Salford House

Salford House is a residential home providing personal care to 25 older people. There were 23 bedrooms spread across three floors. Two of these could be used as shared rooms. At the time of our inspection there were 18 people living at the home. Some of these people were living with dementia.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were particularly responsive to people’s individual wishes and preferences and staff went out of their way to ensure people received personalised care.

There was a relaxed and friendly atmosphere in the home and people told us staff were kind and treated them with dignity and respect. We saw warm and friendly interactions between people and staff, and staff told us they enjoyed working at the home. Staff had the right skills to meet people’s needs.

People told us they were protected from avoidable harm and felt safe at Salford House. Staff understood their responsibilities to keep people safe and were confident the registered manager would investigate any concerns thoroughly.

Risks to people’s health and wellbeing had been identified, assessed and monitored. Records contained guidance to staff on how to manage risks and staff understood these. Medicines were ordered, received, stored, administered and disposed of safely. People told us staff followed good infection control processes and the home was clean and tidy.

There was a robust recruitment procedure which prevented unsuitable staff from working with vulnerable adults. People told us there were enough skilled staff to meet their health, emotional and social needs. Staff told us they had time to spend with people and we saw this during our visit.

People had enough to eat and drink and gave positive feedback about the food. Guidance was provided in care plans about how to encourage people to maintain a healthy diet and their nutritional needs had been assessed. People could eat when, where and what they wanted to.

People's needs, and preferences had been assessed before they moved into the home. People’s care and support was planned in partnership with them, those closest to them and appropriate health professionals. Records showed referrals had been made to other healthcare professionals when necessary to ensure people remained well.

The registered manager completed regular checks to ensure people received high quality and compassionate care. Where improvements were identified, action had been taken or was planned.

People knew how to complain and were confident they would be listened too. Staff provided positive feedback about the management of the home.

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

Rating at last inspection

The last rating for this service was good (published 3 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Salford House is a residential home which provides care over two floors to older people including people who are living with dementia.

Salford House is registered to provide care for 25 people. At the time of our inspection visit there were 21 people living at the home which increased to 22 because of a new admission.

At the last inspection, the service was rated good overall, however effective was rated as requires improvement. We found improvements were made to the effectiveness of the service and at this inspection we found the service remained Good overall.

There was a registered manager at the home. 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 and relatives were complimentary and satisfied with the quality of care provided. People were supported to remain as independent as possible so they could live their lives as they wanted. People made choices about what they wanted to do for themselves and how they wanted to spend their time. People were supported to maintain important relationships with family and friendly relationships had been built between some people in the home.

People were encouraged to make their own decisions about the care they received and care was given in line with their expressed wishes.

Care plans contained detailed and supportive information for staff to help them provide the individual care people required. People and relatives were involved in making care decisions and reviewing the care provided to ensure it continued to meet their needs.

For people assessed as being at risk, care records included information for staff so risks to people were minimised. Staff understood people’s individual needs and abilities which meant they provided care in a way that helped keep people safe. Staff received essential and regular training to meet people’s needs, and effectively used their skills, knowledge and experience to support people.

People’s care and support was provided by a caring and consistent staff team and there were enough trained and experienced staff to be responsive to meet their needs. People told us they enjoyed and felt safe living at Salford House. Relatives were complimentary of the support given to their family members and relatives were kept informed about important changes.

Staff knew how to keep people safe from the risk of abuse. Staff and the registered manager understood what actions they needed to take if they had any concerns for people's wellbeing or safety.

The registered manager and care staff understood their responsibilities in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, staff’s knowledge ensured people received consistent support when they were involved in making some decisions. Staff always gained people’s consent before they provided care and support.

People were supported and encouraged to pursue hobbies and leisure activities and people said they enjoyed the variety.

People received meals and drinks that met their individual dietary requirements. Anyone identified at risk of malnutrition or dehydration, were monitored and if concerns were identified, advice was sought and followed.

People’s feedback was sought by completing surveys and the visibility and access of staff and management made people feel they could voice any concerns or complaints. The registered manager had an ‘open door’ for people, relatives, staff and visitors to the home which reduced complaints escalating.

The registered manager’s systems were effective to monitor and drive improvements because regular audits and checks led to improvements. The registered manager had submitted a Provider Information return (PIR) and they understood their legal responsibility to notify of us of important and serious incidents. During our inspection visit however, we found some statutory notifications had not been sent to us. The registered manager assured us all statutory notifications would be sent to us in a timely manner so we could continue to monitor this service effectively.

Further information is in the detailed findings below.

This is a summary of what we found-

Is the service safe?

People told us they felt safe and secure.

Staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

We inspected the staff rotas. These showed there was sufficient staff on duty to meet people's needs throughout the day. People received a consistent and safe level of support.

Is the service effective?

People told us they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us, "It is nice here; everything is in the right place." Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this and care staff responded promptly to people's requests. People told us, "The staff come very quickly" and "Staff come and check I'm okay."

Is the service responsive?

People's needs had been assessed before they moved into the home. We found records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives. We found that the manager worked with other health professionals, such as GPs, to ensure people's care needs were met.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People told us they were asked for their feedback on the service they received and that they had also filled in a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. We found the manager undertook a number of checks on the home to ensure people's needs were met.

People and relatives told us consent was sought regarding the planning and carrying out of care. They told us that the care that was discussed with them matched the care that was being provided. They also told us consent was obtained throughout the day before any support was provided to people.

We saw that the care plans were person centred and reflected people's individual needs. We found the members of staff supported people as detailed within their care plans. We noted staff were compassionate and caring when supporting people.

People we spoke with told us that staff were friendly and supported their needs well. We saw staff knew what people's care needs were and how they needed to be supported.

We noted the home was clean and there was a cleaning schedule which staff followed. We saw checks were made to review the cleanliness of the home.

We spoke with staff who told us they were supported by the management team. They also told us that training was provided which was specific to meet people's support needs.

We found the service was well led and had systems in place to monitor the quality of service being provided.

From the discussions held with the staff and the staff training attendance information we saw it was evident that the registered manager and deputy manager have implemented strict guidance for staff in relation to staff attendance at training sessions provided through the home. This was evident as staff training records now show that the majority of training sessions have been attended by the majority of staff. The exceptions being those staff who either on long term sick leave or maternity leave. Conversations held with individual care staff also confirmed that they had in recent months attended a lot of training which had been provided through the home.

We saw systems in place allowing people to communicate their experiences of the home and the care they had received. We were told that people had been involved in changes made to the home's environment and that people's opinions had been taken into account.

People told us they enjoyed the food. People said they had a choice of meal options and they could access sufficient drinks. During the lunch time we observed that the food looked nutritious, was well presented and people had been given a choice of soft drinks to have with their meal. People were seen to enjoy the meals.

We saw people's needs had been assessed, risks identified and personalised plans of care developed for each person. There was evidence of support by healthcare professionals to ensure people's ongoing healthcare needs were met.

We saw staff training records showing there had been minimal staff attendance at the trainings provided by the home during 2012. The manager told us she had not taken any action in relation to staff non-attendance at training sessions.

We have asked the provider to note that not all people's records were complete on the day of the inspection.