Cairn Home

We found the following examples of good practice.

Staff encouraged relatives and friends to keep in contact with their loved ones. The provider had adapted vacant bedrooms to facilitate safe face to face visits inside. There was also a visiting pod outside in the garden for family and friends to use.

Staff supported people to keep apart as much as possible to try and maintain safe social distancing. The design and layout of Cairn Home helped to promote this practice.

The premises were clean and well maintained. All staff regularly cleaned frequent touch points, such as handrails and light switches.

All staff had received training in infection prevention and control and their competency in this area was regularly checked. Staff were seen to be following correct practice in this area.

Cairn Home provides residential care services to older people with a range of support needs, including dementia and sensory impairment. It can accommodate up to 30 people.

People’s experience of using this service:

People we spoke with were overwhelmingly positive about their experience of receiving care at Cairn Home. More than one person told us it compared very positively with their experience of other services, and often people described the culture within the home as “one big happy family.”

The service had an open and supportive culture. Staff had a good understanding of people’s needs. They treated people with respect and upheld their dignity when carrying out care and support tasks.

People’s needs were thoroughly assessed before they began to use the service. The registered manager described recent assessment processes and it was clear they developed a good picture of people’s needs before devising their care packages. This was undertaken with as much input from the person as possible.

Staff were competent and had the skills and knowledge to enable them to support people safely and effectively. Staff received the training and support they needed to carry out their roles effectively. Staff received regular supervisions and annual appraisals were planned. There was minimal turnover of staff, with many staff having worked at the home for a number of years.

Staff had awareness of safeguarding; they knew how to raise concerns and had received appropriate training. Steps were taken to minimise risk, and this was managed in a dynamic way so that when people’s needs changed risk assessments were amended to ensure they continued to keep people safe.

Staff worked with other agencies to provide consistent, effective and timely care. We saw evidence that the staff and management worked with other organisations to meet people’s assessed needs.

Managers were highly visible within the service and accessible to people using the service. People told us they knew the management team well and could speak with them whenever they wanted to. We saw that managers conducted a daily, documented, walk round of the home, and the rota had been designed to maximise the amount of time there was management presence within the home. The registered manager followed governance systems which provided effective oversight and monitoring of the service.

The premises were homely and well maintained. We observed a relaxed atmosphere throughout the home.

The service continued to meet the characteristics of Good in all areas.

Rating at last inspection:

The service was last inspected in August 2016, where it was rated good.

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

Cairn Home was last inspected by CQC on 13 May 2014 and was compliant with the regulations in force at that time.

Cairn Home is a purpose built residential home that is registered to provide accommodation for up to 30 older people, some of whom may have visual impairments. It is located in the Crosspool area of Sheffield and is close to local amenities and bus routes. On the day of our inspection there were 29 people using the service.

There was a manager at the service who was registered with CQC. 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. The registered manager and the senior assistant manager had both worked for the service for over 20 years.

People living at Cairn Home and their relatives told us they thought the service was very good. Comments from people included, “I feel safe and secure” and “I would never be anywhere else.”

Recent questionnaires completed by friends and relatives held only positive comments about Cairn Home.

All staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by management

Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

The service had a safe and effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

There were sufficient numbers of staff employed in order to meet the needs of the people who used the service. We saw staff had some time to spend chatting with people during the day.

Staff were suitably trained to carry out their job roles effectively. All staff had training in understanding and supporting people with visual impairments.

Staff told us and records showed that they received regular supervisions and appraisals. Staff told us they found these meetings useful and they felt supported by management.

People living at Cairn Home told us they enjoyed the variety of food and drinks available to them. We saw there were different options available at every mealtime, and drinks and snacks were served throughout the day.

We saw the home was clean and freshly decorated. People told us the cleaners were good and came every day. People were also very complimentary about the laundry service.

There was a range of activities on offer to people living at Cairn Home. The service had its own mini bus so staff were able to take people out on trips to local amenities and further afield.

People who lived at Cairn Home, and their relatives, were aware of how to make a complaint. However there had been no formal complaints recorded at the service.

Processes were in place to monitor the quality and safety of the service. The registered manager had taken action where appropriate to resolve any issues raised effectively and in a timely manner.

Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at during the inspection.

Is the service safe?

People's needs were assessed and treatment was planned with the help of individuals and their representatives. The care files we checked confirmed that initial assessments had been carried out by experienced staff before people were accepted into the service. This was to ensure the service could meet identified needs, thereby promoting the safety of people.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The main aim was to promote independence and minimise the risk caused by poor eyesight. When we looked round the premises we noted colours red and yellow had been used. The manager told us there was a special emphasis on the environment to ensure people were able to move around the home freely and safely. They said the carpets were colour coded throughout the corridors and the handrails and all fittings were also colour coded to make them more visible.

The manager knew the procedure to follow if they found staff were no longer fit to work in the health or social care sector; thereby making sure people were protected and their safety was maintained.

There was a gap in the information held by the provider in respect of the staff employed by them. This related to staff declarations of any physical or mental condition which would be relevant to their ability to work in the environment safely. We have asked the provider to take action and comply with the relevant regulation. However we noted that staff were in receipt of regular supervision therefore such issues would be identified and dealt with by the manager.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, relevant policies and procedures were in place. Appropriate staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's experiences were taken into account and their privacy and dignity was respected in the way people were cared for. People who were in receipt of this service had difficulty with their eyesight. Some people were blind and others were partially sighted. This meant people needed clear instructions from staff and others. They also needed to familiarise themselves with the environment to maintain their independence. They were assisted with this by staff at the home.

The manager and the deputy told us that at the initial assessment they involved professionals including people's own GPs and family members to establish the best way to help the people familiarise themselves with the new environment. People told us that they had visited the home several times before they moved in. One person said, 'When I visited the first time I knew I could live here. Staff were very friendly and I felt comfortable.' This meant people were consulted from the initial stages of their admission to the home and therefore they felt involved.

During our observations we noted that people's views and expectations were taken into account by staff who were supporting them. People told us staff respected their privacy and dignity. They said that they understood the care and treatment choices available to them.

The manager told us that all the people who lived at the home had capacity to make decisions. They said staff had received training on the mental capacity act and deprivation of liberty safeguards as part of their induction. This was to ensure staff had a basic understanding of the subject and relevant legislation.

People told us that they were happy with the care they received and their needs had been met. It was clear from our observations that staff had a good understanding of people's care and support needs and they knew how to meet them and avoid unnecessary risks.

Is the service caring?

We were informed by people and care staff that people were able to be involved in making decisions about their care and treatment each day. They said they were able to change their mind and not be worried. People said that care workers appreciated and respected their wishes. These were some comments from the people we spoke with: 'The staff give me options, whether I want to have a shower or a wash. I can choose and have it when I want. Within reason mind you', 'Sometimes staff ask me if I want to go out to the shops. I have no problem telling them if I didn't feel like it.' 'There are some lovely people who work here; they have a lot of patience. They don't seem to mind repeating things to me. I keep forgetting. It's good to know staff don't mind.'

People were supported by staff who were attentive and friendly. We saw care workers showed patience and gave encouragement when supporting people. We observed people were able to take their time, doing things at their own pace and were not rushed.

People's care and treatment was planned and delivered in a way that protected them from unlawful discrimination. This is because staff had received training and received supervision to make sure they followed the correct procedures when caring for people.

Is the service responsive?

Appropriate professionals were involved at the correct time to make sure people were in receipt of care and treatment promptly.

Records confirmed people's preferences, interests, aspirations and diverse needs had been taken into account when care and support was planned and delivered. People were supported in promoting their independence and community involvement. On the day of our inspection a number of people were out on a trip to a garden centre and then out to lunch. We saw people being involved in activities during the afternoon in the dining room. We heard a lot of laughter. One person said, 'I ask staff to take me to the garden to get some fresh air and sit for a little while. They are very obliging.'

Is the service well-led?

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. We were informed by the manager that they carried out annual satisfaction surveys. Feedback was analysed and the manager, with the help of the provider, took appropriate action. They told us that the results of the surveys were very positive from the people who used the service and from staff. They said they did not have any negative comments from the surveys.

Staff had a good understanding of the ethos of the home. Senior staff were involved in the quality assurance processes which were in place. Staff told us they were clear about their roles and responsibilities. They said they worked as a team and helped each other.

During our inspection we found the home had a warm, welcoming and 'homely' environment. We found people looked clean, tidy and we saw their basic care needs had been met. We talked with seven people who used the service. People said, 'very happy in here 'couldn't think of anywhere better', 'staff are very caring', 'nothing any trouble, they sort everything straight away' and '(the home is) heaven!' One relative said 'happy atmosphere, happy staff and management.'

We found the home had systems and processes in place to ensure the safe administration of medications.

We found people had their health and welfare needs met by safe and competent staff.

We found there were effective systems to regularly assess and monitor the quality of service that patients receive.