At our inspection we gathered evidence that helped answer our five questions.Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with nine people who used the service and three relatives of other people who used the service. We spoke with staff and management and we looked at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with told us they felt safe living at the home. Comments included, "It's very good here." One person told us, 'When I use my call bell the staff respond pretty swiftly and I feel able to speak with staff about any concerns I may have.' People who used the service had been provided with pendant alarms that they used when they needed assistance. We looked at records of response times to calls for assistance and we found that staff had responded very quickly, usually in under three minutes. People also had call alarms in their bedrooms. This meant that people could feel safe and assured that they could summon help from anywhere inside the home. This also showed that enough staff were on duty to be able to respond promptly to people's needs.
Relatives told us that they felt people who used the service were safe at the home. They said they knew how to raise any concerns. They added they were confident that staff and the management at the home would take any concerns seriously. No relatives we spoke with had any concerns.
We saw that staff treated people with dignity and respect. Staff spoke politely to people and offered encouragement when they supported them. Care staff we spoke with knew the forms of abuse recognised in the Health and Social Care Act 2010. Staff knew how to identify and report concerns about people's safety internally within the home and with the relevant outside agencies.
Earlier in 2014, a series of errors in medications administration had occurred. These had been investigated. We found the provider had made changes and improvements to the way medications were managed and administered that reduced the risk of errors. No errors had been made since.
Care plans we looked at contained risk assessments of things that could potentially harm people. Care plans included plans of how to protect people from risk of falls and risk of injury whilst receiving personal care.
Senior staff we spoke with understood the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that protects vulnerable people who are or may become deprived of their liberty through the use of restraint, restriction of movement and control.
The home was very clean. A relative told us, "The home is beautiful. There is no smell. It's always lovely."
Is the service effective?
People's health and care needs were assessed with them or their relatives. Care plans included details of people's needs and information about how they were supported with their needs. Care workers made daily records of how they had supported people. We looked at those records and we found that they showed that care workers had supported people in line with their care plans. We found care worker's daily notes varied in quality but noted that the provider had arranged training for care workers to help them improve their record keeping.
People who used the service told us that they had been well cared for and supported. One person told us, "I'm very satisfied. I get the support I need. The staff make sure I'm comfortable." Other people told us that staff supported them with their personal care routines. Relatives were complimentary about the care their family members had received. One relative told us, "The care is as good as it can get." All relatives we spoke with told us they were confident that care had been delivered in line with care plans.
All the people who used the service were registered with one of two GP surgeries. The provider had arranged weekly GP visits so that people's health could be checked.
We found from the evidence we gathered that the service had effectively planned and delivered care that met people's needs.
Is the service caring?
People told us they were well cared for. One person told us, "Staff treat me with respect and observe my dignity at all times." Another person told us, 'Staff treat me with respect and dignity, I couldn't wish for better people.' People who used the service told us that staff were "pleasant." Those comments were representative of what other people told us. Relatives described staff as "brilliant." We saw that staff spoke politely with people. Staff referred to people by their preferred name. We saw took time to have meaningful conversations with people.
People had been supported with their health and nursing needs because the service worked closely with health professionals, such as GPs, community nurses, physiotherapists and others. We found that staff monitored people's health and made referrals to the appropriate specialists when required.
People's preferences, interests and diverse needs had been respected. People had been able to attend church services or receive visits from representatives of local churches.
People took part in social activities that involved other people who used the service and had also been supported to enjoy activities that were of particular interest to them. We found that the provider was further developing a range of activities for people with dementia.
We found that the staff understood people's individual needs and had supported people with those needs in a caring way.
Is the service responsive?
People told us they were well looked after. Records we looked at showed that people had been supported with their personal care and welfare needs. People told us that they knew how they could make suggestions or raise concerns and that they were confident they would be listened to. The service organised residents and relatives meetings where people made suggestions and received feedback from the service about the results of satisfaction surveys. A relative told us they had been invited to those meetings. They added, "We always have opportunities to say what we think about the service."
We found that the service had been responsive to people's on-going and new needs.
Is the service well-led?
The provider had a system for monitoring the quality of service. This included checks of documentation and records and observations of care worker's practice. Staff meetings took place at regular intervals. We saw from records of those meetings that the manager had shared information about the outcome of monitoring activity.
The service had procedures for reporting of accidents and injuries. We saw that reports were reviewed and analysed and that action had been taken to reduce the risk of the same type of accident occurring again.
The manager regularly sought the views of people who used the service and their relatives. That had been through one to one discussions with people and reviews of people's care plans. The provider also used a satisfaction surveys to obtain people's views. Four surveys took place over a 12 month period. Each survey focused on what people thought of particular aspects of the service such as food, activities and staff. We found that the surveys showed that people were satisfied with their experience of the service and that the provider had acted on what people had said.
It was evident that the owner of the home took an active interest in the quality of care provided. Staff we spoke with understood the aims of the home. A senior care worker told us, "It's a good team. Everyone pulls together."