Marine Park View

Seahaven Care Home is a residential care home providing accommodation and personal care to up to 30 people in one adapted building. The service provides support to older people, including people who may live with dementia or a dementia related condition or a learning disability. At the time of our inspection there were 23 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service had not been meeting the underpinning principles of Right support, right care, right culture. Significant improvements were being made to address the principles for all people using the service. However, changes implemented had not yet had time to become embedded or sustained and additional improvements were needed.

Right Support: Improvements were being made to the service to ensure the service was flexible and adapted to people's changing needs and wishes and promoted their independence. Care had not been person-centred and tailored to each individual, but improvements were being made so people were listened to and were becoming central to the focus of care delivery. Some people and relatives said communication could be improved. There were opportunities now for people and staff to give their views about the service. Improvements were being made to involving people in the running of the service and to consult with them. We have made a recommendation about ensuring information is accessible, where needed, to keep people informed and to assist with their decision making.

Improvements were being made to give people control in their lives and involve them in decision making. People had not been supported to have maximum choice and control of their lives and staff had not supported them in the least restrictive way possible and in their best interests; the policies and systems in the service had not supported this practice.

Robust systems were not in place to monitor risks to people’s safety and ensure the environment was appropriately maintained. Medicines were not all managed safely, improvements were needed to medicines storage and medicines records required more information for the use of ‘when required’ medicines, where prescribed. The building was not well-maintained, with ineffective infection prevention and control procedures to keep people safe. Bedrooms were not personalised. Staff had received safeguarding training and it was planned they would receive local authority safeguarding training, so they understood how to report any concerns to external agencies, if they were not addressed internally.

Right Care: Improvements were being made to ensure care was person-centred and promoted people’s dignity, privacy and human rights. Staffing levels had increased and staff had received additional training to ensure they understood their role and responsibilities. Improvements were being made to records to ensure staff had guidance about how to support people. However further improvements were needed including the provision of more activities and outings to ensure people remained occupied and engaged and received person-centred care.

Right Culture: Substantial improvements were being made to the running of the service to ensure people were the main focus of care delivery and they received safe, effective care that met their needs. There had been a change in management and staff had received training to ensure the ethos, values, attitudes and behaviours of leaders and care staff ensured people using services would be supported to lead confident, inclusive and empowered lives.

Staff were positive about the changes being introduced and working at the service. They said the new management team were approachable and they were supported in their role. Communication needed to become more effective with relatives and people, to keep them informed and receive their feedback about service provision, and to respond to complaints and concerns. A quality assurance system was in place, but it needed to become more robust to assess the standards of care in the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 18 May 2018).

Why we inspected

We undertook a focused inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about people’s care, staffing, management and the culture at the service. A decision was made for us to inspect and examine those risks.

We inspected and found there were concerns with other aspects of people’s care, so we widened the scope of the inspection to become a comprehensive inspection which included all the key questions of safe, effective, caring, responsive and well-led.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found evidence during this inspection that people were at risk of harm from these concerns. The provider was taking action to mitigate the risks from some of these concerns. Please see the safe, effective, caring, responsive and well-led sections of this full report.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, fit and proper persons employed, the environment, person-centred care, records and good governance at this inspection.

We have made the following recommendations:

Information should be made accessible to meet people’s needs.

Relatives and visitors to be made aware that visiting is not restricted. Systems to communicate with relatives to be strengthened to ensure people and relatives are kept up to date with changes being introduced and to gather their feedback.

Improvements to be made to people’s dining experience.

Improvements to be made to activities and outings to keep people engaged and occupied, as they choose.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Seahaven Care Home is a residential care home providing personal and nursing care to 25 people at the time of inspection, some of whom were living with a dementia. The service can support up to 30 people in one large adapted building.

People's experience of using this service and what we found

There was enough staff to safely support people. People had their dependency assessed regularly and the registered manager updated staffing levels to reflect changes to people's needs. Trained staff supported people and new staff were recruited safely. The registered manager provided support to staff through regular supervisions.

Lessons learned from incidents were shared with staff verbally. The registered manager ensured records accurately reflected these conversations and updated processes when needed. Accidents and incidents were reviewed and analysed for any trends or areas for improvement.

People were supported to maintain a balanced diet. Staff monitored people to assess their risk of malnutrition. If people were at risk, appropriate referrals were made to other healthcare professionals for advice and guidance. Staff worked in partnership with other healthcare professionals and supported people to attend other healthcare services.

There was an effective infection prevention and control policy in place and staff followed this to keep people safe. This had been reviewed and updated to reflect the current pandemic relating to COVID-19 and extra steps were in place to minimise the risk to people living at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 May 2018).

Why we inspected

We undertook this targeted inspection to check on specific concerns we had about staffing levels, staff knowledge, monitoring of people's nutritional needs and infection prevention and control at the service. The overall rating for the service has not changed following this targeted inspection and remains good.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID- 19 and other infection outbreaks effectively.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

At the last comprehensive inspection of the service on 19 and 20 October 2016 we identified breaches of regulation 12, safe care and treatment, regulation 17, good governance and regulation 18, staffing. The provider had not fully assessed the risks to the health and safety of people who used the service. The provider failed to ensure that the premises were safe to use for their intended purpose. We found the provider did not appropriately manage the deployment of staff at meal times to ensure people received dedicated support when they needed it. The provider did not have effective systems in place to assess, monitor and improve the quality and safety of the service provided. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We carried out a focused inspection on 15 June 2017 to check that the service was meeting legal requirements. During the inspection we found the provider had made improvements in some areas. However, we found the provider had not completed all the actions set out in their action plan. We found there were continuing breaches of regulations. This was because the provider had not adequately assessed the risks to the health and safety of people who used the service, plans to mitigate risks and to provide personalised care were not specific to the identified risk. Policies and procedures had not been reviewed.

At this inspection the service had made the required improvements. We found no breaches of regulations and the service was meeting the legal requirements. The premises were safe and the registered manager carried out regular premises checks to ensure all aspects of health and safety were being met. People’s care plans reflected their individual needs and risks were assessed. The registered manager had reviewed and updated all of the policies and procedures to make sure they reflected current legislation.

Seahaven Care Home is a ‘care home’ located in South Shields. People in this care home receive accommodation and 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. Seahaven Care Home accommodates people in one adapted building and on the date of this inspection there were 16 people living at the home.

There was a registered manager in post who has been registered with the Care Quality Commission (CQC) to provide regulated activities since December 2017. 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 told us that they felt safe at the home and relatives agreed with these comments. We found there were policies and procedures in place to help keep people safe. Staff had received training and attended supervision sessions around safeguarding vulnerable adults.

Staff were safely recruited, had appropriate checks, references and they were provided with all the necessary induction training required for their role. The registered manager continued to provide on-going training for staff and monitored when refresher training was required. Accidents and incidents were recorded correctly and if any actions were required, they were acted upon and documented.

The premises were safe. Regular checks of the premises, equipment and utilities were carried out and documented. On the first day of inspection the laundry room was left unlocked but the registered manager had a keypad lock installed straight away to remove any risk to residents. Infection control measures were in place and the home was clean. We saw domestic staff cleaning the home regularly during the inspection.

We saw positive dining experiences. During lunchtime on the first day of inspection we observed that there was enough staff present to support people in the dining room. There were different choices for meals with a pictorial menu. The dining room also had a reading corner to encourage people with individual activities. The service had evidence to show that people were regularly participating in activities. There were sufficient staffing levels at Seahaven Care Home. People living at the service commented that they did not have to wait for staff to help them.

The service continued to provide safe medicine management. Procedures were in place to ensure the safe receipt, storage, administration and disposal of medicines. We spoke to a member of the local GP practice visiting people for reviews and there were records regarding other professionals involved in people’s care. People were supported to maintain a balanced diet and we saw people had access to a range of foods and fluids throughout the day. People told us that they were always offered drinks and food throughout the day.

The premises were ‘dementia friendly’ as the walls, floors and doors were painted in contrasting colours and there was pictorial signage to help people orientate themselves. The registered manager was working on a memory project on the second floor. This involved a seaside theme to reflect the location of the service.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. Applications had been made on behalf of some people to restrict their freedom for safety reasons in line with the Mental Capacity Act 2005. Staff demonstrated their understanding of the MCA. The registered manager had made applications on behalf of people living at the service to restrict their freedom for their own safety in line with the MCA. We saw staff asking people for consent when supporting them and asking for people’s choices for meals and drinks.

Staff treated people with dignity and respect. They showed kind and caring attitudes and people told us the staff spoke nicely to them. We observed people enjoyed positive relationships with staff and it was apparent they knew each other well. People told us that staff knew what they liked and disliked.

People and relatives knew how to raise a complaint or concern. The complaints system was available to everyone who visited the service. The registered manager and the provider used feedback received to drive continuous improvement throughout the service.

The registered manager had previously worked on an end of life care project and was beginning to thread this into the culture of the service. This enabled the service to have an experienced person to train and underpin all aspects of delivering personalised end of life care for people and to support staff to deliver this.

People had person-centred care plans and risk assessments in place to keep them safe. People, relatives and external health professionals were all involved in best interest decisions and mental capacity assessments. People’s care records were accurate and up-to-date.

The provider and registered manager had a clear vision to care for people living at the home. Staff told us that they could approach the registered manager if they needed support or guidance. Relatives said that they were always welcome at the service. The registered manager carried out regular checks and audits of the service and worked with the provider to achieve positive outcomes for people who used the service.

At this inspection the service had made the required improvements. We found no breaches of regulations and the service was meeting the legal requirements. The premises were safe and the registered manager carried out regular premises checks to ensure all aspects of health and safety were being met. People’s care plans reflected their individual needs and risks were assessed. The registered manager had reviewed and updated all of the policies and procedures to make sure they reflected current legislation.

Seahaven Care Home is a ‘care home’ located in South Shields. People in this care home receive accommodation and 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. Seahaven Care Home accommodates people in one adapted building and on the date of this inspection there were 16 people living at the home.

There was a registered manager in post who has been registered with the Care Quality Commission (CQC) to provide regulated activities since December 2017. 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 told us that they felt safe at the home and relatives agreed with these comments. We found there were policies and procedures in place to help keep people safe. Staff had received training and attended supervision sessions around safeguarding vulnerable adults.

Staff were safely recruited, had appropriate checks, references and they were provided with all the necessary induction training required for their role. The registered manager continued to provide on-going training for staff and monitored when refresher training was required. Accidents and incidents were recorded correctly and if any actions were required, they were acted upon and documented.

The premises were safe. Regular checks of the premises, equipment and utilities were carried out and documented. On the first day of inspection the la

Seahaven Care Home is a residential home which provides personal care for up to 28 people. There were 21 people living there at the time of our inspection, some of whom were living with dementia and mental health needs. The accommodation is over three floors.

A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 previous inspection in October 2016, we identified breaches of regulation 12, safe care and treatment, regulation 17, good governance and regulation 18, staffing. The provider had not fully assessed the risks to the health and safety of people who used the service. The provider failed to ensure that the premises were safe to use for their intended purpose. We found the provider did not appropriately manage the deployment of staff at meal times to ensure people received dedicated support when they needed it. The provider did not have effective systems in place to assess, monitor and improve the quality and safety of the service provided. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this unannounced focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. The inspection was also prompted in part following concerns raised regarding staffing levels, staff’s ability to manage behaviours that may challenge, care practices, environmental issues and governance within the service. This report covers our findings in relation to these issues and the three key areas of safe, effective and well led.

During this inspection we found the provider had made improvements in some areas. However, we found the provider had not completed all the actions set out in their action plan. We found there were continuing breaches of regulations. This was because the provider had not adequately assessed the risks to the health and safety of people who used the service, plans to mitigate risks and to provide personalised care were not specific to the identified risk. Policies and procedures had not been reviewed.

The provider had not ensured staff had appropriate training to support people using the service. Staff supervisions and appraisals were planned and some had taken place. However we noted that some staff supervisions were not taking place in line with the provider’s own policy of six times a year.

Areas where substances that are hazardous to health were being used were left unlocked. The premises continued to require refurbishment and repair.

People’s personal care records were not always stored securely. Personal hygiene charts were being used, these were not personalised and appeared to be more of a list of tasks to be completed and ticked off.

Records relating to food and fluid intake were not totalled or reviewed.

The provider's quality monitoring processes were not always effective in identifying areas which required improvement.

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

Access to the stairs had been addressed to ensure people were safe. Key pads were now in place.

The carpet in one person’s room had been made safe.

Staffing levels had been reviewed and increased on night duty. Plans were in place to increase the levels of staff on day duty.

The provider had taken the smoking room out of use. Alternative arrangements had been made for people who wished to smoke to do so outside with appropriate shelter.

We found the provider had obtained pictures of food to develop the pictorial menu. The provider had added sensory equipment to one of the lounges to support people living with dementia. People were being supported with eating and drinking in a dignified manner.

Staff were aware of people’s needs and could explain how they supported people.

Despite our findings and identified shortfalls, people and relatives were happy with the care and support they received. Comments were very positive about the care home and the staff.

We have carried out two inspections including this inspection over a period of 15 months. We rated the service as requires improvement at our inspections in March and October 2016 and identified two breaches in March 2016 relating to fit and proper person and good governance. At our inspection in October 2016 we found breaches which related to safe care and treatment, staffing and good governance.

At this inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to regulation 12, safe care and treatment, regulation 18, staffing and regulation 17, good governance.

Seahaven Care Home is a residential home which provides personal care for up to 28 people. There were 17 people living there at the time of our inspection, some of whom were living with dementia. The accommodation is over three floors.

A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last inspected the home on 30 and 31 March 2016 and found the provider had breached the regulations for safe care and treatment, good governance and recruitment. Following the inspection we issued a warning notice to the provider.

At the last inspection we found that the registered provider did not have accurate records and procedures to support and evidence the safe administration of controlled drugs, when required medicines and prescribed creams. We found people were not always protected from the risk of infection. Thorough background checks were not always carried out before staff started working at the service, which left people vulnerable to the risk of the provider employing unsuitable staff. The provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure people received appropriate care and support.

During this inspection we found the provider had made improvements in some areas. However, we found the provider had breached Regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider had not fully assessed the risks to the health and safety of people who used the service and taken reasonable steps to mitigate such risks. The provider's quality monitoring processes were not always effective in identifying improvements. Staff deployment at meal times was not managed appropriately. We have made a recommendation about the specialist needs of people living with dementia.

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

Infection prevention and control measures had improved although this area did not form part of the registered manager’s quality assurance checks. There were adequate supplies of alcohol hand gel, hand wash, paper towels and disposable gloves and aprons and waste bins in bathrooms were pedal operated to reduce the risk of infection spreading. Additional infection control measures were detailed in people’s care plans where appropriate.

Medicines management had improved. Medicines were stored securely and managed safely and effectively. People received their prescribed medicines when they needed them. Prescribed creams were administered in the right way and at the right frequency, in line with the instructions on people's prescriptions.

Staff understood their safeguarding responsibilities and told us they would have no hesitation in reporting any concerns about the safety or care of people who lived there. Records confirmed staff received regular supervision sessions and an annual appraisal to discuss their performance and development.

People’s meal time experience was inconsistent. Meals were served individually rather than by table which meant some people had their meals whilst others on the same table had to wait. Some staff had little interaction with people they supported to eat while others explained what they were doing.

The provider followed the requirements of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been authorised for relevant people.

The registered manager told us all staff training had been reviewed after the last inspection to identify where further training was needed. All outstanding training was due to be completed by the end of 2016 and we saw arrangements had been made to achieve this. Staff had completed updated training in a number of key areas since the last inspection.

Most people gave us positive feedback about their care. They told us most staff were kind and caring. One person said, “Staff treat me nicely. They’re very considerate.” A relative told us, “Staff are very good with [family member] and me. I wouldn’t have [family member] anywhere else. It suits our purpose. It’s the right style of place for us. Staff make time to talk to [family member] even though they are not responsive.”

A member of the community nursing team who visited the service during our visit told us, “The staff are very conscientious and are up to date with residents’ needs. Staff know everything about the residents and have good communication with the families. Residents are clean and well looked after.”

Care records had improved since the last inspection and contained detailed information and guidance about how to support people based on their individual health needs and preferences. Individual hygiene sheets had been introduced since the last inspection which was more person-centred. Care records were reviewed and updated regularly or when people's needs changed.

People we spoke with told us if they had a problem or concern they would speak to staff. Relatives we spoke with knew how to make a complaint.

Staff meetings were held regularly and staff told us they had enough opportunities to provide feedback about the service.

People, relatives and staff told us they felt the service was well-run by the registered manager. One person told us, “[Registered manager] is so good. She’s really lovely and the deputy is.” Staff told us the registered manager was approachable and they could speak to them at any time.

The provider's quality monitoring processes had led to some improvements since the last inspection, but there were still areas for improvement.

Seahaven Care Home is a residential home which provides personal care for up to 28 people, with dementia or general care needs. There were 20 people living there at the time of our inspection; six of whom were receiving short term care. The accommodation is over three floors.

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.

We found the provider had breached Regulations 12, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider did not have accurate records and procedures to support and evidence the safe administration of controlled drugs, when required medicines and prescribed creams. We found people were not always protected from the risk of infection. Thorough background checks were not always carried out before staff started working at the service, which left people vulnerable to the risk of the provider employing unsuitable staff. The provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure people received appropriate care and support.

We have made a recommendation about meal times.

People received their medicines when they needed them. Records of prescribed daily medicines were completed accurately.

People, their relatives and staff felt the service was safe. One person said, “I feel safe here.” A relative told us, “[Family member] is safe and very happy here.” Staff told us if they had any concerns about safeguarding issues they would report it immediately. Staff told us they had confidence in the management team to follow up safeguarding concerns properly.

People told us they were happy with the food which looked healthy and appetising. People’s health needs were assessed and monitored, and staff contacted relevant health care professionals when necessary. A visiting health care professional told us, “Staff come with me to observe and my recommendations are followed well by the staff.”

People and relatives spoke positively about the staff. One person told us, “The staff are good, they look after me well.” A relative said, “I can’t fault the staff here. They are all brilliant from the manager to the cleaners. They know how to look after [family member], much better than I could.” People were treated with respect and their independence was promoted. There were positive interactions between staff and the people who lived at the service.

Care plans we viewed were well written and contained specific guidance on how staff could care for a person in the way they needed and wanted. Care plans were reviewed regularly and when people’s needs changed. People had access to a range of activities and the opportunity to go on outings in the local area.

People, relatives and staff gave us positive feedback about the registered manager. They told us the registered manager was approachable and always willing to listen and help. One staff member told us, “They’re brilliant, so approachable.” Staff told us Seahaven was a nice place to work and there was a good atmosphere.

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

A single inspector carried out this inspection.The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found.

The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:

Is the service safe?

We saw that risks to people's safety had been identified and assessed to ensure that appropriate care and support was provided to keep them safe. Relatives told us they were confident people were safe. One said, 'My mother likes the staff and feels safe as you could get.' Another relative told us, 'They treat my wife really well. I come every day at different times and everything is always the same.'

We found that people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk. Staff were confident about the action they should take if they believed anyone was at risk of abuse. The evidence we found showed people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We spoke to the manager and staff who told us that they had undertaken training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). (These are safeguards to ensure care interventions do not deprive people of their liberty and that decisions are made in the best interests of the person).The manager told us that one person, who lacked capacity to make decisions, was currently under a DoLS authorisation to maintain their safety. The manager expressed an understanding of the procedures and principals of this legislation. Following a recent court ruling regarding depriving people of their liberty in care settings the provider may wish to review the living arrangements of individual residents, to identify where their circumstances may amount to a deprivation of liberty, according to the revised definition.

Staff were provided with the training and support they needed to ensure people received caring and consistent support. The provider carried out checks to ensure people were treated well. Relatives were asked for their feedback and felt listened to by the service.

Is the service effective?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We found that people who used the service were receiving the care and support they needed. The staff we spoke with could describe how they met the assessed needs of the people they were providing care and support to. Relatives and health and social care professionals told us people received good and appropriate care.

Relatives acting on behalf of people using the service were given appropriate information and support regarding their relative's care and treatment and understood the care and treatment choices available to them.

Support for staff was provided through training, supervision and appraisal. The staff we spoke with confirmed they received supervision and appraisal, during the previous 12 months.

We found that the provider did not have a robust system of quality audits in place to identify gaps in care records and take appropriate action to address these gaps. Although the provider logged relevant information, such as details of incidents, accidents and complaints, we did not find evidence that this was analysed to identify trends and patterns in order to improve the care that people received.

Is the service caring?

People said they received good care. One person said, 'The care staff are good and nothing I ask of them is too much trouble.' Another person said, "It is like home from home.' Family members told us that staff treated their relative with affection. They said, "The staff are caring', and, 'They take time to talk and explain things to you".

Our observations during our inspection confirmed that staff delivered care in line with people's care plans. We saw that staff were attentive, kind and gentle whilst delivering care and continually explained to people what they were doing.

Is the service responsive?

We observed that staff provided personalised care and they respected people's choices and wishes. Those people who needed a 'mental capacity assessment' or a 'best interest's decision' had these made by the right people. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People and their families were encouraged to be involved in decisions about their care and treatment. A relative told us, 'My relative is really happy there.' Relatives participated in regular reviews of their relative's care and felt that the service responded to any concerns or issues. One relative commented, 'They (staff) keep us informed. We feel free to speak with them. We always have done. If we have had concerns, they've always done something about it'.

Is the service well led?

Staff were confident that if they were to raise any safeguarding concerns, these would be taken seriously by management.

The provider had ensured staff received appropriate training and support, which meant staff were motivated and professional in the way they carried out their work.

Systems were in place to communicate with people. Relatives were regularly involved and consulted about the service to ensure any issues were promptly addressed.

You can see our judgements on the front page of this report.