St Winefrides Residential Home

St Winefrides Residential Home is a large, detached, older style property situated close to the town centre of Littlehampton. It is registered to provide accommodation and care for up to 24 older people living with dementia. At the time of our inspection there were 22 people living at the home. Communal areas included a large sitting room, a lounge used by people wishing for a quieter environment, known as the 'quiet lounge'. The 'quiet lounge' overlooked the garden to the rear of the property. There were sitting areas in the corridors to allow people to sit and rest when needed. The home had a dining room.

People’s experience of using this service:

People received exceptionally high-quality person-centred care that exceeded their expectations. The management and staff team went above and beyond to ensure that people’s care and preferences met their expectations, with people’s wellbeing and independence being at the heart of the home. Activities for people were innovative and highly regarded by people and relatives. The home went the extra mile to ensure that people were involved in their community and empowered in the planning of activities to reduce social isolation and improve well-being. A relative told us, “The staff are attentive to everyone needs and are proactive in engaging with people.”

People told us they felt safe and knew who to contact if they had any concerns. Systems supported people to stay safe and reduce the risks to them. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There was sufficient staff to support people safely and the registered manager had safe recruitment procedures and processes in place.

Staff were trained in administering medicines and people were protected by the prevention and control of infection. Staff wore gloves and aprons when supporting people. Staff completed training that reflected people’s varied needs and staff were experienced in their roles to provide effective care to people. Staff received regular supervisions and an annual appraisal.

People's risks were identified and assessed appropriately, they were supported to maintain their health and had support to access health care services when they needed to. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received kind and compassionate care. People and relatives told us staff treated them with kindness and we observed friendly interactions throughout the inspection. People were comfortable in the company of staff. Staff felt supported and confident that any suggestions or concerns would be listened to and acted upon. People and relatives were asked for their feedback about the home through meetings, care reviews and surveys. A range of quality assurance systems measured and monitored the quality of care and the home overall.

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

Rating at last inspection: Good (report published on 9 February 2017).

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated Good.

St Winefrides Residential Home is a large, detached, older style property situated close to the town centre of Littlehampton. It is registered to provide accommodation and care for up to 24 older people living with dementia. At the time of our inspection there were 19 people living at the home. Eighteen bedrooms were of single occupancy and three were shared. Communal areas included a large sitting room, a lounge used by people wishing for a quieter environment, known as the ‘quiet lounge’. The ‘quiet lounge’ overlooked an accessible garden to the rear of the property. There was also sitting areas in the corridors to allow people to sit and rest when needed. The home also had a dining room.

The service had two registered managers in post. 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 and associated Regulations about how the service is run. Both registered managers were available on the day of our inspection.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People told us they felt safe at the home.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Accidents and incidents were accurately recorded and were assessed to identify patterns and triggers. Records were detailed and referred to actions taken following accidents and incidents.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

There were sufficient staff to meet people's needs and keep them safe. The registered manager used a dependency tool to determine staffing levels. This information was reviewed following falls or changes in a person's health condition, which might increase, or change people's dependency level.

Safe staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

Staff had received a range of training and many had achieved or were working towards a National Vocational Qualification in Health and Social Care. Staff attended supervision meetings with the registered manager at least six times per year.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The members of the management team and care staff we spoke with had a full and up to date understanding of the MCA and DoLS. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

People had sufficient to eat and drink and were offered a choice throughout the day. They had access to a range of healthcare professionals and services.

The home had been decorated and arranged in a way that supported people living with dementia.

Staff were caring, knew people well, and treated people in a dignified and respectful way. Staff acknowledged people's privacy and had developed positive working relationships with people. Relatives spoke positively about the staff at St Winefrides Residential Home. Staff listened and acted on what people said and there were opportunities for people to contribute to how the service was organised.

Care plans provided staff with detailed and comprehensive information about people, their likes, dislikes, preferences and how they wanted to be cared for. A range of activities was planned that met people's interests and facilitated their hobbies. People had access to the community, supported by staff.

Complaints were listened to and managed in line with the provider's policy. In the past 12 months, there had been no formal complaints.

People and their relatives were involved in developing the service through meetings. People, relatives, healthcare professionals connected to the service and staff were asked for their feedback in annual surveys. Staff felt the registered managers were very supportive and said there was an open door policy. Relatives spoke positively about the care their family members received.

Quality assurance systems were in place to regularly review and improve the quality of the service that was provided.

We spent 30 minutes watching care and support provided to four people who sat in the lounge waiting for lunch to be served. People were falling asleep in their chairs. Two people were watching television and talked to each other. The atmosphere was calm and relaxed. A member of staff was present throughout this period. They sat with people whilst writing in records.

We also spoke with a relative who was visiting the care home. They confirmed they were very satisfied with the care provided. For example they told us,” The care is good. The staff know what they are doing. I believe they are competent.”

We also gathered evidence of people's experiences of the service by looking at a selection of records and talking with members of staff. We found that people's care needs were being managed safely by the service and that staff had a good understanding of their roles and responsibilities.

We spent 30 minutes watching care and support provided to five people when they were being served coffee and tea during the morning. We found that people had positive experiences. We were informed that a Christmas party had been organised the evening before by the provider for people, their relatives and for staff. This meant that people we observed were quiet and were falling asleep. The care staff on duty knew what support each person needed and they respected their wishes if people wanted to be left on their own.

As we were unable to speak to people using the service, we gathered evidence of people's experience of the service by reviewing the comment and complaints log. We found that people's experiences were positive. A relative commented, "We are very grateful that our relative came to St Winefrides and they were looked after so well." A second relative commented, "All the staff seemed to genuinely care about my relative's welfare and went out of their way to make sure my relative was happy."