The unannounced inspection was on 22 February 2012 and took place over four hours. There were six people living at Redstones and two staff members on duty, which included the manager/owner. We spoke with five people living at the home, which included visiting people in their individual rooms or in the lounge. The sixth person had a hospital appointment so we were only able to speak to them briefly. We also spoke with the manager about their role and how the home was run.We looked at records relating to medication, training, complaints and quality assurance. We also looked at the care records for two people. The manager also sent us completed provider compliance assessments for the essential standards. We asked about risks and how these were managed. The manager told us there was no one living at the home with a pressure sore, no one with moving and handling needs, and there was nobody needing support because of unplanned weight loss, incontinence or dietary needs. Currently there is no one living at the home with dementia. The manager told us that people living at the home did not have high care needs and this was reflected by there being no waking night staff on duty.
Five people told us about the day to day decisions that they made. For example, what time to get up and go to bed, how help with personal care was provided, what they ate and how they spent their time. Two people told us that the manager really listened to their views and involved them in decisions, for example regarding their health.
Five people told us that they were well cared for and had access to health professionals when they needed them. This reflected people's positive feedback in their surveys, which were sent out by the manager in 2011.
People told us that they had the opportunity to visit before moving in and we saw assessment records in place for individuals. These showed that the manager assessed people's care needs to ensure that the service could provide them with the appropriate support. Five people said they had been asked about their preferences, for example food, and felt involved in the assessment process. People told us that staff were clear about their likes and dislikes and that a choice of meals was offered.
Five people told us how they kept up their individual interests, such as embroidering, reading or crosswords. People told us they valued being able to hold onto their independence, such as going to collect their newspaper, and to go out with friends and family. During our visit, one person went out with a relative for lunch.
People told us that their medication was well managed, and they could request pain killers when they needed them. We saw from risk assessments that people had the option of self-medicating but had chosen not to, which people confirmed. We saw that people were given their medication and that people made a decision when to take it.
Five people told us that they were happy with the way that they were cared for, and described a friendly and homely atmosphere. One person described the manager as 'very thoughtful'. Two people could tell us about the type of care that the home could provide and told us that they were aware of the lack of waking night staff but that this had not been problematic.
We asked people if they were asked their views on the service provided. People told us that there were residents' meetings, and we saw the minutes for these. People said that generally discussions took place informally as it was a small home and that the manager would come to see them individually. They said one of the main topics was food. In surveys, we saw very positive comments about the quality of the food and the choice available, which reflected our conversations with people.
After the inspection, the manager confirmed by e-mail and in a telephone conversation that the medication practice had been improved. She explained how a medication error had happened and how it had been resolved on the same day. She also confirmed that all staff will attend a refresher medication training course, and advised that a thermometer in the medication cupboard showed that the temperature was within acceptable limits.