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Inspection carried out on 23 November 2018

During a routine inspection

We inspected the service on 23 November 2018. The inspection was unannounced. Froome Bank 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. The service accommodates up to eight people.

On the day of our inspection eighteen people were living at the home.

People continued to benefit from living in a home where staff understood the risks to their safety and where they were protected from avoidable harm, discrimination and abuse. Staff supported people to stay as safe as possible as their needs and their safety needs changed. People were supported to have the equipment they needed to remain safe, and staff encouraged people to use this. Safe staff recruitment processes were used, to further reduce risks to people and there were enough staff to meet people’s care and safety needs. People did not have to wait long if they needed any assistance from staff, and people were confident staff would help them when they wanted.

There were systems in place to support people to have the medicines they needed to remain safe and well. Senior staff regularly checked people were administered their medicines safely. Staff were not allowed to administer people’s medicines until they had received the training they needed, and their competency had been checked. The registered manager and provider had put systems in place to review any untoward incidents, take any learning from these and reduce risk to people further.

People continued to receive an effective service and people were supported by staff who had received training and developed the skills needed to assist people. Staff assessed people’s needs and used this information to help people to settle into the home quickly. People made their own decisions about what they wanted to eat and drink. Where people needed additional support to have enough to eat and drink to remain well, this was discreetly provided by staff. People were confident if they needed any health care from other organisations staff would arrange this. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People liked the staff who cared for them and told us the staff were kind. People were treated with respect, and their rights to independence and privacy were acted on by staff. Staff knew what was important to people and encouraged them to make their own decisions about their day to day care. Staff used different ways of communicating with people, based on their preferences, where people needed extra support to make some decisions. People were supported by staff who understood how they liked to be reassured, when this was needed.

People continued to receive a responsive service. People’s needs were reflected in the care plans developed with them and their relatives, which were regularly reviewed. Staff adjusted people’s care plans as their wishes and needs changed. Relatives were asked for their views on the care to be offered. People’s care plans reflected advice provided by external health and social care professionals.

Some people enjoyed the independence of spending their time doing things they enjoyed on their own, such as reading and chatting to other people who lived at Froome Bank. Other people liked support from staff to do interesting things, and have trips out. The registered manager planned to review people’s access to activities, so they could be assured people would continue to enjoy a breadth of fun things to do at the time right for them.

Systems were in place to support people to raise any concerns or make any complaints. None of the people or their relatives had wanted to make any complaints because t

Inspection carried out on 13 April 2016

During a routine inspection

The inspection was unannounced and took place 13 April 2016.

Froome Bank is registered to provide accommodation and personal care for a maximum of 18 older. There were 16 people living at home on the day of the inspection. The home is spilt into two suites, one of which provides care to people living with a dementia related illness.

There was a manager in place who was currently applying to become a register manager with the Care Quality Commission . 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 home and that the care staff were friendly. All care staff told us they were confident that they understood how to keep people safe from the potential risk of abuse and what the action they would take to protect a person at risk. Care staff provided people with their medicines when they needed them and kept records to show what medicines had been given.

People were able to tell care staff about the care and treatment they needed and day to day decisions. Where people had not been able to make decisions on their own they had been supported by the management team to have decisions made in their best interests. People were assured that all care staff have been trained and understood how to look after them. All care staff we spoke with felt they had the right skills and knowledge and attended regular training to ensure they kept their knowledge updated.

People were involved in choosing their meals and all care staff were seen to support people to eat and drink if needed. People told us the food was nice and well prepared with two choices at each meal time. People were supported to access local professional healthcare outside of the home. They had regular visits from their GP, dentists and opticians. Where appointments were needed at hospital or with consultants these were supported by care staff and any changes to care needs recorded and implemented.

People told us they enjoyed the company of care staff and got to spend time with them chatting and getting to know them. All care staff told us that whilst they provided care they also spent time with people to ensure they were happy and relaxed in their home. Visitors to the home felt their family members were well cared for and that the care staff always stopped to chat and update them with any changes.

People enjoyed group and individual activities which care staff provided at twice a day. People also got to enjoy their own hobbies and interests. Relatives felt that care staff were approachable and listen to their requests in the care of their family member and felt their ideas or concerns were acted on. People told us the management team and care staff at the home were easy to talk with.

Care staff felt the management team listened to and involved them when providing feedback on the service. The management team ensured regular checks were completed to monitor the quality of the care that people received.

Inspection carried out on 9 April 2014

During a routine inspection

On the day of the inspection 18 people were receiving care and support at the home. During the inspection we read three people�s care records and spoke to several people who used the service. We spoke with a visiting relative and staff. We observed people�s care throughout the day.

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people were be safeguarded as required.

The service was safe, clean and hygienic. Systems were in place for the segregation of waste. People we spoke with confirmed they felt safe living at the home. One person said �They [staff] clean my room every day�.

Staff received appropriate professional development and were able to obtain further relevant qualifications. This helped to ensure that people were kept safe and their needs met.

Safeguarding procedures were in place and staff had received safeguarding training. Procedures were in place for the recording of finances. However, records of third parties legal authority to manage a person�s finances were not always maintained.

Is the service effective?

People�s health and care needs were assessed. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Some people did not always understand what a care plan was but expressed that staff helped them in the way they wanted.

People�s needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. People who were assessed as being at risk and alone in the community had access to a secure garden area. A call system was available throughout the home to enable people to request help or to request drinks.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, �Staff will always help�, �They [staff] are brilliant� and �I am very happy here, I have no complaints�.

People using the service, their relatives and friends completed an annual satisfaction survey. This information had been analysed to identify areas for improvement. A relative commented that they were happy with the service provided.

People�s preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people�s wishes.

Is the service responsive?

We saw staff that responded quickly to meet people�s needs and ensured people�s safety was maintained. This was also confirmed by people we spoke with. People were able to express their views and these were acted on. People had the opportunity to engage in a range of activities both in the home and within the community.

People we spoke with knew how to raise a concern or make a complaint if they were unhappy. Staff told us that they would support people to make a complaint if the person was not able to do this for themselves. People told us that they had no complaints and were happy with the care they received.

Is 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. We saw that people were supported to attend activities with the Alzheimer�s society. Staff felt supported in their roles and felt their views were listened too.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes in place. This helped to ensure that people received a good quality service at all times.

Inspection carried out on 6 August 2013

During a routine inspection

We spent time at the home watching to see how staff supported people some of whom were living with dementia. We spoke with several people living at the home and some visitors. People told us that staff were caring, listened to them and treated them with dignity and respect.

Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. A good variety of activities were provided to help people engage and maintain their self-esteem.

People had received their daily medicines as prescribed by the doctor. Safe systems were in place to manage medicines. There was scope to increase the monitoring of these systems to ensure any problems would be identified more quickly.

We found that the service was being effectively run and was responsive to people�s changing needs. The staff team were well led and the staff felt suitably trained and well supported. Systems were in place to manage health and safety hazards.

Inspection carried out on 3 October 2012

During a routine inspection

We spent time at the home watching to see how staff supported people. We spoke with seven people living at the home, looked at records, and spoke with staff and the manager.

People told us that staff always treated them with dignity and respect. Comments included, �I took a while to settle in but I quite like it now, the staff are kind and helpful� and �this is my home now and it is a good place�. People told us that they felt safe at the home and would know who to talk to if they had any concerns.

Care and support was planned and delivered in a way that was intended to ensure people�s safety and welfare. A good variety of activities were provided to help people engage and maintain their self-esteem.

The staff team were suitably trained and well supported.

Reports under our old system of regulation (including those from before CQC was created)