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Inspection carried out on 6 December 2018

During a routine inspection

Crown House Care Home provides care and support for up to 22 elderly people. At the time of our inspection 19 people were using the service. It is an extended and adapted luxury 17th century coaching inn.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their required needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. 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.

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions and observed practice.

People were able to make choices about the food and drink they had, and staff gave support if and when required to enable people to eat a balanced diet.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that people received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Care plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure which was accessible to all.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below.

Inspection carried out on 13 April 2016

During a routine inspection

This inspection took place on 13 April 2016 and was unannounced and was carried out by one inspector.

Crown House is a service that provides accommodation for up to 22 people. There were 22 people who used the service at this time. Care and support was provided to enable people to live an active life and as full a life as possible. People set their own goals and support was provided for people to achieve these.

The service is set on one level and has a lift and stairs for access from an entrance hall on the lower level. People who used the service told us that they were able to walk around the shops and visit friends as the service was in the centre of Oakham village with easy access to local services such as the library. People lived as independently as possible and actively used local amenities on a regular basis.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

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People who used the service told us that they felt safe. Relatives also said that they had no worries about the safety of people or the service. Everyone we spoke with said that staff were very caring and treated people with dignity and respect, but at the same time, were considerate and compassionate.

People had easy access to local amenities and most people who used the service were in and out of the building during this inspection. We saw that staff greeted people with a smile and chatted about where the person had been and people were talking and happy to discuss their day. This was confirmed during our discussions with people.

Staff expressed a robust awareness of how to protect people from abuse and avoidable harm. They also felt more than comfortable speaking openly to staff and management about any concerns.

Staff had the necessary training and skills to provide them with the knowledge to support people appropriately. We reviewed the training programme that ensured that basic training was completed by all new staff and then further refresher training was regularly updated. Staff confirmed that they had a programme of on-going training that updated their skills. An induction programme was in place for all new staff that were employed at the service.

Relatives said that they knew they could bring any concerns to members of staff, who would deal appropriately and immediately with these.

Healthcare professionals were contacted when this was needed and any instructions were recorded and monitored. Care plans had details of a person's individual support needs, these were reviewed regularly. This was confirmed by our discussions with people who lived at the service and also through our review of records.

All staff were aware of the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) 2008. Our observations and review of records showed that people were encouraged to make independent decisions and choices. People who lived at the service confirmed that staff asked before any support was provided and that they spent their day as they wanted.

There were systems in place to assess and monitor the quality of the service. This included regular discussions with people who used the service. The provider regularly issued questionnaires to gather the opinions and thoughts of individuals, the results were then collated and discussed with the staff team.

Inspection carried out on 27 November 2013

During a routine inspection

We spoke with four people who used the service and two visiting relatives.

A person who used the service told us “everyone here is caring and helpful, and always respectful and careful. They give me as much privacy as possible. Everything is clean and kept nicely”.

People told us they felt safe and that staff helped them to be as independent as possible. People chose how they spent their time and whether they took part in any of the activities available

A visiting relative told us that the service was “fantastic”.

Inspection carried out on 7 December 2012

During a routine inspection

We spoke with four people who used the service and a visiting relative.

People we spoke with told us that Crown House was a wonderful place and a second home, everyone is kind and respectful. They also told us that they felt safe and that there enough staff and that they knew how to do their jobs.

One person who used the service said he they were "treated as an individual"

A visiting relative told us that the care her relative received was "the 'best".

Inspection carried out on 15 December 2011

During an inspection in response to concerns

We carried out this inspection because we had not visited Crown House since 2009. The local authority had identified concerns regarding staff training and recruitment records. The provider had made improvements to the recording of training and record keeping since the local authorities quality monitoring visit

People praised the quality of service provided and in particular praised the staff employed. One person told us 'you couldn't be anywhere nicer'.

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