Serenita

The service has a large open plan lounge, dining room and games area, an accessible garden and bedrooms all of which are en-suite. At the time of our inspection 28 people were using the service. At our last inspection we rated the service good. At this inspection we found the service remained good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Systems were in place to safeguard people from abuse and staff knew the procedure and guidance to follow if something went wrong. Risks relating to people's care were identified and staff knew how to manage these risks to help keep people safe but still encourage people's independence. Staff spoke to people about the risks they faced to help people understand how to keep safe.

People's medicines were managed safely by staff. There was enough staff to care for people and they received adequate training, induction and supervision to support them to do their jobs. The recruitment process ensured staff were suitable to work with people.

People's needs and preferences were assessed by the service before they began receiving care. People had a choice of food and helped plan their weekly menu. Staff encouraged people to make healthy choices when they needed to. Staff promoted the healthcare needs of people and worked well with healthcare professionals, they took on board recommendations to help make sure individual health needs were met.

Specialist dietary needs such as those associated with diabetes were provided for. 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.

People were encouraged to be as independent as they could be. Staff treated people with dignity and respect. People were supported to be involved in hobbies and activities that interested them. This included access to the community and involvement with clubs and outside social events when people wanted to.

People's care plans were sufficiently detailed to inform staff about people's needs and to guide staff in caring for them. The service had a complaints procedure which addressed any complaints within the agreed timescale. Systems were in place to make sure managers and staff learnt from events such as accidents, incidents and complaints. This reduced the risk to people and helped the service continually improve. The service had a range of audits in place to assess, monitor and drive improvement.

This inspection took place on 06 April 2016 and was unannounced.

There was a registered manager in post. 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.

Care plans provided information about how people wished to be supported and staff were aware of people’s individual care needs and preferences. People told us they were involved in their care planning. One of the care plans did not include accurate information. The provider’s audit of the service identified some of the care plans needed updating and the registered manager had an action plan in place to address this.

The service had systems to ensure medicines were administered and stored correctly and securely. Medicines records did not always record people’s allergies. The registered manager told us they would address this.

People and their relatives were happy with support arrangements provided. People told us they felt safe and were treated with respect. Staff interactions with people were positive and caring.

Systems were in place to protect people from harm and abuse and staff knew how to follow them. Risk assessments had been carried out and they contained guidance for staff on protecting people.

There were enough staff available to keep people safe and meet their needs. A recruitment procedure was in place and staff received pre-employment checks before starting work with the service.

Staff received training to understand their role and they completed training to ensure the care and support provided to people was safe. There were some gaps in staff training and the registered manager had plans in place to address this. New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported.

People were complimentary of the food provided. Where people required specialised diets these were prepared appropriately.

People’s rights were protected because the home followed the principles of The Mental Capacity Act 2005 where people lacked capacity to make decisions for themselves.

There were systems in place to receive feedback from people who use the service and staff. The service had not recently requested feedback from relatives. People and relatives were aware of how to raise concerns and they were confident if they raised concerns these would be responded to.

The registered manager and provider had systems in place to monitor the quality of the service. The service had an action plan in place that identified shortfalls in the service and the required improvements.

We saw that care was personalised and aimed at promoting independence so that people could progress to living back in the community. We also saw that people were actively involved in their own plan of care and that people's needs and wants were taken into consideration. Regular reviews of care plans were undertaken. One person told us "I write in my care plan every day, I feel very involved" and another told us "I am very content".

We saw evidence that people were protected from the risk of abuse, and that when concerns were raised that they were reported in accordance with local procedures.

We saw that staff were well trained and supported to perform their roles. People who use the service told us "the staff are brilliant, I couldn't have done this without them".

The provider had an effective quality assurance system in place and continually monitored the quality of service provision.

We observed staff had a very close and friendly rapport with people. We saw people were encouraged to make their own decisions about daily activities and staff supported them once the decision was made.

We found that people consented to their care and treatment, both in writing and orally on a daily one to one basis.

We saw care planning was person centred and agreed with the individual. Regular reviews were carried out and also involved the individual.

We found the receipt, storage and administration of medication was managed safely within the Royal Pharmaceutical Society guidelines.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the manager. The provider had an effective complaints system available.