Woodham House Stanstead is a care home registered to provide care and support to up to five people with mental health needs.

At our last inspection in July 2015 the service was rated as 'Good’ overall but ‘Requires Improvement’ in relation to the key question, ‘is the service well-led’? This is because the service did not have a registered manager in post. At this inspection we found the service remained ‘Good’ overall whilst continuing to require improvement within the well-led domain. This was because the provider did not have a registered manager in post and had exceeded the maximum beds condition of its registration with the Care Quality Commission. The service is registered for up to five people to live in it. We found that six people were living in in the service at the time of our inspection. This is a failure to comply with section 33 of the Health and Social Care Act 2008. We are considering the action we will take.

The service did not have a registered manager at the time of the inspection. 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.

The quality of the service was audited and the service undertook partnership working with external organisations.

The service continued to be safe. Staff received training to protect people from abuse and avoidable harm. There was a robust recruitment process in place to ensure staff were safe and suitable. Staff were deployed in sufficient numbers to meet people’s needs in a safe way. People’s medicines were administered safely. Food was stored and prepared hygienically.

The service continued to be effective. Staff training, supervision and appraisal remained on-going. People’s rights under legislation were upheld and they accessed healthcare services as their needs required.

The service continued to be caring. People told us that staff were kind and caring. Positive relationships existed between people and staff. People were supported to maintain and develop their independence and staff treated people with respect.

The service continued to be responsive to people’s needs. People had assessments that identified their needs and care plans which detailed how people’s needs would be met. People were supported to participate in the activities they wanted to and their views were gathered by the provider and acted upon.

Woodham House Stanstead provides personal care, support and accommodation for people with mental health needs. The service is located in a large house with a garden and can accommodate five people. At the time of the inspection four people were using the service and another person was visiting the service with a view to using it.

This unannounced inspection took place on 17 July 2015. The service was last inspected on 27 November 2013 when it was found to have met legal requirements.

The service should have a registered manager. 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.

The manager of the service is in the process of registering with the CQC. We will be keeping this under review to ensure the service has a registered manager as soon as possible.

People in the service were safe. Staff had carried out risk assessments and implemented plans to promote people’s safety. They had updated these plans when people’s needs changed. The current risks to people’s health and safety were managed. Staff gave people the assistance they needed to take their medicines as prescribed.

Staff knew how to protect people from harm by recognising and reporting any concerns about abuse or neglect. The manager ensured there were enough people on duty to meet people’s needs.

Staff were well-trained and understood how to support people with complex mental health needs. They gave people support to develop their skills in relation to meal preparation. The manager and staff worked in partnership with the mental health team to promote people’s well-being. Staff supported people to attend appointments in relation to their physical health.

Staff knew people well and treated them with respect. People’s right to privacy was upheld and staff were polite and friendly. People were fully involved in planning their support and deciding how they spent their time.

The manager and staff assessed people’s needs before they started to use the service. Staff developed and delivered effective support plans which promoted people’s mental health and developed their independent living skills. People were asked for their views of the service and these were taken into account. People had access to information about how to make a complaint.

Staff understood their role in relation to the service’s aims of ‘recovery, rehabilitation and re-integration’. They supported people to develop independent living skills. The manager carried out checks on the quality of the service and, when necessary, took action to improve the service people received.

We met three of the four people living at the service at the time of our inspection; they gave us their views of the service they experienced. We observed practice during our visit and contacted professionals with an involvement in the service.

We observed that people’s privacy and dignity were respected and the interactions between staff and people were kindly and patient.

People were supported to follow activities in the community and at home. There was consideration of people's cultural and religious needs.

A mental health professional told us staff at the service had worked with people they supported, they took on board recommendations made by the mental health professional, and as a result people responded well and experienced positive outcomes.

People were supported to develop and retain relationships with relatives and friends.

Important events affecting people's welfare had not been reported to the Care Quality Commission as required.