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Inspection carried out on 4 June 2019

During a routine inspection

Caldene Rest Home is a residential care home providing personal care to 27 people aged 65 and over at the time of the inspection. They were also registered with CQC to provide nursing care but when we arrived to begin the inspection, we were told they did not currently provide nursing care due to difficulty in recruiting nurses. The registered manager confirmed there was no one with nursing needs living at the home. During our inspection, 20 people were living at the home and two people were in hospital.

People’s experience of using this service:

People were positive about their experience of living at the home. For example, one person said, “I’ve got a nice room upstairs and I am quite happy here. The people treat me well.” A visitor said, “I recommend this home.”

People were safe with attentive staff who ensured they used their walking aids. There was a stable caring staff group. People continued to be supported by staff who respected their privacy and dignity. Staff relationships with the people they assisted continued to be caring and supportive. People's nutritional needs were met, and people praised the quality of the food. Care plans for each person held information about their dietary needs and their likes/ dislikes.

Risk assessments identified when people could be at risk. They covered people's physical and mental health needs and the environment they lived in. Care staff were recruited to suit the caring values of the service and recognised the importance of team work to provide consistent and safe care. People were protected from abuse because staff understood their safeguarding responsibilities.

People were supported by staff who completed appropriate training and understood their needs. Staff spoke confidently about the care they delivered and affectionately about the people they supported. They understood how they contributed to both people’s physical health and mental wellbeing.

Referrals were appropriately made to health care services when people’s needs changed. People were supported to maintain good health and had access to appropriate services, which ensured they received on-going healthcare support. Medicine administration, recording and auditing was safe.

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. Information was in place to ensure people’s legal rights were protected.

The management team, through regular reviews, unannounced spot check visits and observations of staff practice, ensured people received a good quality service. Feedback from people using the service and quality assurance records showed this had been achieved.

Rating at last inspection (and update):

The last rating for this service was Good (published December 2016). At this inspection, the rating remained the same.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.

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

Inspection carried out on 31 October 2016

During a routine inspection

Our inspection was unannounced and took place on 31 October 2016.

At our last inspection of 2 November 2015, although issues were not significant enough to warrant a breach of regulation, we found that improvements were needed. These included some aspects of medicine management, recruitment and the quality monitoring of the service. At this inspection we found that improvements had been made in those areas.

The home is registered to provide accommodation and personal care to a maximum of 27 people. On the day of our inspection 24 people lived at the home. People lived with a range of conditions the majority of which related to old age and some people lived with dementia.

The manager was registered with us and was present on the day. 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. Systems were in place to prevent people from the risk of harm and abuse. Staffing levels ensured that there were enough staff to meet people’s needs. Recruitment had been managed in a way that minimised a risk of unsuitable staff being employed. Medicines were managed safely and in a way that ensured that people could take their medicines as they had been prescribed.

Staff felt that they were provided with the training that they required to ensure that they had the skills and knowledge to provide safe and appropriate care to people. Staff also felt that they were adequately supported in their job roles. People received care in line with their best interests and processes were in place to ensure they were not restricted unlawfully. People were happy with the meals offered. People were supported to have the meals that they enjoyed. Drinks were offered throughout the day to prevent the risk of dehydration.

People and their relatives felt that the staff were kind and caring. Interactions between staff and the people who lived at the home were positive. Staff were friendly, polite and helpful to people.

People had been assessed before they moved into the home to ensure that their needs could be met. The complaints system was well managed and was available for people and their relatives to use. Activities were offered however, more individual consultation with people may ensure that people’s activity needs could be better met.

A registered manager was in post as is required by law. People knew who the registered manager was and they were visible within the service. Quality monitoring processes, the use of provider feedback forms and meetings helped to ensure that service was being run in the best interests of the people who lived there.

Inspection carried out on 2 November 2015

During a routine inspection

Our inspection was unannounced and took place on 2 November 2015.

The home is registered to provide accommodation and personal care to a maximum of 27 people. On the day of our inspection 22 people lived at the home. People lived with a range of conditions the majority of which related to old age and included dementia.

At our last inspection in October 2013 the provider was meeting all of the regulations that we assessed.

The manager was registered with us. 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 who lived at the home felt safe. Systems were in place to protect people from the risk of harm and abuse. However, some recruitment of staff had not fully ensured that prospective staff would be suitable to work at the home.

Medicines were managed safely and ensured that people received their medicine as it had been prescribed by their GP.

People were happy with the meals offered. People were supported to have the meals that they enjoyed. Drinks were offered throughout the day to prevent the risk of dehydration.

People and their relatives felt that enough staff were available to meet their needs and that they were kind and caring. Interactions between staff and the people who lived at the home were positive. Staff were friendly, polite and helpful to people.

People received care in line with their best interests and processes were in place to ensure they were not restricted unlawfully.

Staff felt that they were provided with the training that they required to ensure that they had the skills and knowledge to provide safe and appropriate care to people. Staff also felt that they were adequately supported in their job roles.

People were offered a range of in-house activities and some accessed community facilities on a regular basis that they enjoyed.

A complaints system was available for people to use.

Although some quality monitoring processes were in place provider visits to the home did not include formal processes to check that the registered manager and staff were working as they should. We found that the gas appliances required attention, that staff training records were in need of updating, and that the medicine room needed better security. Formal checks and audits would have found these shortfalls that we identified and allowed corrective actions to be implemented.

Inspection carried out on 14 October 2013

During a routine inspection

At the time of our inspection 24 people lived at Caldene Care Home. Five of those people had nursing needs, a number had needs relating to their dementia, and at least two of those people received respite care. Respite care is when people receive care for a short period of time for various reasons. This could be to give their relatives a break.

During our inspection we spoke with eight people who lived there, five visitors, eight staff, (which included a staff member who worked on nights at the home), a healthcare professional and the registered provider. All people we spoke with told us that they were happy with both the care provided and the staff. One person who lived there told us, “I am happy and content. I am well looked after by nice staff. I am comfortable, I eat well, I sleep well, I have a comfortable warm bedroom what more do I need? ”. Another person said, “Oh, it is a very good place”. A relative of a person who lived there said, “They are so well looked and we are kept informed of any changes. We do not have any concerns”. All staff we spoke with confirmed that the people who lived there were well looked after and were safe.

As some people who lived there had complex needs due to their dementia they were not able to tell us about their experiences of the care and support that they received. To address this we used different methods to help us understand those people’s experiences, including observation. We observed interactions between staff and people who used the service. We saw that people were smiling and were confident to approach staff when they wanted something.

We found that people were treated with politeness and that their privacy and dignity was maintained.

We saw that people's needs had been assessed by a range of health professionals including specialist doctors, specialist nurses, the dietician, and the speech and language therapist. This meant that staff had taken action so that people's health and care needs would be monitored and met.

We found that the premises were reasonably safe and in most parts adequately maintained.

We determined that staffing levels were adequate to ensure that people’s needs were met and that they were safe.

We saw that complaints processes were in place for people or their relatives to use if they were not happy with the service provided.

Inspection carried out on 2 July 2012

During a routine inspection

There were 19 people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with eight people who lived at the home, three relatives, four members of staff, the manager and the registered provider.

This home has recently changed their registration which means that they could now care for people who have nursing needs. No one with nursing needs was living at the home at the time of our inspection. The manager told us that they would be accepting people with nursing needs in the near future.

People living at the home told us that they were happy living there. One person said " I like it here. The staff are so helpful and friendly". Another person told us "It is a nice place and they look after me".

A relative told us "I am happy with their care, I have no concerns or complaints".

A staff member said "This is the best home staff work as a team. We all love the people who live here and make sure that they are cared for".

Some of the people living at this home had dementia care needs. As people with dementia are not always able to tell us about their experiences, we used a formal way to observe people during this inspection visit to help us understand their experiences better. We call this a Short Observational Framework for Inspection (SOFI). We spent two hours in a communal area, observed a total of four people and recorded their experiences at regular intervals. This included people’s state of well being, how they interacted with staff members and other people who lived at the home and the environment.

Our observations showed that people were at ease with the staff. We saw that staff treated people with respect and dignity and understood how to communicate with them. People told us and we saw that choices were offered and that people’s views were sought and taken into consideration.

Staff received a range of training which included dementia care and abuse awareness training, so that they had up to date knowledge and skills in order to support the people who lived at the home and keep them safe. Staff we spoke with knew about people’s needs and personal wishes this meant that care could be provided in the way that people wanted it to be.

We found that adequate attention was paid to people's diet and fluid needs. People told us that they were given food and drink choices and that they enjoyed the food.

We saw that in-house activities were provided.People told us that they liked joining in with the activities.

We sampled the files for three members of staff. We found that recruitment checking processes were robust and thorough which meant that unsuitable staff were less likely to be appointed so people were at less risk of harm.

There were systems in place to monitor how the home was run, to ensure people received a quality service.

Inspection carried out on 12 October 2011

During a routine inspection

We spent the day observing people, their routines and interactions with staff. We spoke with four people living at the location. People indicated that they were happy with the care they received from the location.

Below are a few examples of what they said to us;

“The staff are nice and kind”.

“I am looked after well”.

“I like it here”.

We also spoke with two relatives who were happy with the care provided to their relatives. Below are a few examples of what they said to us;

“They are well looked after”.

“I have no complaints about the care”.

“The staff are welcoming, helpful and the manager is approachable”

The manager and staff team were committed to provide a good service to the people who live at this location. Staff told us;

“I like working here. It’s like a big family”.

“People deserve to receive a good quality of care and they get that here”

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