• Care Home
  • Care home

Archived: Centenary House

Overall: Inadequate read more about inspection ratings

70 Charlton Road, Shepton Mallet, Somerset, BA4 5PD (01749) 342727

Provided and run by:
Centenary Care Homes Limited

All Inspections

12 March 2020

During a routine inspection

About the service

Centenary House is a residential care home and was providing personal care to nine people aged 65 and over at the time of the inspection. The service can support up to 13 people. All bedrooms are on the ground floor and there is access to a communal lounge and conservatory.

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

People we spoke with were unable to provide us with detailed explanations of life at the home.

There were widespread and systemic failings identified during the inspection. The quality and safety monitoring systems used by the provider were not fully effective in ensuring the quality of service provision and that people were protected from avoidable harm.

The provider had failed to make appropriate statutory notifications; safeguarding incidents had not been identified and reported. Notifications tell us about significant events that happen in the service. We use this information to monitor the service and to check how events have been managed.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the systems in the service did not support this practice.

At the time of inspection there was no registered manager in place. There were also not enough suitably qualified staff to ensure people received safe and effective care. People did not receive adequate levels of personal care and were seen to be unkempt.

Care plans did not contain sufficient information to ensure people received person centred care. The guidance within peoples' risk assessments was not always followed by staff and records used to monitor peoples' health were not always completed. This exposed people to risks of neglect and unsafe or inappropriate care or treatment.

People had access to healthcare professionals however, the provider could not be assured staff would be able to identify when referrals were required as associated documents were incomplete.

Procedures for the administration and the disposal of medicines had not been completed as required. Medicine errors were not recorded and audited.

The environment including the kitchen, laundry and people’s bedrooms were unclean and not maintained effectively; there was an infection control risk to people using the service. Fire risk had not been appropriately managed and access to the communal environments for people in wheelchairs had not been considered.

People did not receive a balanced and nutritious diet, there was little access to fruit and vegetables.

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 requires improvement (published 8 January 2020). This service has been rated requires improvement for the last seven consecutive inspections. The service has now further deteriorated to inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, medicines and poor diet. A decision was made for us to inspect and examine those risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Centenary House on our website at www.cqc.org.uk.

Enforcement

We have identified eight breaches in relation to staffing, consent, safeguarding, risk assessments, care planning and activities, governance, dignity and respect and recruitment at this inspection.

Following the inspection, we placed a restriction on the provider’s registration to prevent them from admitting people to the service

Follow up

Shortly after the inspection, the provider put in an application to close the service, which was processed by the CQC; the home was closed and is no longer registered with the CQC. The local authority assisted in moving people to other suitable services.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service was put into ‘special measures’ post inspection. This usually means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements. However the provider made the decision to close the service shortly after the inspection.

Usually if the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

13 November 2019

During a routine inspection

About the service

Centenary House is a. residential care home providing personal and nursing care to 10 people aged 65 and over at the time of the inspection. The service can support up to 13 people. All bedrooms are on the ground floor with a communal lounge and conservatory.

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

People and their relatives told us that there had been a lot of improvement in the management of the service and the delivery of care.

The management of medicines at the service had improved, however there recording of applications of topical medicines such as creams was not effective. We have made a recommendation about this. There were no instructions to guide staff about ‘as required’ medicines; however on the second day of our visit these had been put in place. People and their relatives were confident they were safe at the service, a typical comment was, “Oh yes I feel safe, I’m not in the slightest bit worried.” Relatives confirmed improvements had been made to the cleanliness of the service. Risks to people both individual and from the environment were assessed and plans put in place to keep people safe.

The environment had areas with worn furniture and carpets and some parts of the home needed decoration. People were supported by competent staff who were trained and supervised. People were complimentary about the food and told us they had choice. Where people needed particular diets there was information to guide staff and the chef. 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. People were supported to receive the health care they needed.

People and their relatives were complimentary about the staff team and the delivery of care. A relative said, “We are very happy with the care here.” People were supported to live as they wished, and their independence was promoted. Staff respected people’s privacy and dignity and sought consent before delivering any care. Staff knew people well and we observed warm and friendly interactions between people and staff.

Care plans were person-centred and guided staff to deliver care in the way individuals’ preferred. They contained detailed information about people’s preferred routines and interests. There was a range of activities available; some people did not wish to attend and this was respected. Complaints were responded to quickly and used to improve the running of the service. When people approached the end of their life the staff team worked with the district nurse team and GP to manage this.

Leadership and oversight at the service had improved. This is still a work in progress, however there are now mostly effective systems of governance in place. The manager has addressed all the regulatory breaches and has put in place systems to monitor the service. However, the systems in place, while identifying shortfalls in the recording of creams application, had not rectified this. There was a plan in place which identified further work needed on the environment. The culture was now person-centred and aimed to be inclusive of staff, people and relatives. The manager learnt from any incidents. During our inspection when we identified any shortfalls the manager took immediate action.

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

Rating at last inspection and update

The last rating for this service was requires improvement (Published May 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been rated requires improvement for the last six consecutive inspections, however we found significant improvement had been made since the last inspection.

During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

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.

7 February 2019

During a routine inspection

About the service:

•Centenary House is a care home registered to provide personal care and accommodation to up to 13 people. The home specialises in the care of older people. At the time of the inspection 12 people lived at Centenary House.

People’s experience of using this service:

•Systems and processes to monitor the service were not effective, did not drive improvement and the provider had poor oversight. As a result, the quality of care provided to people had not improved since the last inspection.

•The service was not safe because people were not always protected against the risks associated with medicines.

•Records did not identify what people had to eat and drink each day which meant people at risk of weight loss were not monitored.

•Care records did not reflect the needs and preferences of people using the service. They were task orientated not person centred. The lack of detail meant care and support may not be given effectively.

•There was a lack of stimulation for people using the service. Several people said they would like to see improvements in this area. Very few activities were offered and those that were did not always consider individual interests, preferences or abilities.

•Some aspects of the premises were not clean. Poor infection control standards were found throughout the service. Some environmental risk had not been identified.

•We saw positive interactions during the inspection, with staff being kind, friendly and patient when assisting people.

•Staff and visiting professionals felt the registered manager was trying to make improvements with the resources available.

More information about the detailed findings can be found below.

Rating at last inspection:

•At the last inspection the service was rated Requires Improvement (December 2017). Following the last inspection, we carried out a focused inspection that was also rated Requires Improvement (June 2018). At this inspection we found the service had not improved and remains rated as requires improvement overall.

Why we inspected:

•This inspection was a scheduled inspection based on the previous rating and aimed to follow up on concerns we found in June 2018. In addition, we had received some information of concern prior to the inspection which we explored as part of this inspection.

Enforcement:

•Full information about CQCs regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

15 May 2018

During an inspection looking at part of the service

We carried out a comprehensive inspection of Centenary House on 20 and 21 December 2017.

Following this inspection we served a Warning Notice for a breach of Regulation 17 of the Health and Social Care Act 2008, Good governance.

We undertook a focused inspection on 15 May 2018 to check the provider was meeting the legal requirements for the regulation they had breached that resulted in them being served a Warning Notice. This focused inspection was to ensure the provider had taken sufficient action that ensured people were protected against the risks associated with exposure to hot radiators, hot water and the risks relating to fire doors being propped open so that they would not fully close in the event of a fire. This report only covers our findings in relation to these areas. At the last inspection ‘Well led’ was rated required improvement. This rating will not change because this was not a full comprehensive inspection. You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for ‘Centenary House’ on our website at www.cqc.org.uk

Centenary House is registered to provide personal care and accommodation to up to 13 people. The home is an older style building with accommodation for people arranged on the ground floor. The home specialises in the care of older people. At the time of the inspection there were 11 people living at the home.

There was no 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. The provider told us a new manager was due to start in post in June 2018.

During this focused inspection on 15 May 2018, we found action had been taken to ensure people were protected from the risks associated with burning themselves on hot radiators. All of the radiators in people’s bedrooms had radiator covers on them. Where there were radiators that were unable to be covered in bathrooms for example, there were risk management plans in place to prevent the radiators from becoming hot.

People were protected from the risks associated with being exposed to hot water. All of the sinks in people’s bedroom had been fitted with thermostatic mixing valves, which limited the water temperature they could reach. Regular checks of the water temperatures were being carried out by staff.

Action had been taken in relation to the risks identified by Devon and Somerset Fire Service in January 2017. People’s bedroom doors had been fitted with hold open devises to enable them to safely close in the event of a fire. We noted one door had been propped open with a cd rack as the door opener was not fully working. The provider had contacted the company that installed the devises to request they visit and ensure the devise worked appropriately.

20 December 2017

During a routine inspection

This inspection took place on 20 and 21 December 2017, the first day of the inspection was unannounced.

We last inspected Centenary House in September 2016, during this inspection we found people’s medicines were not consistency managed safely, there was a lack of meaningful activities for people, the governance systems were not fully effective and the provider had failed to notify the Care Quality Commission of events and incidents in line with their legal responsibilities.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, responsive and well led to at least good. During this inspection we found that improvements had been made in some areas, however we found further concerns which resulted in breaches in the regulations.

Centenary House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Centenary House is registered to provide personal care and accommodation to up to 13 people. The home is an older style building with accommodation for people arranged on the ground floor. The home specialises in the care of older people. At the time of the inspection there were 12 people living at the home.

There was a manager in post and they were going through the process to apply to become the registered manager. 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 not consistently protected from the risks associated with burning themselves on hot radiators. Not all of the radiators were covered and one person had part of their bed pushed up against an uncovered radiator that was on. Water temperatures were not being tested to ensure they remained in a safe range and risks to legionella bacteria in the water systems were not being managed consistently.

Medicines were administered safely to people and people were happy with how staff administered their medicines. Some improvements were still required with medicines management. Medicines stored in the fridge were not stored securely. The fridge temperature was not taken consistently to ensure it remained within a safe range.

The home was not consistently clean, including the kitchen and there were areas of the home that needed improving. The provider had a refurbishment plan in place for the home identifying areas for improvement.

Timely action was not always taken when risks were identified in the home. Some bedroom doors were propped open which would prevent them closing and providing protection in the event of a fire in the home. This had been identified by the fire service in January 2017 and they had not all been fitted at the time of the inspection.

The systems for assessing, monitoring and improving the quality and safety of the service provided were not fully effective.

We received mixed feedback relating to the staffing levels in the home, the provider had recently agreed for another staff member to be available in the afternoons. Recruitment procedures were in place to ensure staff employed were suitable for their role.

Incidents and accidents did not occurred often in the home, when they did they were recorded by staff. When an incident had occurred any learning from it was shared with the staff team.

People felt safe at the home and with the staff who supported them. Staff were aware of the correct action to take if they suspected someone was being abused.

Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

People commented positively about the food, people had access to a choice of food and received adequate nutrition and hydration.

Staff told us they received supervision and felt supported in their role. Staff received a range of training to meet people’s needs.

People were supported by staff who were kind and caring. Staff treated people with respect and dignity.

There were organised activities and people were able to choose to socialise or spend time alone. People and relatives felt able to raise concerns with staff and the manager.

Staff felt well supported by the manager and felt there was an open door policy to raise concerns. People and relatives were complimentary about the manager and staff.

There were systems in place to share information and seek people's and relatives views about the care and the running of the home.

We found breaches in three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, two of these were repeated breaches. You can

see what action we told the provider to take at the back of the full version of this report.

6 September 2016

During a routine inspection

This inspection took place on 06 and 07 September 2016 and was unannounced.

Centenary House is registered for older people and provides care and accommodation for up to 13 people. At the time of our inspection there were 13 people using the service.

There is no registered manager in post. However the manager has made an application to be the registered manager. 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.

There were failings in the administration and management of medicines. People were at risk of not receiving their medicines and some medicines had been given to people when it should have been discarded because they were out of date. There were errors in how records had been kept and changes in medicines recorded without a clear record of when and who had made the decision. This had resulted in one instance where there was unclear instructions as to the administering of medicine.

There was a lack of meaningful activities reflecting the likes and interests of people in the home. People and staff commented on how there were little or no activities. One person said "There is little to do here, I just sit all day." and another "There used to be things happening but there seems very little now."

Care planning was very task focused and did not provide staff with information about the person as an individual in respect of their life experience, relationships, interests and hobbies.

People told us they felt safe in the home. This was because as one person told us "There are always staff around when you need them." and " Staff always know what they have to do and have had the training." People could be confident staff had a good understanding of their responsibilities about reporting any concerns of possible abuse or staff practice which was potentially abusive.

There was inconsistency in how people were supported to have their meals. On occasions people were not receiving the assistance they needed to have their meals.

Staff were clear about their responsibilities in reporting any concerns about possible abuse. The manager had acted in a open and professional manner when responding to concerns which had been investigated by the local authority and found to be unsubstantiated.

Improvements had been made in the staffing arrangements in the home and this was commented on by people and staff. One person said "It is better now seem more staff around." A staff member said "It has improved dramatically." People told us how they were confident about the skills staff had and how they were very responsive to requests for assistance.

People's rights were protected because consent was sought where equipment was being used which could be viewed as restrictive such as bed rails and in one instance a stair gate positioned at the door of a person's room.

People were being cared for by staff who were seen by people as caring and kind. One person had told us "Carers treat us very kindly respecting my privacy, they talk to us nicely. You see them looking after other residents the same, we are all treated the same." Another person when asked what care workers do well replied "They treat you with respect." However we observed inconsistencies in how staff interacted with people on occasions doing so with respect and respecting people's dignity on other occasions failing to do so.

There was a welcoming environment where people could maintain important relationships. One person told us how through having regular family visitors they felt they were still in touch with what was happening. Relatives spoke of feeling able to visit at any time and felt comfortable doing so.

There were inconsistencies in how the service engaged with people. People spoke of being able to voice any concerns and how approachable the manager was. However there was a failure to follow through and take action where people had made comments about where they thought improvements could be made in the quality of the service. People felt confident in asking for help particularly where their needs had change but there were no formal ways of involving people in reviewing their care arrangements.

The manager had failed to notify us, as required by regulation, of specific incidents and events. This meant we had been unable to ensure at the time of these events people's health, welfare and care needs were still being met.

Whilst there were audits and monitoring of the service they had failed to identify areas for improvement. There was a lack of actions being taken as a result of audits and people's comments about the quality of the service.

The manager was working to promote a culture of openness and this was illustrated by comments made to us by people and staff. One person saying how the manager was approachable and always available. Another person told us "They (manager) are always around asking about us and seeing everything is ok." A staff member also commented on how communications and team working had improved since the manager had arrived.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Care Quality Commission (Registration) Regulations 2009.

26 and 27 August 2015

During a routine inspection

This inspection took place on 26 and 27 August 2015 and was unannounced.

Centenary House is registered to provide accommodation and personal care for up to 13 older people. At the time of our inspection there were 10 people living in the home.

There was no registered manager 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 and associated Regulations about how the service is run. The home was being run by a new manager following the departure of the previous registered manager in January 2015. The current manager is in the process of applying to be the registered manager for the service.

We saw how there was not always availability of staff particularly when a person needed two care workers to provide personal care. People told us staff were at times slow to respond and staff said it would be better with more staff. There was no system to help in making a judgement about staffing arrangements.

The manager had failed to notify us of incidents which could be viewed as a person having been subject to abuse. Whilst they had notified the local authority and taken action CQC had not been given the opportunity to decide if we needed to take any action to protect people.

Since our last inspection a new manager had been appointed. Since the appointment of the new manager we were told there had been an improvement in staff morale, staff were “Working more as a team” and “People were happier and the atmosphere had improved.” People and staff told us the manager was approachable and “Someone who you can talk to” and “Approachable and supportive.” There was an environment in the home which was described by visitors and staff as “Calm and relaxed.”

The manager and provider had taken action to make improvements to the service and address failures identified in our last inspection. New arrangements and systems had been put in place when recruiting staff and in the administration and management of medicines. These new arrangements meant the service was more robust in these areas in ensuring the safety and welfare of people.

People told us they received their medicines when it was required and people where able had the choice to administer their medicines thereby retaining independence in relation to this task.

New arrangements had been put in place to assess the nutritional needs of people and have in place nutritional care plans. The service was in the process of implementing a new, more comprehensive and thorough care planning system.

People told us they felt safe with the staff “Knowing what they have to do and how to do it.” and “I feel safe with staff because they are confident and I trust them.” Staff had received the appropriate training and were able to demonstrate skills and knowledge in relation to aspects of care they provided. For example they were able to tell how they managed people who were at risk of skin breakdown or had poor skin condition, how to recognise the possibility of abuse and their responsibilities to report any concerns.

The manager and staff had a good understanding of the Mental Capacity Act and how to protect people who may lack capacity and ensure people rights were upheld.

People had access to community health services where this was required. One person told us they had requested a visit from their doctor and they were visiting that day. A healthcare professional told us the service had responded to a person changing care “We were very impressed with the care provided.”

Staff were observed supporting people in a caring and sensitive manner. People described staff as Caring and friendly.” and “All very kind and thoughtful.” However we noted how some staff referred to people as “Darling”. This could be viewed as disrespectful and people had not been asked if they were happy to be addressed in this manner.

People told how they had been involved in making a decision about the care they received. There had been some reviews by the local authority of people who were viewed as “Complex care needs”. These reviews had identified how people were receiving the appropriate care.

There was evidence through care plans, daily records and conversations with people and staff how care was responsive to people’s needs. Staff had identified changes in people’s health and made referrals for specialist advice and support.

There were systems in place for the auditing and monitoring of the quality of the service. The provider undertook visits to the service to talk with people and identify any areas of improvement. We noted that whilst there was an action plan there were no timescales set to ensure actions had been taken in a reasonable and appropriate time.

Staff had received regular one to one supervision as well as staff meeting where the manager had discussed their vision for the service and how they wanted the service to be provided. The manager told us they wanted to see a more person centred service where people received the care they needed.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

16 and 17 October 2014

During a routine inspection

This unannounced inspection took place on 16 and 17 October 2014. This inspection took place because of concerns we had received.

The last inspection of Centenary House was carried out in February 2013. No concerns were raised at that inspection.

The care home is registered to provide accommodation and personal care for up to 23 people. It specialises in the care of older people.

There is 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.

Although people told us they felt safe in the home we found a number of concerns. People were not always receiving the care and support they needed because staff were not available to respond and assist people when required. There was a lack of appropriate arrangements for recruiting staff and a failure to undertake the required checks when employing care staff.

People told us they received their medicines when they needed them. However, we found the arrangements for the management and stock control of medicines were inadequate. There were medicines being kept for a long period, some of which had been prescribed for people who were no longer in the home.

People told us they found staff “caring and kind” and there was a warm and friendly atmosphere in the home. However there were some areas which needed addressing to ensure people received a caring service in respect of basic care needs. For example making sure people were wearing appropriate clothing.

People had access to a range of health care professionals to make sure their needs were assessed and they received appropriate support and treatment. However there was no system for the assessment, monitoring and review of people’s nutritional needs. Although risk assessments had been completed to reduce the risks to people, we found there was no written guidance about how people were to be kept safe in the event of an emergency.

There were inconsistencies in the care planning information about moving and handling tasks. There was a potential for people to receive inappropriate or unsafe care through staff not being told accurate information about how to support individuals safely.

Whilst there were some activities they did not always meet people’s preferences or reflect their interests. People were enabled to make choices in how they lived their lives. There was a welcoming environment and relatives spoke of friendly and approachable staff.

People were confident talking with the registered manager about any concerns and felt they would be listened to however there was no sense of people being fully involved in the development of the service. People were given very little opportunities to comment on the quality of care and make suggestions about improvements.

There were inconsistencies about the approach of the registered manager in how they managed the home, supported staff and how they ensured there was an environment where staff were valued and respected.

From what we were told the registered manager was committed to caring for the people who lived in the home. However they had failed to undertake important aspects of their role and responsibilities. Specifically in identifying areas for improvement and failures in care arrangements such as management of medicines, aspects of care planning and in undertaking safe recruitment practice.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

10 February 2014

During a routine inspection

There were 11 people who use the service on the day of our visit; two care staff, the manager and a domestic member of staff were on duty. We spoke with three people who use the service and one relative, although not everyone was able to answer our questions fully. People we spoke with said 'we were given information when we first arrived' and that opinions about care 'are taken into consideration'. People also told us 'they look after people quite well' and 'they're pretty good at doing things for you'. Staff said 'it's a friendly, happy home'.

Comments about meals included 'good food', 'plenty of it' and 'everything is cooked here, it's all homemade'.

Everyone we spoke with said that staff were 'very polite' and addressed them by their preferred names. We saw that staff used appropriate communication and were familiar with people's needs.

We observed medication being administered; this was done appropriately. People that we spoke with said that they had their medications at the right times and they were administered in a way which preserved their privacy and dignity.

Most people we spoke with during the inspection felt that there were always enough staff on duty. One person said 'it's hard work for two' but agreed that they got the care they needed at a time which suited them. Another person told us they had never noticed any shortages of staff.

18 December 2012

During a routine inspection

During this inspection we spoke with four of the eleven people who lived in the home. People told us that they were happy living at Centenary House and felt the care they received was 'excellent'. One person told us, 'I am really happy living here; they are like my family now. They are all really nice and the staff are excellent'.

We observed the way staff interacted with people who lived in the home. We saw that staff had a friendly relaxed rapport with people. This meant people were relaxed and felt that staff understood their needs, likes and dislikes.

We saw that people were encouraged to keep some control over the way their care was provided. For example one person still arranged all their own medical appointments whilst another person told us they were just off to the dentist.

We discussed the way infection control was managed in the home. We saw that very clear guidelines were in place and we observed staff followed appropriate procedures to prevent the spread of any infection in the home.

We looked at the administration of medication. We found that people were protected by appropriate procedures. This ensured people received the correct medication at the correct time through the day. We saw that all staff who administered medication had received appropriate training.

The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.

21 April 2012

During an inspection looking at part of the service

This inspection was carried out to follow up on concerns identified at our last inspection, which took place 29 September 2011.

We spoke with four people who lived in the home. People told us they were very happy living at Centenary House. We asked people how they were involved in agreeing their care and the running of the home. One person told us they were really happy that they now signed their care plan. Another person however said, 'I really don't understand the need to be discussing my care and signing bits of paper. We never had to do it before.' Both people knew who their key worker was and said they spoke to them regularly. Another person spoken with said they had plenty of activities in the home and confirmed they had been asked what activities they would like to be introduced.

29 September 2011

During a routine inspection

We spoke with seven of the eleven people living in the home. Everybody spoken with agreed that Centenary House was a homely and friendly place to live. People told us that they felt very well cared for and knew all the staff members by their first names. One person told us, "I am very happy living here it is like home from home. The staff know what I need and I never have to ask twice." Another person said, " It's very good living here I am really happy."

We also spoke with three people visiting the home. One person said, "The girls are always very nice, I am more than happy with the way my 'relative' is looked after. They, (their relative), have improved dramatically since they moved here." Another visitor said, "The home has a warm friendly atmosphere, which is what I like. The staff know what my 'relative' prefers and they are always happy to oblige." A third visitor told us, "I am really happy with the way the home is run; I don't think big homes are as friendly. I did have to complain once about the way one of the care workers spoke. I spoke to the manager about what was said and she dealt with it immediately, I was very happy with the outcome because it was done in such a way that did not upset my relative."

During our visit we observed the way staff helped people and provided care and support. They spoke to people in a very respectful and dignified manner, whilst also keeping a friendly approach with people laughing and chatting throughout the day.

This inspection was carried out as part of our planned schedule of inspections; however we had also been contacted regarding concerns with the way some areas of the home were being managed.