Charnwood Country Residence

People’s experience of using this service: The provider continues to provide an outstanding service for people. The provider and management team were extremely good at planning and delivering care that was tailored to people’s individual needs and preferences. Care plans and transition programmes for moving into the service were developed for people, which were very comprehensive and met their needs in a truly personalised way. There was a thoughtful and inclusive approach to organising interesting and meaningful occupations and activities for people, which enhanced the quality of their lives. The provider employed a physiotherapist to support people enhance their mobility and an Admiral Nurse (who specialises in dementia care) to provide support and guidance to people living with dementia.

The provider had exceptional leadership qualities and had developed a culture of continual improvement and learning to ensure people received a quality service. The provider has six services; five have been rated Outstanding by the Care Quality Commission (CQC) and one rated Good. The provider developed creative and positive learning experiences for staff, which enhanced their skills and encouraged them to have a thoughtful approach when supporting people. There was a supportive organisational structure and excellent monitoring systems to ensure the provider and senior management knew what was happening in the service. There was a registered manager but due to specific circumstances, a new manager had been appointed and was completing a transition period with the support from the provider.

Staff had developed very positive and meaningful relationships with people. The care provided was compassionate and sensitive to people’s diverse needs. People were respected, were included in decisions and their privacy and independence maintained to a high standard.

People felt safe and could raise concerns. The staff team knew the action to take to safeguard people from the risk of harm and abuse. They supported people to take managed risks and enabled them to live the lifestyle of their choosing. Staff were recruited safely and deployed in sufficient numbers to meet people’s needs.

People’s health and nutritional needs were proactively met. They were supported to take their medicines as prescribed and had access to health professionals when required. The menus provided people with a nutritious and healthy diet, whilst still ensuring there were treats and snacks in-between meals. The provider ensured they worked within mental capacity legislation when people had been assessed as lacking capacity to make their own decisions. When they were able, people were supported to make their own decisions about the care they received. Staff had a good understanding of consent and gave examples of how they obtained this before carrying out care tasks.

Staff received training, supervision and support that helped them to feel confident when supporting people. The environment was very clean and tidy and was suitable for people’s needs.

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

Rating at last inspection: Outstanding (report published 21 July 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Charnwood provides accommodation and personal care for up to 27 people. At the time of our inspection there were 20 people living at the home.

There was 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 and associated regulations about how the service is run.

The service provided excellent and innovative person centred care that maintained people’s health and wellbeing. Staff supported people to maintain interests and hobbies, promoting people’s abilities and skills.

People were consistently treated with dignity and respect. People had good positive relationships with staff. The provider supported people to promote dignity and respect to the wider community and worked to challenge people’s perceptions of age and dementia.

Staff were motivated and had good levels of support as well as extensive and on-going training to enable them to meet the individual needs of people living at the home. There were sufficient numbers of experienced and well trained staff to ensure people were supported safely and people’s health needs responded to quickly. Medicines were managed safely and people received their medicines in line with their prescription.

The service responded effectively to people's needs and preferences. People were supported by a service that was focused on getting to know the people they supported. Relatives told us the service was responsive and well managed. People and relatives knew the registered manager and the provider. People were encouraged to be actively involved in the running of the home through regular meetings. They felt that if they had any concerns they were able to speak with the registered manager or provider. The provider welcomed people's views and opinions and acted upon them.

People felt safe and knew how to raise concerns. Staff felt comfortable to raise any concerns about people’s safety and understood about how to keep people safe. Staff supported people to take positive risks. Where risks had been identified risk assessments were in place and action had been taken to reduce the risks.

People enjoyed the food and had the support they needed to enjoy their food and drinks safely. People were able to make choices about the food and drink they wanted. There was a choice of freshly prepared nutritious food and where additional monitoring and support was needed this was provided.

People's health needs were monitored and changes were made to people's care in response to any changes in their needs. People had access to other health professionals and were referred to them by the registered manager if there were any concerns about their health needs.

The provider was innovative in the use of new technology and adaptations to minimise the impact of dementia on people’s independence and wellbeing.

There were a range of audits and checks to make sure that good standards of care and support were maintained. Feedback from the people and relatives was gathered on a regular basis and where any actions were identified theses were actioned quickly.

There were strong links with the local community that promoted positive approaches to the people that lived there.

Charnwood Country Residence is registered to provide accommodation for 22 people who require personal care. On the day of our visit there were 21 people using the service. The registered manager named on the front of this report was not in post and not managing the regulatory activities at this location at the time of the inspection. The current manager is in the process of registering with the Care Quality Commission.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at.

Is the service safe?

People told us that they felt safe. Individual risk assessments were well completed and actions to minimise the risks identified were reflected in care plans. Service wide risk assessments, together with the actions to reduce those risks, were reviewed regularly.

Appropriate systems and processes were followed with regard to the Mental Capacity Act 2005. Staff had received training in relation to this and were clear about their role and responsibilities.

The provider had systems and processes in place to ensure that medicines were obtained, administered and disposed of safely. This ensured that people were protected from the risks associated with the unsafe use and management of medicines.

Is the service effective?

People told us that they had consented for the care that was detailed in their care plan. This was documented in their care records. One person told us, 'The staff ask me if it is OK before they do any personal care.' There were systems and processes in place for making decisions in people's 'best interest' where they were unable to consent for themselves. This conformed to legal requirements.

People's needs were assessed and care plans developed. People told us that they had been involved in developing their care plan. Care plans reflected both the needs and wishes of people. Staff had a good knowledge of people's care needs

Staff had access to a range of relevant training to meet the needs of the people they cared for. Policies and procedures were appropriate, up to date, and reflected current research and guidance.

Is the service caring?

People told us that the staff were kind and compassionate. One person told us, 'The staff are very kind and caring.' Another told us that, 'The staff care about how I feel and make sure I am happy.' We observed staff treating people in a friendly and caring way. People told us that the staff had time to support them to attend activities, to go out or just to chat. One person told us, 'Nothing is too much trouble.'

Is the service responsive?

An annual customer satisfaction survey was undertaken. An analysis of the results of this survey was shared with people who used the service, their families and the staff at Charnwood. There was an action plan to address the minor issues raised in the survey. People who had raised specific issues had received an individual response from the proprietor.

People who used the service and staff were clear about the complaints process. People told us they were confident that any issue raised, or complaint made, would be thoroughly investigated and acted upon. A family member told us that, 'Whenever I raise an issue it is always dealt with immediately.'

People had access to a wide range of activities. A list of arranged activities was circulated weekly. A member of staff was employed to coordinate the activities. People told us that the activities were interesting and varied.

Is the service well-led?

Staff we spoke with told us they felt well supported by their manager. Staff said they were able to raise issues with their manager at any time and were confident they would be acted upon. Staff had opportunities to raise and discuss issues at staff meetings and at supervision sessions.

Staff had received training about reporting poor practice and 'whistle blowing'. Staff were confident about how to escalate concerns should the need arise.

Audits were undertaken and the results used to improve the service. Action plans clearly identified who was responsible for implementing any change required.

We saw that staff were patient and caring when they supported people. Care plans showed that people's needs had been assessed, and these assessments had been regularly updated.

People told us that they liked the food at the home. We saw that lunch was an appetising meal and that people were enjoying their mealtime. Staff were monitoring food intake for people at risk of weight loss.

There were sufficient staff on duty to meet people's needs. Staff received a range of training to equip them with the skills and knowledge they needed to provide support to the people living at the home.

We saw that staff were respectful and kind to people. People told us that the staff were "wonderful, always ready to help" and "you couldn't find better staff anywhere". People told us that staff always responded promptly to any requests. We saw that staff were taking time to make sure that people understood what was said to them. Staff were very attentive to people's needs.

We saw that people were being encouraged to be as independent as possible. People told us that they enjoyed the activities at the home. Care records were detailed and gave staff the information they would need to provide support for people. People's needs and preferences were clearly recorded and staff showed a good knowledge of each person's needs, and their likes and dislikes.

People described the home as "a lovely place" and "so homely and friendly". They told us that they were confident that the staff would take care of their needs. People said that they felt safe at the home. Records showed that staff had received a range of training to support them in their roles.

People told us that they knew who to talk to if they had any concerns about the service. One person said "I'd be happy to talk to any of them if I needed to".