Archived: Waypoints Plymouth

At our last inspection in October 2018 we rated the service as requires improvement. This was because the provider's governance framework, to help monitor the management and leadership of the service, and the ongoing quality and safety of the service, had not been fully implemented. In addition, some newly designed systems had not always been robust in identifying areas requiring improvement. The Commission took enforcement action and imposed a positive condition on the providers registration. This meant the provider was required to send a monthly action plan, telling us what action was being taken to help improve the service. We monitored those monthly action plans to ensure they provided the information required.

During this inspection we looked to see if improvements had been made and that the condition had been sufficiently met. The Commission was satisfied with the progress at the service, therefore the rating changed from requires improvement to good, and the condition was removed.

Waypoints Plymouth 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 is registered to provide residential care and accommodation for up to 64 older people who may also be living with dementia. At the time of this inspection, 53 people were living at the home.

Waypoints Plymouth is owned by Waypoints Care Group Limited. The provider also owns two other care homes in Dorset.

The service had a registered manager in post. 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.

Significant improvements had been made to the providers governance framework, meaning that checks to assess and review the ongoing quality of the service, were now imbedded. However, some small changes were still required to ensure the system was fully effective.

People had their needs assessed prior to moving into the service to help ensure the service was suitable, and had their health and social care needs met in a co-ordinated way. People had care plans in place and people’s communication needs were known, but care plans were not always accurate. The registered manager told us immediate action would be taken to update care records.

People had the opportunity to participate in social activities. However, the registered manager told us they would review social engagement for people, as we found some people did not always have stimulation.

People’s risks associated with their care were known but not always recorded. Immediate action to update people’s records was taken at the time of our inspection. People’s accidents and incidents were monitored for themes and trends and to help reduce reoccurrences.

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 also supported these practices. At the time of our inspection the registered manager was taking action to improve the recording of people’s mental capacity and consent in their care plans.

People told us the quality of the food was nice, with plenty choices available. People had their nutrition and hydration needs met by knowledgeable staff, and people now received support with their meals in a respectful manor.

People were looked after by staff trained to meet their needs. Nursing training and competence had now improved. People were cared for with dignity and respect at the end of their life.

People were cared for by kind and compassionate staff, who not only looked after people living at the service, but extended their warmth to people’s family’s. People’s privacy and dignity was promoted and staff gave people as much control over their own care as possible, by offering choice.

People knew who to complain to. People lived in an environment which had been adapted to their needs and a full-time maintenance person helped to ensure the safety and upkeep of the building.

The Accessible Information Standard (AIS) was known and had been considered. The AIS aims to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand

People told us they felt safe. People were supported by sufficient numbers of staff who had been recruited safely and had undertaken training to recognise any potential signs of abuse.

People’s medicines were managed safely, but the providers medicine checks had not always identified when action was required in respect of equipment.

People lived in a service that was assessed for its overall safety, infection control practices were in place and the provider was proactively trying to diminish all odours within the service.

People were cared for in a service which had a positive culture, and care and support was delivered in line with a core set of values. People, relatives and staff were engaged in the development of the service and felt able to share their views and ideas for improvement.

People, relatives and staff spoke highly of the registered manager and told us, improvement at the service had been noticeable and the provider and registered manager remained strongly committed to improving the service.

We did not find any breaches of regulation, however recommend the provider implements findings from their own research into activities suitable for people with dementia, which takes accounts of people's personal backgrounds and hobbies, individual preferences and abilities to provide personalised, meaningful social engagement. In addition, we recommend the provider takes action to strengthen their governance procedures to help ensure it identifies gaps in record keeping and the checking of medical equipment.

Prior to our inspection the Commission had received a concern that people were being unsafely supported with their mobility and that their bedroom furniture was not always repaired. There had also been reports from the provider and local authority of a high number of safeguarding incidents involving people walking into other people’s bedrooms uninvited and of people causing harm to one another. The provider had also failed to notify us of significant events in line with their legal obligations.

Waypoints Plymouth is owned by Waypoints Care Group Limited. The provider also owns two other care homes in Dorset. The service provides care and accommodation for up to 64 people. On the day of the inspection 61 people lived in the home.

Waypoints Plymouth provides care for people with physical and mental health conditions which include people living with a diagnosis of dementia. The provider's philosophy of care was stated to be “Creating a sense of independence, normality and enjoyment” and “Supporting people with the least restrictions, ensuring their freedom, choice and control”.

At the time of our inspection the service did not have a registered manager in post. The service was being managed by a Director of Waypoints Care Group Limited. A new manager had been appointed from 20 March 2017 and we were told would be registering with the 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.

At our last inspection on 08 August 2016 and 09 August 2016 we asked the provider to make improvements to ensure there were sufficient numbers of staff employed to meet people’s individual needs; and to ensure people were protected from risks associated with their care. We also required the provider to improve practice in the service based on the findings of previous safeguarding investigations in order to keep people safe and free from avoidable harm and abuse. We requested the provider make sure people’s care records were accurate and people’s complaints were listened to. As well as ensuring there were effective governance systems in place to assess, monitor and improve the ongoing quality of the service.

In addition, we asked the provider to consider the ethos, management and culture of the service. This was because some relatives and staff had told us of inconsistent management approaches and poor communication. Following our inspection, the provider sent us an action plan telling us how they intended to meet the associated regulations. During this inspection we looked to see if improvements had been made. We found some action had been taken, but further improvements were required.

People were not protected avoidable harm that may affect their human rights, because people were able to freely walk into other vulnerable people’s bedrooms and cause harm. Although, this freedom of movement was the basis of the provider’s dementia care ethos, consideration had not been given to how people were protected from experiencing psychological or physical harm. Previous safeguarding alerts and investigations carried out by the local authority had also shown similar themes; that the layout of the service did not always keep people safe and protected from harm.

People told us they felt safe living at the service. However one person told us they did not feel safe because, they were worried about other people entering their bedroom. They explained they had told staff, but nothing had changed. The preventative measures which were in place to alert staff when a person entered another person’s bedroom uninvited, were not always effective and people did not always have a call bell in reach to be able to call staff for assistance when this happened.

People who lived at the service were not always supported to manage risks associated with their behaviour in order to protect themselves and others. People’s behaviour was not always monitored to help understand the reasons for why they may behave in a certain way, in order to find possible solutions. People were not always cared for by staff who understood how to mitigate risks associated with a person’s care, and risk assessments were not always in place to help provide guidance and direction to staff.

People lived in an environment which had been assessed to ensure it was safe; however people did not always live in an environment which was free from odour. Some people’s bedrooms and shared areas smelled of urine.

People did not always receive their medicines when prescribed. People’s medicines were administered by staff who had received training.

People told us there were enough staff to meet their needs and since our last inspection consideration had been given to increase the numbers of staff working within one area of the service. People were supported by staff who had received training in order to meet their individual needs, and nursing staff attended specialist clinical training. However, when training had been provided it had not always been put into practice.

People's consent to care had been sought and recorded in their care plans and staff were heard to verbally ask people for their consent prior to supporting them. Managers understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).

People's confidential information was not always protected because their personal care records were not always locked away. People’s privacy and dignity was not always respected. People’s personal belongings were not always kept safe or respected by others living at the service.

People and their relatives generally told us staff were caring and we observed this during our inspection. However, some other people and relatives were not as complimentary. People and their relatives told us the food was nice.

People had care plans in place which provided guidance and direction to staff about how to meet their individual needs. However, care plans were not always effectively updated to ensure they were reflective of people's current care needs. People were supported to maintain their health and wellbeing by accessing external health and social care professionals.

People living with dementia were not always provided with personalised care. People’s care plans were not individualised to demonstrate how they were being supported with their dementia care needs. This was also reflected in some staff actions when they appeared to be more focused on completing tasks rather than meeting the social and emotional needs of people.

People could participate in social activities. There was a passionate and enthusiastic activities co-ordinator, who demonstrated through her actions the fundamental qualities of delivering good dementia care. However, some people spent their time walking around the building and staff did not always take the opportunity to make conversation or encourage different social stimulation.

People’s complaints were spoken about positively by the management of the service, and were used to help improve the service. People were invited to come and talk about their concerns or worries. Managers said they were trying to change the culture by introducing an “open door” approach.

Since our last inspection, the leadership of the service had changed and although in its infancy, people, families and staff talked of improvements and a positive change to the atmosphere of the service. Families and staff were being asked for their views and opinions in order to improve the quality of the service.

The provider described the service as being in “transition”. There was recognition and honesty throughout our inspection about the improvements which were required. The provider was open, transparent and had admitted when things had gone wrong. The provider worked in partnership with other external health and social care agencies. However, feedback from the local authority quality and improvement team (QAIT) was that the provider did not always lean from their mistakes.

The provider’s governance systems had failed to ensure people were kept safe from abuse and avoidable harm. Audits were in place to help monitor the quality of the service; however these had not always been effective in identifying when improvements were needed. The provider’s culture of a ‘person centred approach’ was not always observed to be imbedded into staffs practice.

The provider had organisational policies and procedures which set out what was expected of staff when supporting people. However, the provider had not ensured staff in day to day charge of the service had received an induction to the organisation which meant they were not aware of the provider’s policies and procedures.

The provider had not always notified the Commission of significant events which had occurred in line with their legal obligations. However, the provider took action to rectify this and notifications were now being submitted as required.

Following our inspection, the Commission requested that the provider submit an action plan by 07 March 2017 to outline their intentions as to how they would immediately mitigate the identified risks to people. The provider also confirmed they would stop any new admissions to the service at this time. We also contacted the local authority safeguarding team who took prompt action to ensure people’s health, safety and wellbeing.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

We carried out an unannounced comprehensive inspection on 27 and 28 February 2017 and the service was placed into ‘special measures’.

We told the provider to make improvements to make sure people were kept safe from avoidable harm and abuse. Risks associated with people’s care were to be recorded and known by staff so they could be cared for safely, and received care that met with their needs, wishes and preferences. People’s medicines to be given as prescribed and for the environment to be free from offensive odours. In addition, we told the provider people should be treated with dignity, respect and have their privacy respected and their confidential information to be stored securely. Staff training to be embedded into practice, nursing competency improved and the culture of the service reviewed to ensure people living with dementia received personalised care. We also requested the overall management, leadership and culture of the service should be improved. That the provider learnt from mistakes and implemented recommendations from the local authority safeguarding team, to help keep people safe. Also, the provider’s monitoring processes, used to help identify when improvements were required, were inadequate in ensuring the health, safety and welfare of people. The provider had also failed to inform the Commission of serious injuries in line with their legal obligations.

Immediately after our inspection, the Commission requested the provider submit an urgent action plan to tell us how they would keep people safe and we also met with the provider. The provider told us they would stop new admissions to the service, in order for them to put things right. We also contacted the local authority safeguarding team who took prompt action to ensure people's health, safety and wellbeing. The local authority and Clinical Commissioning Group (CCG) took action to stop placing at to the service. During this inspection we looked to see if improvements had been made. We found action had been taken, but some improvements were still ongoing.

Waypoints Plymouth is owned by Waypoints Care Group Limited. The provider also owns two other care homes in Dorset. The service provides care and accommodation for up to 64 people. On the day of the inspection 52 people lived in the home. Placements by the local authority and CCG had recently re-commenced.

Since our last inspection there was a new registered manager in post. 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 provider had designed, but had not yet implemented their new overarching governance framework, to help monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving. This meant there was a continued risk to the ongoing quality of the service because the provider may not be alerted to when improvements are required.

The registered manager had devised some new systems and process to help monitor the quality of care people received. However, these had not always been robust in identifying areas requiring improvement, and still required embedding into culture and practice.

People’s families were being asked to complete questionnaires to help collate their views with regards to the ongoing improvements at the service. Questionnaire returns were ongoing, with the registered manager reviewing each one when it was received.

There was a new management team in place. This included a new registered manager and a new head of clinical care. However, two external professionals felt strong leadership was still required in respect of the nursing team, to help radically change the nursing culture.

People and relatives spoke positively about the new registered manager and of the dramatic change in ‘atmosphere’. Staff, had also seen changes within the service but recognised improvements were still ongoing.

The registered manager had worked tirelessly to make improvements at the service, and was passionate about ensuring people received a compassionate service. External professionals were supportive of the service, and of the registered manager’s enthusiasm to make things better.

When mistakes were made, these were now learnt from and used to help improve the ongoing quality and safety of people. The provider and registered manager were open, transparent and admitted when things had gone wrong. The registered manager kept their ongoing practice and learning up to date. The provider had notified the Commission of significant events which had occurred in line with their legal obligations. For example, regarding safeguarding concerns and serious injuries.

People continued to live in an environment which was not free from offensive odours. Although, the provider had attempted to take action by changing cleaning products, on both days of our inspection there was a smell of urine in the reception area and in some bedrooms.

Overall, people’s risks associated with their care were now recorded so staff knew how to support them, but their records were not always updated when changes occurred. This meant staff may not know how to support people safely. Staff, were not always observant to hazards that could result in people falling.

People were now protected from avoidable harm and abuse. People and their families told us they felt an improvement to the feeling of their safety. Since our last inspection people, along with the support of their families had been consulted about moving bedrooms. This was to help ensure people with similar needs were cared for in a safe way and in an environment conducive to their needs.

People were cared for by staff who had been safely recruited, and there were enough staff to meet people’s needs. However, an external professional told us, further action was required to ensure the mix of clinical and social care staff, met with the needs of people, particularly with regards to dementia care.

People’s medicines were now stored and administered safely and there was a system in place to help ensure the effective ordering and management of people’s medicines.

Overall, people lived in an environment which had been assessed to ensure it was safe. However, in the activities room, cupboards were found to be unlocked which contained cleaning products which could be a risk to people should it be consumed.

The dining experience people received was observed to be of a variable quality. Whilst some people were supported by staff who displayed positive interactions, other people were not. People were not always offered a choice of what they would like to drink or assisted as needed. The dining tables were not always set to remind people of the time of day, and the menu displayed was not in a format that everyone maybe able to understand. People were complimentary of the food.

Overall, people had their needs met by staff who had undertaken training. Changes, to dementia training were being implemented to help staff ensure were meeting the provider’s philosophy of providing person centred care. An external professional told us, improvements were required in dementia training for all staff, because when they visited they did not always observe staff supporting people in line with dementia care principles.

Nursing competency continued to require improving. Although, staff undertook clinical training to help assist with their ongoing competency. Two external professionals told us, nursing competence in respect of both general and mental health nursing required improving. This was because they felt nursing staff did not carry out a continued individualised assessment of people’s needs, to help ensure their care was pro-active rather than re-active.

People's consent to care had been sought and recorded in their care plans. The registered manager and staff understood their responsibility in relation to the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).

People were supported to maintain their health and wellbeing by accessing external health and social care professionals.

People’s environment had been re-designed to help reduce unnecessary instances of physical altercations between people. A new maintenance person had been recruited to help ensure repairs to the environment were carried out promptly.

People’s privacy and dignity was now respected. The changes to the environment had greatly reduced the number of occurrences of people walking into other people’s bedrooms uninvited.

People and their families told us staff, were kind. Compassion was shown by staff, who were observed sitting and talking with people. We saw staff holding people’s hands, comforting people by placing an arm around them when they were upset, and walked with people around the home, whilst participating in meaningful conversation. People and/or their families told us they were involved in decisions relating to their care. Days, which were special to people such as birthdays were fondly remembered and celebrated. People’s families were welcome to visit at any time.

People were now invited to come and talk about their concerns or worries, helping to reduce the need for people to complain formally. People'

At our last inspection on 30 June 2015 and 1 and 3 July 2015 we asked the provider to make improvements to how people’s care was documented, ensure medicine records were completed accurately and that social activities were meaningful and planned in line with people’s interests. During this inspection we looked to see if these improvements had been made and we found that action had been taken.

Waypoints Plymouth is owned by Waypoints Care Group Limited. The provider also owns another care home in Dorset. The service provides care and accommodation for up to 64 people. On the day of the inspection 58 people lived in the home.

Waypoints Plymouth provides care for people with physical and mental health conditions which include people living with dementia. The provider’s philosophy of care is about “creating a sense of independence, normality and enjoyment” for people living with a dementia. Supporting people with the least restrictions, ensuring their freedom, choice and control.

The service had a registered manager in post. However, at the time of our inspection the registered manager was absent due to ill health. The service was being managed by the head of care, who was supported by the provider’s operations director. 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.

Prior to our inspection the Commission had received a number of whistleblowing concerns. These included, issues relating to staffing levels, people not always being kept safe from avoidable harm or abuse, the management of accidents and incidents, poor manual handling practices, the cleanliness of the environment and that staff did not always follow policy and procedures.

We were also told staff did not always treat people with dignity and respect, follow people’s care plans and accurately record their care. Concerns had also been raised that nutrition was not effectively monitored, and people’s continence and personal care needs were not being met. We were also told there was a lack of management and structure at the service, and complaints were not listened to or taken seriously.

People, relatives and staff told us there was not enough staff to meet their individual needs. Relatives also felt there was a lack of continuity of care for people, because staff worked across the service and not specifically in one area. Some external health professionals also shared this view. People were not always protected from avoidable harm and abuse because the provider did not always learn from previous safeguarding investigations. People were not always protected from risks associated with their care, for example risk assessments were not always followed.

People were protected by good infection control practices. Overall, the service was free from odour but in some areas there was a smell of urine. Relatives also commented about this, but explained they understood the challenges staff faced in meeting some people’s needs. People’s medicines were administered safely and the provider responded when errors in practice had been identified, for example by arranging additional training.

Overall, relatives told us they felt their loved one was safe living at the service. Staff knew what action to take if they suspected someone was being abused mistreated or neglected. Staff were recruited safely to work with vulnerable people.

People were cared for by staff who had received training and support. Some external health professionals expressed concern that staff were not always adequately trained to support people with dementia. People were encouraged and supported with their nutrition. A flexible approach to meal times meant people were able to choose and enjoy their meals when they wanted to. People had access to healthcare services to maintain their health and wellbeing. People’s consent to care was sought in line with legislation and guidance to ensure their human rights were protected. People lived in an environment which was designed to support and empower them.

People were cared for by staff who were kind and compassionate. People and their families were supported to be involved in decisions relating to their loved ones care. People’s privacy was not always respected because people had entered other people’s bedrooms without their consent.

People had a pre-assessment prior to moving into the service, this helped to ensure staff could meet their needs. People’s relatives, on the whole felt their loved one received good care, but some had concerns about the provider’s ethos and whether it was always embedded into staff’s practice. People had care plans in place to provide guidance and direction for staff about how to meet their needs. However, care plans were not always effectively updated to ensure they were reflective of how to meet people’s individual needs. Some external health professionals told us, people’s needs were not always met with continuity because of the use of agency staff at the service.

People’s social activities were organised in line with their interests. Activity co-ordinators had a person-centred approach to meeting people’s social needs, for example time was taken to get to know people. People’s complaints were investigated and used to help improve the service. However, some relatives felt, some managers did not always effectively listen and take responsive action.

Overall, people, staff and relatives felt the service was well-led. Some however, felt there were management inconsistences. Some external health professionals expressed concern that staff were not always effectively supported.

People, relatives and staff were asked for their views about the running of the service. However, some people felt they were not always listened to. There were systems and processes in place to help monitor the quality of care people received. However, some audits had not always identified when prompt action was required.

The provider was keen to develop the service in line with current dementia research. The provider and managers were open and transparent and understood the requirements of the duty of candour. The Commission had also been informed of significant events in line with their legal obligations, for example safeguarding concerns.

We recommend the provider ensures that all staff receives training to effectively meet the needs of people with dementia, including challenging behaviour.

We found breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

At the time of our inspection there were 56 people who used the service. Our inspection team was made up of two inspectors. This is a summary of what we found. The summary is based on meeting with and speaking to twenty people who used the service, seven relatives of those who used the service, twelve staff supporting them, The Head of Care, the Registered Manager and from looking at records.

We, the Care Quality Commission (CQC) carried out an inspection of Waypoints in response to information of concern we had received about the service. The information we had received related to staffing levels and poor communication. We found that there was no evidence to support any of the allegations.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There were systems in place to ensure staff received training which was specific to the needs of the people who lived at the home. This included dementia care training, end of life care and the protection of vulnerable adults.

There were systems in place to ensure risks to people's safety and welfare were identified and risk assessments were put in place to minimise such risks. There were systems in place to ensure appropriate procedures were in place in the event of a foreseeable emergency.

People we spoke with told us they felt safe, one person commented, “I feel safe and well looked after”.

A recent mock fire drill in conjunction with the local fire service, led the Registered Manager to comment, “The results were very impressive, none of the care staff were informed it was going to happen, and I was really impressed at how well everyone worked together to ensure people were safe”.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection two people had DoLS authorisations in place. The Registered Manager was able to demonstrate a clear knowledge of the process the home followed and evidenced where the applications had been made and reviewed.

The home had four separate units which were all interlinked. We saw the duty rota which showed the home had sufficient staff to cover all the units both days and night shifts.

Is the service effective?

People told us they were happy with the care they received. We saw from care records that people's care needs had been appropriately assessed and care plans reflected need.

People we spoke with said, “The staff here are very good”; “It’s splendid here, I can’t fault it” and “I’m very happy here, I wouldn’t entertain going anywhere else”.

Is the service caring?

People were supported by staff who displayed warmth and affection. We saw that staff showed understanding, patience and gave encouragement when supporting people. We saw that people were able to do things at their own pace and were not rushed.

We spoke to people who used the service and their relatives. Comments included: “They have improved so much since being here”; “I can find no fault with the care, they are happy and I am happy”; and “I am well looked after, I have no complaints, the staff are very caring”.

Is the service responsive?

Guidance from health care professionals was sought to ensure best practice was applied, care plans were updated and it was evidenced and recorded that guidance was followed where appropriate to effectively meet people's needs and manage risk.

Records showed that people's preferences, interests and diverse needs had been

recorded and care and support had been provided in accordance with people's wishes.

Where the Registered Manager had identified posts could not be covered by the regularly employed staff, agency or bank staff were brought into cover these shifts.

Is the service well-led?

There was a clear staffing structure which ensured that there were clear lines of accountability and responsibility. The staff confirmed that the Registered Manager and qualified staff were available on call whenever needed. Staff told us that they received regular supervision sessions and staff meetings. One staff member said, “We all support each other” and “We meet on a one to one regularly”.

We found that learning from incidents and investigations took place and appropriate changes were implemented. Complaints and comments were taken into account to improve the service. One person commented, “My tap wasn’t working, I saw the handyman and told him about it, it was fixed the same day” and another said, ‘I really do feel that you (The Registered Manager) listen, I have observed real improvements’.

Quality assurance processes were in place in the home. We saw evidence of people and their relatives being asked for feedback and this being responded to and acted on.

Waypoints was opened in August 2012 and this was the first inspection by the CQC.

We talked with eight people who lived at the home, nine members of staff and four visitors to the home. They all told us that they were happy with the care provided at Waypoints. People told us “The staff are great” and “Staff can’t do enough for you”.

One relative said “We are very happy with the care our relative receives, we are kept updated by the manager ”. Another relative told us “This home is five star”.

People told us that at all times staff treated them with kindness and respected them. They said they thought their needs were being met. Records relating to people’s care needed further detail to ensure that all staff would be aware of people’s care needs.

People were cared for by staff who had received training to provide them with the skills to meet their role, this included staff trained in how to keep people safe. People and staff at the home said that there were enough staff available on each shift to meet people’s needs.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

Systems were in place for monitoring the quality and risks associated with the service to ensure that improvements identified were identified and addressed.