Archived: Neville House

People’s experience of using this service: Without exception, we received positive feedback from every person we spoke with about the care and support they received. One person told us, “My daughter looked all over for a place for me. She couldn’t have chosen a better place. You couldn’t have a better home.” A relative told us, “I just feel so happy about [Name of person being here].”

People told us they felt safe. There were enough staff to safely care and support people and staff understood how to protect people from abuse. People's individual needs were risk assessed and staff had the right information to support people safely when using equipment such as hoists and walking aids.

People told us they enjoyed the food. People were given a choice of meals which included specialist dietary options, including vegetarian meals. People ate at their own pace and were supported by staff in a patient and relaxed manner.

Staff told us they felt well supported by the management team and received regular supervision and appraisals. Staff received appropriate training and were supported to undertake additional training in areas of interest to them.

People were supported to be as independent as possible and staff encouraged them to make their own decisions wherever they could. Staff had a good understanding of people’s individual needs and supported them to access healthcare services without delay.

We found a welcoming and relaxed atmosphere and observed a strong sense of community amongst the people who used the service. We observed kind and compassionate interactions between staff and people.

People told us the service was well-led. They could talk to the registered manager if they had any concerns and were confident they would be listened to. Relatives told us the registered manager was approachable and accessible.

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

Rating at last inspection: Good (Report published 8 September 2016).

Why we inspected: This inspection was a scheduled 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.

This unannounced inspection was carried out on 25 July 2016. The last inspection took place on 15 September 2014 during which we found the regulations we looked at were being met.

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.

People told us that they felt safe living at the home. Staff told us they had received training with regard to safeguarding adults and were knowledgeable about the procedures to follow to ensure that people were protected from harm. Staff were also aware of whistleblowing procedures and said they would have no hesitation in reporting any concerns if they witnessed poor care practice.

People received their medicines at the times they needed them. The systems in place meant medicines were administered and recorded properly and this was audited regularly by the service and the dispensing pharmacist. Staff were assessed for competency prior to administering medication and this was re-assessed regularly.

There were sufficient numbers of suitably qualified staff employed at the home. The provider’s recruitment process ensured that satisfactory recruitment checks had been completed which meant only staff who were deemed suitable to work with people at the home were employed.

Staff received appropriate training, supervision and support. Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to ensure that people’s rights were protected.

Care records were person centred and detailed, ensuring staff had specific information about how they should support people. Care records included guidance for staff to safely support people by reducing risks to their health and welfare.

People were provided with a varied menu and had a range of meals and healthy options to choose from. There was a sufficient quantity of food and drinks and snacks made available to people at all times.

People’s care was provided by staff in a caring, kind and compassionate way. People’s hobbies and interests had been identified and were supported by staff in a way which involved people to prevent them from becoming socially isolated. Visitors were made welcome to the home and people were supported to maintain relationships with their friends and relatives. People were supported to be actively involved in local community life.

People were involved in the decisions about their care and their care plans provided information on how to assist and support them in meeting their needs. People's needs were regularly reviewed and, where necessary, appropriate changes were made to the support people received. People were supported to maintain their health and had access to health services if needed.

People knew how to make a complaint if they were unhappy and all the people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything.

The registered provider had a quality monitoring process in place to assess the quality of the service being provided. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home. They told us the registered manager was supportive and promoted positive team working.

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.

Is the service safe?

The service was safe, clean and hygienic. One person we spoke with told us, "I am very happy with the cleanliness here, I've never had to complain." We observed the home had no malodours and all areas of the home we saw were visibly clean.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

We asked staff about the deprivation of liberty safeguards (DoLS) policy. They were aware of the requirements of the Mental Capacity Act and knew what they should do should they need to refer someone for an assessment.

Is the service effective?

People's health and care needs were assessed where possible with them or someone who knows them well. Specialist dietary, mobility and equipment needs had been identified in care plans where appropriate.

Is the service caring?

Care staff were attentive and spent time talking with people and making sure their needs were being met. People we spoke with told us, 'I like it here, you couldn't wish for a better place, its home from home.'

People who used the service had completed satisfaction surveys in 2013. This year relatives and friends had been asked for their views. Ten responses had been received and in all cases people had rated the home as 'overall ' excellent.'

Is the service responsive?

People knew how to make a complaint if they were unhappy. We saw the complaints policy displayed in the reception area of the home. Staff told us they would help people to make a complaint. A staff member told us, "I would report any concerns at the time it was reported to me, I would speak to a senior member of staff, no hesitation."

Is the service well led?

Effective management systems were in place to promote people's safety and welfare. Staff we spoke with demonstrated a real commitment and understanding of the needs of those living at Neville House. The manager had a good understanding of the Care Quality Commission, its regulations and processes, and with her role and responsibilities. This was confirmed by staff who said they felt very supported to do their jobs well. Comments we received included, 'We work as a team and I feel part of that team,' and, 'We provide a good level of care here, if it's good enough for my mum, then that's what we aim to provide.'

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result we could see that the quality of the service was continuously improving. The service worked well with other agencies and health services to make sure people received their care in a seamless way.

We spoke with twelve people who used the service and five visitors. People we spoke with told us they felt respected and listened to.

We used a number of methods to help us understand the experiences of people using the service. This included talking to visitors, staff and observing the care provided. People told us they were treated well by the staff. One person told us, 'The care here is second to none, the staff are excellent.' We observed staff being friendly and warm towards people.

We saw from people's care records that they were supported to retain their independence as much as possible. The records we reviewed were person centred and included essential risk assessments. On the whole these had been kept under review, to enable appropriate treatment, care and support to be given.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage the administration of medicines safely.

Observations on the day of inspection, people we spoke with and records we looked at confirmed that there were sufficient staff to meet peoples care needs. People told us they were supported as and when needed.

There was an effective complaints system available. At the time of our visit there were no outstanding complaints.

People also said that they find the care at the home good and that staff attend to their needs in a respectful and dignified way. People said 'I feel very well cared for and the staff are very conscientious and treat you respectfully.'

We looked at the care records and saw that people had thorough assessments and care plans were updated regularly. We saw that mostly records were completed and up to date; however we saw that some records required more detail to be accurate and to ensure people were kept safe from harm.

We looked at how staff were supported whilst they worked at the home. Staff told us they felt supported and worked well as a team together. Staff told us that they had supervision with the manager and appraisal systems were in place. We also looked at the staff team meetings and saw that these were held regularly.

People living at the home and the staff confirmed that knew how to raise concerns. They also said they were confident issues raised with the management team would be sorted out and action taken.