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Inspection carried out on 13 February 2018

During a routine inspection

The Florence House 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.

Florence House accommodates 21 people in one adapted building over two floors. There were 15 people using this service at the time of this inspection.

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 on going 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.

This unannounced comprehensive inspection took place on the 13 February 2018.

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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 2008 and associated Regulations about how the service is run.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

The environment was clean and a safe place for people to live. We found equipment had been serviced and maintained as required. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available for staff to use when required.

People were helped to take their medicines by staff who were trained and had been assessed to be competent to administer medicines.

People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were looked after by staff who were trained and supported to do their job.

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.

People had access to healthcare professionals and their healthcare needs had been met. Care records seen confirmed visits to and from General Practitioners (GP's) and other healthcare professionals had been recorded.

People were supported to eat and drink sufficient amounts of food and drink.

Staff knew people they supported and provided a personalised service in a caring way. This was confirmed by talking with people who lived at the service and relatives.

Care plans were organised and had identified care and support people required. We found by conversations with staff they had a good understanding of protecting and respecting people's human rights.

People participated in a range of activities within the service or in the community and received the support they needed to help them to do this. The support included staff assisting people to meet their cultural and religious needs.

People were involved in the running of the service. Regular meetings were held for the people and their relatives so that they could discuss any issues or make recommendations for improvements to how the service was run.

There was a process in place so that people’s concerns and complaints were listened to and were acted upon. Information available with regards to support from an external advocate should this be required by them.

There were clear management arrangements in place. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action was taken where improvements were identi

Inspection carried out on 21 January 2016

During a routine inspection

Florence House is a care home that provides accommodation and personal care to up to 21 older people, some of whom are living with dementia. It is not registered to provide nursing care. There were 19 people living at the home at the time of this visit. There are internal and external communal areas, including a lounge and dining area, a hairdressing room and a garden for people and their visitors to use. The home is made up of two floors which can be accessed by stairs or a lift. All bedrooms are en-suite with a toilet and hand wash basin. There are two communal bathrooms for people to use.

This unannounced inspection took place on 21 January 2016.

There was a registered manager in place during this inspection. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Where people had been assessed as lacking capacity to make day-to-day decisions, applications had been made to the local authorising agencies. Staff demonstrated to us that they respected people’s choices about how they wished to be supported. Staff were able to demonstrate a sufficient understanding of MCA and DoLS to ensure that people would not have their freedom restricted in an unlawful manner.

Plans were put in place to minimise people’s identified risks, to enable people to live as safe and independent a life as possible. Arrangements were in place to ensure that people were supported with their prescribed medication safely. Medication was managed and stored appropriately. People’s nutritional and hydration needs were met.

People, when needed, were assisted to access and were referred to a range of external health care professionals. People were supported to maintain their health and well-being. Staff assisted people to maintain their links with the local community to promote social inclusion. People’s friends and families were encouraged to visit the home and were made to feel welcome.

Staff understood their responsibility to report any poor care practice or suspicions of harm. There were pre-employment safety checks in place to ensure that all new staff were deemed suitable and safe to work with the people they supported. There was an adequate number of staff to provide people with safe support and care.

Staff were trained to provide care which met people’s individual care and support needs. The standard of staff members’ work performance was reviewed during supervisions, appraisals and competency checks. This was to ensure that staff were competent and confident to deliver people’s support and care.

People who used the service were supported by staff in a respectful and kind way. People’s care and support plans gave prompts to staff on any individual assistance a person may have required. Records were in place to monitor people’s assessed risks, care and support needs.

People and their relatives were able to raise any suggestions or concerns that they had with the registered manager and staff and they felt listened to.

The registered manager sought feedback about the quality of the service provided from people, their relatives and visiting stakeholders. Staff meetings took place and staff were encouraged to raise any concerns or suggestions that they may have had. Robust quality monitoring processes to identify areas of improvement required within the service were in place and formally documented any action required.