The inspection took place on 25 and 26 May 2016 and was unannounced. The service was last inspected on 8 May 2014, when we found they were meeting the regulations. The registered manager had been in post for thirteen 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.
The service provides accommodation, nursing and personal care for up to 51 older people, who may have dementia. Fifty people were living at the home at the time of our inspection.
People were at the heart of the service. People, relatives and staff told us they felt like family because of the love and care they all felt from, and for, each other.
People were cared for and supported by kind and caring staff, which made them feel special. Relatives were inspired to become volunteers at the home so they could give back some of the kindness and support they had received.
Relatives felt welcomed at the home and shared in caring for their relations. Staff were valued for their contribution to making people’s experience of the service the best it could be. Staff were proud to work at the home and pleased with the thanks and compliments they received.
The end-of–life care people received was as personalised, caring and supportive as a specialist hospice service. Health professionals and relatives complimented the service on the end–of-life care that the whole staff team delivered.
The provider’s philosophy, vision and values were understood and shared across the staff team. People’s opinions and suggestions were respected and used to improve the quality of the service.
The registered manager was a role model for staff who were all inspired and motivated to deliver the highest quality service. The provider, staff and relatives respected the registered manager’s professionalism and recognised their leadership was inspirational.
The registered manager shared their professional knowledge and experience with staff and implemented innovative methods to ensure all staff understood how they contributed to people’s experience of the service.
The registered manager worked with educational and research organisations to improve the quality of people’s treatment. The quality of care and treatment at the home was sufficiently well recognised that it was a university approved training establishment for nurses.
People received effective care, support and treatment because staff had training, skills and knowledge that was relevant to people’s needs. Healthcare professionals were complimentary about the quality of care and praised the effectiveness of people’s treatment. The staff worked as a team to support people with their health and social needs and staff understood how to improve people’s sense of well-being.
All the staff were supported to maintain their professional development by the registered manager. Staff were encouraged to reflect on their practice and to develop their skills and knowledge, which improved people’s experience of care.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). For people who were assessed as not having the capacity to make all of their own decisions, records showed that their families, legal representatives and healthcare professionals were involved in making decisions in their best interests.
Risks to people’s nutrition were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs and staff supported people to maintain a balanced diet.
Staff monitored people’s appetites, moods and behaviours and referred them to other healthcare professionals when their needs or abilities changed. Staff ensured people obtained advice and support from other healthcare professionals to maintain their health.
People and their families were involved in planning their care, to ensure their care plans matched their individual needs, abilities and preferences. Care staff showed understanding in caring for people, because they understood people’s individual motivations and responses.
People were supported maintain their important relationships and their personal interests. Staff supported and encouraged people to celebrate important personal and national events. People were encouraged and supported to attend exercise and activity sessions. Entertainments were provided at the home that people remembered with pleasure.
There were enough staff on duty to meet people’s physical and social needs. The registered manager checked staff’s suitability to deliver personal care during the recruitment process. The premises and equipment were regularly checked to ensure risks to people’s safety were minimised. People’s medicines were managed, stored in their own rooms and administered safely.
Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. Staff understood the risks to people’s individual health and wellbeing and risks were clearly recorded in their care plans.