This inspection took place on 10 May 2017 and was unannounced.The home is situated in a semi-rural area of Solihull, West Midlands. It is part of The Foundation of Lady Katherine Leveson and provides accommodation and personal care for up to 30 older people. On the day of our visit there were 26 people living in the home.
Communal areas included a large lounge area, a dining room, a room where people could follow their interests and hobbies, a small shop and a library. The home also had large well maintained gardens.
A registered manager who had over 30 years of experience in health and social care had been in post at the home for two years. 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 received exceptional feedback about how the service was personalised and responded to people's individual needs. It was clear that significant improvements had been made since our last inspection. People always received care which was in line with their wishes and preferences. People worked in partnership with the staff to plan their care which meant staff had an in-depth knowledge of people's preferences and support needs.
Clear values and vision for providing high quality care for people was embedded throughout the home. People received a high standard of care because the enthusiastic, passionate and caring management team led by example and set high expectations of staff about the standards of care people should receive.
People told us the hard work and determination of the management team to continually make improvements had a positive impact on their quality of life. There was a strong emphasis on continually looking for ways to improve the service people received. There was an open and transparent culture and the management team were responsive to people's feedback and used this to develop and improve the service. People felt listened to and informed of what was happening in their home. They told us the communication between them and the staff was very good and they felt assured any complaints would be taken seriously and acted upon.
The ethos of the home is to offer care, comfort, nurture, respect and dignity within an environment which is both safe and stimulating. It was clear that the provider, registered manager and staff embraced this ethos and the on-going improvement to all people's lives and well-being was a fundamental aim of this service. People mattered and all staff spoke with pride about the people they cared for and celebrated their individual achievements. Staff understood their roles and responsibilities and were continually supported to increase their knowledge and skills to improve their work practices. Staff received recognition for their work and they felt supported, empowered and valued in their roles.
Staff continually embraced people’s individual lifestyle choices in line with the provider’s vision which included making people feel valued. Staff encouraged people to maintain or develop interests which were important to them and to support them to lead meaningful lives. People maintained positive links with their community that enhanced and benefitted their lives. People spoke very positively about the social activities that were available to them. Staff spoke passionately about the importance of activities being outcome based and meaningful to people. This approach to activities was innovative, person centred and inclusive.
People's religious and spiritual needs were always recognised and embraced which meant people continued to practice their religion how they wished to do so. Whilst the service was part of a Christian foundation the home demonstrated it welcomed people’s differing and diverse cultures.
Audits and checks took place to monitor and review the quality of the service. Accidents and incidents were analysed to identify any patterns or trends to reduce the likelihood of further incidents occurring.
People told us they felt safe living at the home and procedures were in place to protect them from harm. The home demonstrated it was actively involved in raising awareness of adult abuse in their local community. Staff were aware of their responsibilities to keep people safe and reporting any concerns to their managers. Clear risk assessments and management plans contained guidance to support staff to keep people safe when they were providing care. Staff were knowledgeable about the risks and confidently explained in detail how people's support needs varied according to their abilities and preferred routines. The provider's recruitment procedures minimised the risks to people safety.
People spoke positively about the way their medicines were administered by the staff. Safe administration systems were in place and people received their medicines when they needed them.
The home had established effective links and worked in partnership with local health and social care professionals to ensure people had the care and support they needed. People's changing needs were monitored to make sure their health needs were responded to promptly.
Everyone we spoke with provided positive feedback about the food and dining experiences at the home. Staff were aware of people's dietary requirements. People's nutritional needs were assessed regularly. Where people had risks associated with eating and drinking advice had been sought from external health professionals and guidance had been followed.
Staff were available at the times people required to meet their needs and preferences. People told us the staff were always caring and showed them kindness. All of the staff told us they really enjoyed working at the home, and they loved spending their time with the people who lived there. Most staff had worked at the home for a long time and this ensured continuity for the people who lived there. Staff were not rushed and they showed genuine interest for people’s well-being and spoke about them with warmth and affection throughout our visit. Staff continually engaged with people to get to know them and they turned care tasks into opportunities to hold meaningful conversations with people.
The staff team demonstrated their commitment to respectfully maintain people’s dignity and continually supported people to maintain and regain their independence. A thoughtful approach was taken to overcoming barriers to inclusion and staff continuously looked for ways so people could remain as independent as they wished to be.
The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Consent to care was sought in line with legislation and guidance. Mental capacity assessments had been completed and where people had been assessed as not having capacity, best interest decision meetings had taken place and the outcomes were clearly recorded.