We spoke with four people who used the service, one family member, the registered manager and two staff members during this inspection. We also looked at the quality assurance systems and records. This helped answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found.Was the service safe?
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. The registered manager audited any incidents and used the information to improve the service. People who used the service said, "If I had any concerns I would talk to the staff or manager. They would listen to me", "I feel more than confident to raise any concerns and feel they would listen to me. I am not afraid to speak out" and "If I did have any worries I would talk to the staff and they would listen to me". A relative told us, "I feel my mother is safe here". This reduced the risks to people and helped the service to continually improve.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one.
The home was clean, warm and free of any offensive odours. There were dedicated domestic staff to clean the home. Three people who used the service told us, "They clean the home every day", "My room and the home is clean and tidy" and "My room is very clean and tidy. They do it every day as well as my laundry". A visitor said, "It is clean and tidy. The laundry system works well and she always wears her own clothes".
We looked at staff files and saw that people were recruited safely. Suitable checks had been made prior to new staff working at the home. This helped ensure suitable staff were employed at the care home.
We saw that the electrical and gas equipment had been maintained. The fire system was checked regularly. We were told repairs were carried out promptly to ensure it was in good working order.
Was the service effective?
People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. However, a more formal system of recording people's consent would show they had been consulted. People who used the service told us, "They talk to me about my care. It is what I want. I agree to the way I am looked after", "Staff talk to me about my care and ask for my consent before they do anything" and "The staff talk to me about my care and ask me what I want to do. They care for me day and night". A relative told us, "I find the care is very good on the whole. She can be challenging but the staff know how to care for her. They keep us informed of any changes or incidents. Staff know her well".
Specialist dietary, mobility, skin care and community support needs had been identified in care plans where required. Specialist equipment was provided such as pressure relieving devices or mobility aids.
The manager and other key staff audited the effectiveness of the systems they used. This included medication, the environment, infection control and plans of care. The information was used to improve the service.
Staff were trained in all the mandatory topics such as health and safety, infection control, fire awareness, food hygiene, medication administration, first aid, mental capacity, deprivation of liberties and moving and handling. There were other training opportunities in dementia care. Staff were encouraged to take a nationally recognised qualification in health and social care. Both staff members we spoke with thought they were given sufficient training and support to 'do the job'. Staff were given the training and support they needed to be an effective team.
Was the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. There was a friendly atmosphere within the home and we observed that staff interacted and chatted to people who used the service throughout the day. Three people who used the service told us, "The staff are very good. They look after me very well and seem to know what they are doing", "The staff are very good and tolerant. They are especially polite and respectful. Staff seem to know what they are doing and show a good understanding of me" and "It is really good here. The staff cannot do enough for you. They help me with my personal care and there is no embarrassment for me". A relative told us, "Staff appear to know what they are doing. I think they are well trained, friendly and gentle".
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People who used the service were encouraged to provide as much information about their past lives and what they liked or did not. This information gave staff the knowledge to treat people as individuals.
People lived in a comfortable environment and were able to personalise their rooms to make them feel more at home. Two people told us, "I am very happy with my room and impressed with the facilities. I have personalised my room to how I want it to be" and "I have decided to stay and will make my room more my own now I know what I am doing". A relative told us, "She has a nice room. She has photographs and trophies she won to make her room more her own".
Was the service responsive?
People completed a range of activities in and outside the service regularly. Each person had their known hobbies and interests recorded. One person told us, "I like to take myself off to town on my own. I go for a pint on a Sunday". Outside entertainers came into the home and there were regular activities such as exercise, gardening and singing. Two people told us it was their choice they did not attend. Activities were suitable for the people accommodated at the home.
The registered manager held regular meetings with people who used the service and staff. Each day staff attended a 'handover' meeting to ensure they were up to date with people's needs. Staff were able to voice their opinions at meetings and supervision sessions. We saw that results from questionnaires had been very positive but the manager took steps to improve areas where the results were not as good.
Was the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. There was a system for providing information to other providers in an emergency.
Records we looked at were up to date and policies and procedures had been reviewed by the registered manager. The records were stored securely and easily available for inspection.
The service had good quality assurance systems. The registered manager undertook regular audits of the service. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually improving. Two staff members we spoke with told us of their involvement with care plans which was suitable for their roles. They said they had been well trained and the home was clean and tidy. They told us, "We can approach the manager with any issues and she will support you. There is a good staff team. I love it at this home. I like looking after people" and "I really do love working here. I think the residents are the best thing about the job. They keep you busy and on our toes. We have a good, friendly staff team. The senior staff are brilliant and you can go to them for any help or advice".