The inspection was carried out by a CQC inspector. We spoke with four people who used the service and four visiting relatives. We gained information about the service from reviews of records held at the care home and discussions with the provider, registered manager, four care workers and the activities co-ordinator. The views expressed directly to us by people who used the service were limited to varying degrees by their experience of health conditions that affected their understanding and communication. Below is a summary of what we found.Is the service safe?
All of the relatives we spoke with told us they trusted service staff and had not had any reason to raise concerns about the care provided. One person said, '(My relative) is safe here.' Another told us, 'I am very observant and will tell them straight if I have any problems or complaints.'
Staff understood how to recognise and report any concerns they might have about people's safety. We saw staff received training in the protection of vulnerable adults and had the skills and knowledge required to ensure people's health and safety in areas such as moving and handling.
We looked at systems to ensure people's health and safety including accident and incident reporting and the management of fire risk and evacuation. We saw these issues were monitored and reviewed on a regular basis.
We saw the care people received was safe because staff understood people's right to choose how their care was provided. Where this was not the case, as a result of a diagnosed condition such as Alzheimer's disease, there were systems in place to ensure valid consent was sought and provided.
The manager understood their legal duty and knew how to refer people who might be at risk of receiving inappropriate care, for independent assessment under a law called the Deprivation of Liberties Safeguards (DoLS).
Is the service effective?
Relatives told us they were happy with the service provided. One told us the care home was, 'The best (their relative) had been in.'
People's needs were assessed prior to moving to the care home and were reviewed regularly. We saw people's care was more likely to be effective because it was planned based on their individual needs.
Staff told us the way people's care was planned helped them to understand people's needs and provide effective care.
We saw from records, conversations and observations during our visit that staff provided care effectively and in the ways described in people's plans of care.
Is the service caring?
People told us they found service staff to be kind and caring. One relative said the, 'Staff were all friendly and helpful.' Another said whenever they visited they found
their relative and other people who received care to be, 'Relaxed and happy.'
We observed staff interacting with people in a warm and caring way. We heard laughter and singing during our visit and noted staff working to provide care to people with patience and in ways that protected their dignity.
We saw from a comments book and a recent survey of people's opinions that most of those who contributed praised the attitudes of staff. Recent comments included, 'Thanks for the wonderful care.' And, 'It's a pleasure to come and see my (relative).'
Care records we looked at included information about people's lives and families. They conveyed a sense of what was important to the person. We saw these wishes reflected in the way activities were organised and the way care was provided.
Is the service responsive?
People told us staff were approachable and responded positively to requests for information or help. One relative told us, 'Staff and the manager are always available.' Another said that when they had issues they needed to discuss, 'Staff give you an answer.'
The activities co-ordinator told us they were provided with the materials and support to offer a programme of activities that included everybody who received a service and reflected people's interests and wishes. They said if they asked for extra resources the manager and owner responded positively. Staff we spoke with told us colleagues were positive in helping others. During our inspection we noted care workers helping with recreational activities people were enjoying.
We noted from care records we looked at that concerns raised about people's health and welfare were addressed quickly and effectively. Medical support to ensure regular and responsive health care included a weekly GP surgery provided at the care home by one local GP practice.
Is the service well-led?
Staff we spoke with said they enjoyed their work and felt well supported by the manager of the service.
Staff told us about initiatives to encourage people's families and friends to visit and join in activities at the care home. Activities have included family teas and the hosting of wedding anniversary celebrations for people who used the service, their partners and families. One member of staff told us the manager was very good at engaging and encouraging family involvement. We saw that each year family's views about the quality of the service were sought through the circulation of a questionnaire.
We found that the service consistently monitored and reviewed its own practice in order to ensure the care home was a safe place for people to live and a good place to work.