and support plans of their involvement in care and treatment.

People were offered suitable food and drink which was available to them throughout the day. Adapted cutlery and crockery was used to enable people to maintain their independence.

There were sufficient qualified and experienced staff on duty. Staff told us they thought the staffing levels were correct. They also said if they needed more help in an emergency then there were always other staff available.

Records were accurate and fit for purpose. They were stored securely and destroyed in line with the provider’s policy.

The people living in Watson House had complex needs and as such were not able to talk to us about all their experiences. However they welcomed us into their home and were happy for us to spend some time with them.

The house was clean and homely. The people living in Watson House appeared well dressed, happy and content. They got on well with the staff who clearly knew each of them well. People were called by their preferred name and staff treated them with dignity and respect. We observed people being involved in activities and given choices.

We spoke with three staff members and the manager. They all told us they felt supported. One told us “I love my job; this is by far the best place I have worked”. Another said “there is lots of support, and communication is excellent”. They told us that the training was “excellent and constantly available”

The provider had an effective assessing and monitoring system and issues that needed addressing were identified and rectified in a timely manner.