Warwick House

When we last visited the home on 16 December 2015 and13 January 2016 the service was meeting the regulations we looked at and was rated Good overall. At this inspection we found the service remained Good overall and also for each key question.

There was a registered manager in post at the time of our 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.

People were protected from abuse and improper treatment as staff understood their responsibilities to safeguard people. The provider trained staff in safeguarding each year.

The provider reduced risks relating to people's care through suitable risk assessment processes. This included risks relating to people's mental health conditions and substance misuse. People's medicines were managed safely.

Staff were recruited through appropriate recruitment processes to check they were suitable to work with people. There were sufficient numbers of staff deployed to support people.

The premises were maintained safely although some window restrictors had been removed during the on- going renovation work. This meant people were at risk from falling from height and the registered manager told us they would reinstall restrictors promptly. The premises met people's support needs and people had access to all communal areas.

We found the service was clean and infection control processes were in place. However, the registered manager agreed to make infection control audits more comprehensive and robust.

Staff were supported to understand their role and people's needs through induction, training, supervision and annual appraisal.

People were received coordinated care when moving into the service. People's care needs were assessed though consultation with people and the professionals involved in people's care.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 as they received training in this. People were positive about the food they received and food was provided according to people's choices. People were supported with their day to day health needs and to access professionals they needed to maintain their mental and physical health.

Staff knew the people they supported and were respectful towards people. Staff also respected people's privacy.

People were supported to maintain and build their independent living skills and people shared a goal to live more independently after their two year programme ended. People were encouraged to seek work experience, paid employment or training.

People were supported to maintain and develop relationships to reduce social isolation.

Staff used people's care plans to provide people with choice in their care in a person-centred way. People's care plans reflected their physical, mental, emotional and social needs, their personal history, individual preferences, interests and aspirations.

People were supported to access activities they were interested in and told us they had enough to occupy themselves in a meaningful way.

The complaints process continued to be suitable although the service had not received any complaints since our last inspection.

The service was led by a competent and experienced registered manager. The registered manager oversaw governance systems to ensure the service ran smoothly and people received good quality care. Records relating to people and the management of the service were accurate and well maintained.

Leadership was visible across the service as a senior rehabilitation officer was on shift at all times. Senior's received training and mentoring in leadership and management to help them develop professionally. Staff understood their roles and responsibilities.

The provider communicated openly with people, staff and professionals. Daily meeting were held each morning for people to share any concerns and regular staff meetings were also held. The provider sent the mental health professionals involved in people's care monthly updates.

The five questions we ask about services and what we found