During our inspection we spoke with all the people who lived at the home, the registered manager, two senior team leaders and three support workers. We also spoke with a visiting healthcare professional, observed how people were supported, looked at parts of the home and records.We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive to people's needs? Is the service well-led? Below is a summary of what we found.
Is the service safe?
People we were able to speak with told us they felt safe. They said they were encouraged to speak to a member of staff if they had any worries or problems.
The registered manager was fully aware that the staff team were required to support people within the law, which included the Mental Capacity Act 2005 (MCA) and to use least restrictive practices. We saw records that showed a MCA assessment had recently been carried out by an appropriate professional.
Before coming to live at the home a thorough assessment was carried out, which involved a multi-disciplinary team to discuss any potential risks. A person who we spoke with told us they had been involved in the assessment process and had visited the home before they moved in.
We were told that compatibility with the needs of the established group was always considered before agreement was reached to admit a new person to the home.
The home was seen to be clean and tidy throughout and no malodours were detected. People were protected from the risk of infection because appropriate guidance had been followed in all areas of the home.
Is the service effective?
People had access to the treatment they needed to help them with any behaviours that challenged. People told us about the progress they thought they had made in developing strategies to manage their own behaviours in a more acceptable way.
Some people told us about the arrangements that were in place to move to more independent environments which would give them the opportunity to learn new daily living skills such as budgeting.
The building was large and welcoming. Internally there was plenty of space for people to use which included two lounges, a dining room and a large conservatory. The garden area to the rear was well used.
Is the service caring?
People who used the service appeared appropriately dressed and well cared for. We saw that the interaction between people who used the service and the staff supporting them was frequent and friendly.
Despite close one to one support the atmosphere was calm and relaxed. We saw members of staff were able to communicate well with people with good eye contact, a ready smile and humour.
We saw that because staff knew people well, they were able to recognise any triggers and behaviours that could lead to increased anxiety and agitation and used de-escalation techniques to prevent any further escalation.
New support staff who had recently joined the staff team said they had been made to feel welcome and supported by more established staff.
Is the service responsive to people's needs?
We saw that prior to an admission being agreed a thorough assessment was carried out by the registered manager and/or one of the senior team leaders.
We spoke with a visiting healthcare professional who spoke positively about the treatment and support provided by the home. They said that staff at the home treated people as individuals and had a good understanding of their needs and risks which enabled them to provide effective support within a homely environment.
People we spoke with confirmed they were treated as individuals and all the activities they were involved in were what they wanted or liked to do.
Staff had received training in positive behavioural management. A support worker we spoke with said, 'It is about knowing each individual person's triggers, managing and minimising potential risks and building up trust.'
Is the service well-led?
The home had a manager who was registered with the Care Quality Commission (CQC). The registered manager was present during our inspection visits. The registered manager was in almost daily contact with the nominated individual for the service to help ensure they were kept up to date with what was happening at the service.
The registered manager was supported by two senior team leaders who were both nurses. To ensure their continued professional development they had recently completed an applied behavioural analysis and intervention degree.
Everyone we spoke to told us that the management team were very approachable and supportive. The staff team said they were encouraged and could be 'open and honest' and give their views and opinions about the running of the home.
The home was monitored by the provider. A monthly audit was carried out and an annual quality assurance visit, were carried out by managers external to the home.
Prior to our visit to the home we contacted the local authority commissioning, quality assurance and safeguarding teams. We were informed there were no concerns at this time.