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Inspection carried out on 17 January 2019

During a routine inspection

About the service

Sharnbrook House is a care home that offers care and support to 30 older people, some of whom are living with dementia.

People’s experience of using this service

• People were very happy living at Sharnbrook House. They felt safe and liked the staff who looked after them. Relatives were very satisfied with the service the staff gave to their family members and they felt welcomed at the home. Staff were proud to be working at the home and enjoyed their job. Everyone said they would recommend the home.

• Everyone praised the registered manager who was approachable, helpful and provided strong leadership. The staff team enjoyed working together and supported each other and the registered manager. The provider employed enough staff so that they could meet people’s needs in a timely way. Staff went through a thorough recruitment process so that the provider knew they only employed suitable staff.

• The registered manager and staff were proud of their achievements. These included being finalists in the provider’s Care Home of the Year Award and nominations meant that eight staff were awaiting the results of individual awards.

• The provider had systems in place to keep people safe from avoidable harm. Staff knew who to report any concerns to and assessments of potential risk ensured that people were as safe as possible. Staff undertook training in a wide range of topics so they had the knowledge and skills to do their job well and effectively meet people’s needs.

• Staff gave people their prescribed medicines safely. They followed good practice guidelines to help prevent the spread of infection. Equipment was available so that staff could support people in a safe way.

• The kitchen staff cooked a variety of nutritious meals, based on people’s choices and including special diets for those who needed them. External healthcare professionals supported staff to help people maintain or improve their health.

• People made choices in all aspects of their lives, including being involved in decisions about redecoration of the home. Staff knew each person well, including their likes and dislikes and their preferences about how they wanted staff to care for them.

• People spoke about staff very warmly and people and staff got on very well together. Staff respected people’s privacy and dignity and encouraged people to be as independent as possible. People had opportunities to decide on the care they wanted and to review and change the care if it was not meeting their needs. Care records reflected their decisions.

• The staff team were all involved in arranging a wide range of meaningful things for people to do. They organised group and individual activities, outings and entertainments. Staff supported people to take an active part in village life.

• People knew how to complain and were confident that the registered manager would resolve their complaints. The laundry provision was not working as well as people wanted so the registered manager was looking into making alternative arrangements.

• Staff knew they were responsible for giving people a high-quality service based on the provider’s ethos and values. Sharnbrook House was people’s home and staff did everything to make people’s lives as comfortable and fulfilling as possible. A quality monitoring system led to the registered manager identifying improvements.

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

Rating at last inspection

At the last inspection we rated this service Good (report published on 8 August 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 12 July 2016

During a routine inspection

This inspection took place on 12 July 2016. It was unannounced.

Sharnbrook House is registered to provide care for up to 30 people, who may have a range of needs, including old age, physical disabilities and dementia. Nursing care is not provided. During this inspection, 30 people were living at the service.

A registered manager was 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.

People felt safe living at the service. Staff had been trained to recognise signs of potential abuse, and processes were in place to manage identifiable risks to people.

There were sufficient numbers of suitable staff to ensure peoples’ safety and meet their individual needs. The provider also ensured new staff were safe to work at the service by carrying out appropriate recruitment checks.

Systems were in place to ensure people’s daily medicines were managed in a safe way and that they got their medication when they needed it.

Staff had received training to carry out their roles and meet people’s assessed needs.

We found that the service worked to the Mental Capacity Act 2005 key principles, which meant that people’s consent was sought in line with legislation and guidance.

People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

People’s healthcare needs were met. The service had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.

Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.

We saw that people were given opportunities to be actively involved in making decisions about their care and support, and their social needs were provided for.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.

There were effective management and leadership arrangements in place. The service promoted a positive culture that was person centred. Systems were also in place to monitor the quality of the service provided, in order to drive continuous improvement within the service.

Inspection carried out on 21 August 2014

During an inspection in response to concerns

Prior to this inspection we, the Care Quality Commission (CQC) received information of concern regarding poor staffing levels.

This inspection was carried out in response to these concerns.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There were adequate numbers of staff on duty to meet people's needs.

Is the service effective?

On the day of our inspection we found that no agency staff were being used.

Is the service caring?

One person who used the service told us, �The staff are very good, they come straight away if I call them.�

Is the service responsive?

Recruitment sessions had been held to fill staffing vacancies.

Is the service well led?

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. The new manager is in the process of obtaining her registration.

Inspection carried out on 31 December 2013

During a routine inspection

We carried out an inspection of Sharnbrook House, on 31 December 2013. During the inspection we spoke with the registered manager, the deputy manager, four care staff, three cleaning staff and the assistant cook. We also spoke with five of the 28 people who lived at the home. Some people were not able to speak with us; we therefore observed the interactions between them and the staff to understand their experiences.

Everyone we spoke with was complimentary about the standard of food in the home. One person said, "There is always something I like. I enjoy some meals more than others, but nothing is awful." We observed lunch which was a sociable occasion with most people choosing to eat in the dining room. The meal was served individually to people. We observed people being asked about their preferences for having sauces and gravy added to their meal.

We saw that the staff cared for people in a respectful way and had been recruited appropriately. This ensured the staff providing the care and support were checked and cleared as suitable to do so.

The home, which was originally built in the early 18th century, was clean, tidy and homely. It was free from any odours. One person said �I love this place and I like to imagine all the people that have lived here in the past.� People had the opportunity to bring small items of furniture into the home with them.

Inspection carried out on 25 January 2013

During a routine inspection

During our inspection on 25 January 2013, we spoke with four relatives and reviewed the care plans of four out of the 30 people living at the service. We spoke to five staff that were on duty during our visit.

We saw staff interact with and acknowledge people on an individual basis. Clear communication was provided when talking with people about what they were doing and why. We spoke with two relatives of a person with a diagnosis of dementia who said they were very happy with the care provided. They said they were involved in decision making where possible and updated about the care required. We saw care plans were detailed and were signed by the person or their representative.

The provider had put in place a robust system to intended to manage medication safely. We found that medication was administered by staff that had been trained to do so before they undertook any administration.

We saw the interactions between staff and managers were relaxed. Relatives also told us that they liked the atmosphere in the home and it was always friendly and welcoming. Staff told us that they felt supported to carry out their roles.

We observed a complaints policy with leaflets on display. We spoke with two relatives visiting the service and they told us that they found the manager very approachable and would raise any concerns with her in the first instance. We saw that where complaints were made these had been investigated and resolved.

Inspection carried out on 2 December 2011

During a routine inspection

People we spoke with during our visit on 02 December 2011, told us that they felt in control of the care being provided to them, and that their independence, privacy and dignity was upheld.

They told us that they were able to make choices about their daily routines such as when they get up, what they do with their day, where and what to eat.

One person living at the home was heard telling someone who had just moved into the home, that "it's brilliant here".

People told us that they were happy with the care they received, and that their individual preferences and needs were being met.

They told us that they had no concerns about the service, but that if they did, they would feel confident bringing these to the attention of staff working at the home.

Some recent review notes for one person included the following comments from the person's social worker: "it is apparent that (the person) is very happy and has a good quality of life at Sharnbrook House. The atmosphere within the home is relaxed and friendly, with good interaction between residents and care staff".

People told us that the staff were friendly and treated them with respect.