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Inspection carried out on 25 April 2017

During a routine inspection

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

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.

People’s relatives felt people were safe living in the service. Risks to people were appropriately planned for and managed. Medicines were stored, managed and administered safely.

Relatives and other professionals felt there were enough suitably knowledgeable staff to provide people with support and guidance when they needed it.

Staff had received appropriate training, support and development to carry out their role effectively. Plans were in place to develop upon the skills and knowledge of the staff team.

People received appropriate support to maintain healthy nutrition and hydration.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Relatives and other professionals told us staff were kind to people and respected their right to privacy. People were enabled and supported to live as independently as possible..

Relatives and other professionals were encouraged to feed back on the service and felt able to share any comments or concerns with the management.

People received personalised care that met their individual needs and preferences. People’s relatives and other appropriate professionals were actively involved in the planning of their care. People were enabled to access meaningful activities and follow their individual interests.

Relatives knew how to complain and felt they would be listened to.

The registered manager promoted a culture of openness and honesty within the service. Staff, relatives and other professionals were invited to take part in discussions about shaping the future of the service.

There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.

Further information is in the detailed findings below

Inspection carried out on 11 March 2015

During a routine inspection

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

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.

People’s relatives felt people were safe living in the service. Risks to people were appropriately planned for and managed. Medicines were stored, managed and administered safely.

Relatives and other professionals felt there were enough suitably knowledgeable staff to provide people with support and guidance when they needed it.

Staff had received appropriate training, support and development to carry out their role effectively. Plans were in place to develop upon the skills and knowledge of the staff team.

People received appropriate support to maintain healthy nutrition and hydration.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Relatives and other professionals told us staff were kind to people and respected their right to privacy. People were enabled and supported to live as independently as possible..

Relatives and other professionals were encouraged to feed back on the service and felt able to share any comments or concerns with the management.

People received personalised care that met their individual needs and preferences. People’s relatives and other appropriate professionals were actively involved in the planning of their care. People were enabled to access meaningful activities and follow their individual interests.

Relatives knew how to complain and felt they would be listened to.

The registered manager promoted a culture of openness and honesty within the service. Staff, relatives and other professionals were invited to take part in discussions about shaping the future of the service.

There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.

Further information is in the detailed findings below

Inspection carried out on 13, 20 June 2014

During a routine inspection

On 13 June 2014, we visited the service to undertake an inspection. We looked at the care records for all five people using the service at the time of our inspection. In addition, we reviewed audit records, staff records, incident records, nutrition records, and staff rotas. Following our inspection, we considered that we needed to obtain some specialist advice on some of the issues picked up during our inspection. We requested specialist advice on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), with regard to the impact of some of the issues we identified whilst looking at people’s care records. This specialist advice was considered as part of the inspection process on 20 June 2014.

We considered our inspection findings to answer five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? and is the service well led?

Below is a summary of what we found during our inspection;

Is the service safe?

We found that each person had a full and in depth assessment of their needs. These assessments were reviewed regularly and directly informed care planning for these people.

Each person had a set of care plans, which set out how staff should meet their needs. These care plans were written in such a way that promoted people's independence.

The service had carried out risk assessments for each person using the service. These risk assessments were personalised to the risks to the individual. Risk assessments contained information for staff about how to minimise the risks to people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the service was failing to assess people appropriately which meant we were not assured that people’s rights were being protected.

We reviewed the staff rotas for the two months prior to our inspection. We found that there were enough staff members on shift during this time to meet people's needs.

Is the service effective?

People using the service, their relatives and their advocates had been asked for their views about the service. This information had been collated and tracked for trends in feedback. We found that changes were implemented as a result of what people said.

Is the service caring?

Care records showed that people's care was planned and delivered in a way which promoted their dignity and ensured their safety and welfare. These records had been reviewed and updated as needed, and we were assured that people's needs were being met.

We observed how staff interacted with one person present during our inspection. We found that staff interacted with this person in a way which reflected the information in their care records.

Is the service responsive?

Records showed that people using the service were supported to receive input from health professionals in a timely manner.

Is the service well-led?

We found that there was an effective process in place to monitor the quality of the service and identify issues. A senior member of staff from the organisation visited the service regularly and carried out a full audit of the quality of service provided to people. Actions were put in place following this audit, where necessary, and were followed up by senior staff.

Inspection carried out on 4 November 2013

During a routine inspection

On the day of our inspection there were four people living in the service. We were able to speak with one person who told us it was "good" living in the service. We observed people engaged in activities such as cooking and completing a jig saw.

Peoples needs were assessed and risks associated with their care were assessed. These were recorded in people's individual care plans and regularly reviewed.

There was an effective recruitement procedure in place and appropriate checks were carriied out on before staff began work in the service.

During a check to make sure that the improvements required had been made

We did not visit the service or speak with people who used the service. The provider sent us their action plan and we received information from Waveney District Council. This information told us that the provider had taken actions to ensure that people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

Inspection carried out on 3 December 2012

During a routine inspection

During our visit we saw that the people who used the service were preparing to go to their day placements. The staff were attentive to the needs of the people who used the service. They responded to verbal and non verbal requests for assistance promptly. Staff interacted with people in a friendly and respectful manner.

We met the four people who used the service. We spoke with one person who told us that they were happy with the service they were provided with. We asked if the staff treated them with respect and they said, "Yes." The person told us about the activities that they participated in which included, "I like to go to the pub to eat," and, "I go on the bus." They said, "I choose what I want to do."

We looked at four people's care records and found that they identified the care and support provided to meet their needs.

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