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Inspection carried out on 26 April 2019

During a routine inspection

About the service: Minstead Trust is a residential care home providing personal care to seven people who have learning disabilities at the time of our inspection. The aim of the service is to provide people with positive opportunities to learn and develop the skills necessary to become more independent, whilst receiving care and support in a safe environment.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service:

At our last inspection in November 2016 we rated the well led domain as ‘Outstanding’. Our inspection findings, and the feedback received, at this inspection now supported a rating of ‘Good’.

People felt safe living at Minstead Trust and they were very much at the heart of the service. We received consistent positive feedback from people, their relatives and health professionals. People received excellent care, based around their individual needs that ensured care was personalised and responsive.

Staff understood the needs of people using the service and supported them in an exceptionally personalised way. Staff knew people well and we saw that care was provided respectfully and sensitively, taking into account people’s different needs. The impact this had on people was outstanding and had resulted in people living an active life with choice evident throughout.

Staff developed exceptionally positive and caring relationships with people and their families. Staff were highly motivated and demonstrated a commitment to providing the best quality care to people in an individualised and compassionate way. People’s privacy and dignity was always maintained.

Each person had a plan of social, leisure and educational activities that had been tailor made for them. Their plans considered how they wanted to live their lives as well as their emotional and health needs. People and staff had regular and comprehensive discussions to review each person's support plans to make sure they always considered their holistic needs.

People were cared for by a motivated and well-trained staff team, who always put people first. Staff had the specialist knowledge and skills required to meet people’s needs.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

The culture of the service was open, transparent and progressive. All the staff were committed to continuous improvement of the service, individual care and looking at the provider. People using the service, their relatives and the staff felt valued. The service developed and promoted community involvement within the home.

Rating at last inspection: At the last inspection the service was rated as Outstanding. (Report published 03 December 2016).

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will follow up on this inspection as per our re-inspection programme, and through ongoing monitoring of information received about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 9 November 2016

During a routine inspection

Minstead Training Trust provides various services to people with a learning disability including a residential service, day centre opportunities and a respite service. The aim of the service is to provide people with a positive opportunity to learn and develop the skills necessary to become more independent whilst receiving care and support in a safe learning environment. People using the service are referred to as ‘Students’ and so we have used this terminology throughout our report. At the time of our inspection eight people were using the residential element of the service.

The service had a registered manager. 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 provided new opportunities and experiences for people and supported them to constantly reflect on what they had achieved and look at what they would like to do in the future. For example, some people were being supported to start the process of applying for work or college placements. Other people were learning skills to be more independent.

People lived in a safe and comfortable environment. They were able to take risks and were supported to make decisions which reflected their preferences and individual needs. The staff worked in an extremely person centred way, by responding to the person's individual communication needs to make sure the care and support they were provided was right for each person. This included the way in which they responded to risks, making sure people felt safe and had the support they needed in any given situation. This meant that each person had a bespoke service which was developed with them and changed to reflect the changes taking place in their lives, confidence and abilities. This was confirmed by the relatives and professionals who we spoke with, who felt the person centred approach was a particularly positive feature of the service.

Each person had a plan of social, leisure and educational activities which were tailor made for them and considered how they wanted to live their lives as well as their emotional and health needs. The staff worked very closely with a team of healthcare consultants to make sure support was planned in an appropriate and individualised way. This meant that all the decisions about people's care and support were well thought out and included the perspectives of different professionals. They had regular and comprehensive discussions to review each person's support plans to make sure they always considered their holistic needs. They monitored how people reacted and felt about each situation they were exposed to so that care could be adjusted to ensure it met the person's need. People were involved in planning their own care and making decisions. For people who could not express how they felt verbally, the staff made sure they had opportunities to express themselves in the way they could and that this was understood and acted upon.

Staff were provided with opportunities to develop their skills and career. Individual staff abilities and interests were valued and incorporated into the way the service worked. All of the staff were able to contribute their ideas at all levels of the organisation from planning individual people's care to being part of developing new ways of working and procedures. The staff gave extremely positive feedback about working for the provider and the opportunities they felt they had been given.

The systems for monitoring and improving the service were an intrinsic part of the way the service worked. The staff continually monitored individual care, feedback from people using the service and information about them was used to reflect on and improve practice. Records were well thought out, clear a

Inspection carried out on 14 May 2013

During a routine inspection

We looked at the homes safeguarding policy and found that it was satisfactory and accessible to staff. Staff were knowledgeable about the whistleblowing policy and told us that they would contact the Care Quality Commission or the local authority if they felt that concerns were not being addressed.

There were effective recruitment and selection processes in place. The manager explained to us that care staff were interviewed and were subject to a Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA) check.

People who use the service, their representatives and staff were asked for their views about their care and support and they were acted on. One relative said "They do ask us what we think and they always act on it". We looked at questionnaires that were completed by relatives. One person said "We can't fault Minstead, information is always accurate and we are involved".

Inspection carried out on 10 October 2012

During a routine inspection

We found that plans provided information and guidance about people's likes, dislikes and care planning. The registered person told us that they listen to what people are interested in and try to support them to develop in that area. We saw pictorial weekly timetables and pictorial care plans. One person said "I change my plan when I want to"

People’s needs were assessed and care was planned and delivered in line with their individual care plan. All three care records reflected an appropriate range of assessment of health and well being needs and personal interests. Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. One person said "I feel safe here" People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Care staff we spoke with attended an appropriate range of training courses relevant to people's needs. Training covered Mental Capacity Act 2005, Deprivation of Liberty Safeguards, moving and handling and safe food handling. We were also told that one member of staff requested to complete a counselling course which was approved. People were given support by the provider to make a comment or complaint where they needed assistance. Staff told us that several people had independent advocates. One person said "I'd get my family to help me if I had to complain"

Reports under our old system of regulation (including those from before CQC was created)