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Inspection carried out on 3 October 2017

During a routine inspection

Stapleton House is a care home that provides nursing and personal care to a maximum of 45 older people, including people who live with dementia or a dementia related condition. At the time of inspection there were 31 people who were using the service

At the last inspection in August 2015 we had rated the service as good. At this inspection we found the service remained good and met each of the fundamental standards we inspected.

People told us they were well looked after and they appeared content and relaxed with the staff who supported them. Relatives told us they were satisfied with the service provided by Stapleton House staff. Staff knew the people they were supporting well.

People said they felt safe and they could speak to staff as they were approachable. We have made a recommendation about staffing levels to be kept under review and that staff are appropriately deployed to ensure people’s needs are met safely. We observed activities were not always available to keep some people engaged and stimulated in some areas of the home where staff were not always available. Improvements were required to some aspects of people’s dining experience in this part of the home.

Systems were in place for people to receive their medicines in a safe way. Risk assessments accurately identified current risks to the person, as well as ways for staff to minimise or appropriately manage these risks.

Staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Appropriate training was provided and staff were supervised and supported. Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. 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.

Detailed records accurately reflected the care provided by staff. Care was provided with kindness and people’s privacy and dignity were respected. Communication was effective in ensuring staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received a varied and balanced diet to meet their nutritional needs.

A complaints procedure was available. Staff and relatives said the management team were approachable. People had the opportunity to give their views about the service. There was regular consultation with people and family members and their views were used to improve the service. People had access to an advocate if required. The home had a quality assurance programme to check the quality of care provided.

Changes had been made to the environment as a programme of refurbishment was taking place. Some areas that we identified at inspection for more immediate attention were dealt with straight away. The home promoted the orientation and independence of people who lived with dementia and further work was taking place as part of the refurbishment.

Further information is in the detailed findings below.

Inspection carried out on 24 August 2015

During a routine inspection

This inspection took place on 24 August 2015 and was announced. This meant the provider knew we would be visiting. The service has not previously been inspected.

Stapleton House provides care for up to 45 people some of whom have nursing care needs. The service is based in a two-storey building, some of which was purpose built. At the time of the inspection there were 36 people using the service. 15 people were living with dementia.

The service had a registered manager. 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 at the service. Risks to people’s safety and health were appropriately assessed, managed and reviewed. Individual risk assessments were carried out and regularly reviewed. A robust recruitment and induction process was in place. Staffing levels allowed people to receive personalised and meaningful care.

Staff were trained in safeguarding and whistleblowing and were able to demonstrate a working knowledge of both. The service had plans in place to ensure people’s safety and a continuity of care in emergency situations.

Staff received appropriate training and felt confident in their ability to support people. Meaningful supervisions were carried out, which staff found useful in developing their skills and the service in general. People were offered a good selection of appealing and nutritious food, and those with particular dietary or nutritional needs were appropriately supported.

The service protected people’s rights by ensuring they were not restricted unnecessarily unless it was in their best interests. The service worked collaboratively with the relevant authorities to ensure people’s best interests were protected without compromising their rights, ensuring the appropriate procedures were followed.

People were supported with dignity and respect. The service had a homely and welcoming atmosphere. Staff were respectful, friendly and caring.

Care plans were detailed and personalised, which meant people received the care and support they wanted. Plans were regularly reviewed to ensure they reflected people’s current wishes, and people and their relatives felt involved in this process.

The service provided a range of activities, and people were involved in developing these. The activities co-ordinator was aware of people’s preferences and ensured that everyone was involved in activities if they wished to be.

The registered manager and the provider regularly assessed all aspects of the service to ensure that quality was maintained. Where complaints were received they were dealt with promptly.

Staff felt supported by management and described a positive, caring culture at the service.