Harelands House

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. However, the service improved to outstanding in well-led.

The inspection took place on 16 and 17 January 2018 and was announced in line with our guidance to ensure staff were present at the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The manager had been in post since October 2014.

Staff were consistently kind, caring and supportive and although most often they only supported people for a short period of time had developed positive relationships with people who used the service and their families.

The views of people who used the service were sought regularly using people's own individual communication methods.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff also supported family members, for instance the service could take people if there was an emergency to ensure their care was maintained. Staff tried as much as possible to ensure that when people came into the service they followed their routines and activities they normally did at home.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and worked to ensure people's rights were respected.

Staff were supported to undertake their roles and had incentives to perform better. Staff also received

induction, training and supervision relevant to their roles. This ensured they had sufficient knowledge to meet people's needs.

Managers at the home and head office audited systems to help maintain and improve performance.

There were safe systems in place for the storage and disposal of medicines. Staff received training in how to administer medicines and had their competency in this area assessed.

People received individual care packages which took account of their needs which were mainly a learning disability or Autism. Staff were trained in the care of people with these conditions and how to safely de- escalate any behaviours that challenge. There was also the provision of equipment such as track hoists for people with mobility issues.

The five questions we ask about services and what we found