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There was not a registered manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. However the provider had taken reasonable steps to ensure the service was well led during the absence of the registered manager and had recruited a new manager who was due to commence work on the 8 February 2016. The provider told us the new manager would be applying to become the registered manager.

Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and worked with advocacy agencies, healthcare professionals and family members to ensure decisions made in people’s best interests were appropriately documented.

People were not unlawfully deprived of their liberty without authorisation from the local authority. Staff were knowledgeable about the deprivation of liberty safeguards (DoLS) in place for people and accurately described the content detailed in people’s authorisations.

People were protected from possible harm. Staff were able to identify the different signs of abuse and were knowledgeable about the homes safeguarding processes and procedures. They consistently told us they would contact CQC and the local authority if they felt someone was at risk of abuse. Notifications sent to CQC and discussions with the local authority safeguarding team confirmed this.

Staff interacted with people and showed respect when they delivered care. Healthcare professionals consistently told us staff engaged with people effectively and encouraged people to participate in activities. People’s records documented their hobbies, interests and described what they enjoyed doing in their spare time.

Records showed staff supported people regularly to attend various health related appointments. Examples of these included visits to see the GP, hospital appointments and assessments with other organisations such as the community mental health team.

People received support that met their needs because staff regularly involved them in reviewing their care plans. Records showed reviews took place on a regular basis or when someone’s needs changed.

The service had an open culture where people told us they were encouraged to discuss what was important to them. We consistently observed positive interaction between staff and people.

The needs of the people living at the home were complex which meant they were not able to tell us about their experiences. We therefore used a number of different methods to help us understand their experiences of living there.

Where it was appropriate we observed how people were supported by staff at a mealtimes and other times during the day.

We telephoned and were able to speak with relatives of all three people who lived at the home. They told us what they thought about the help and support the home provided for their relatives.

We contacted a care manager/social worker of one of the three people who lived at the home and they told us what they thought about the service their client received. We also tried but failed to obtain the views of local GPs who had patients who lived at the home.

We spoke with three members of the home's staff, the home's proposed manager and the provider's operations manager.

We gathered evidence against the outcomes we inspected to help answer our five key questions.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service caring?

Care and support was planned and delivered in a way intended to ensure people's safety and welfare and uphold their rights.

Is the service responsive?

Peoples care and support needs were regularly reviewed to ensure the home could continue to meet them.

Is the service safe?

People who used the service were protected from the risk of harm because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

People were protected from risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People who used services would only be deprived of their liberty when this had been authorised by the appropriate authorities in accordance with the Mental Capacity Act 2005 Deprivation of Liberty safeguards. This ensured people were protected from having their rights being restricted without good reason.

Is the service effective?

People were asked for their consent before they received care or support and their wishes were respected. Where people did not have the capacity to consent to the care and support they needed the provider acted in accordance with legal requirements under the Mental Capacity Act 2005.

Is the service well led?

The provider had systems in place to check and monitor the quality of the service and identify, assess and manage risks to the health, safety and welfare of people using it and others.