We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service caring?
People who lived in the home told us the manager and staff were very caring and supportive. They said they were very fond of the manager and they got on well with the other staff.
We observed there was a friendly family atmosphere in the home and everyone appeared to get on well together. All of the interactions we observed between people and staff were caring and supportive.
The manager and staff spoke to people in a polite friendly manner and they treated people with dignity and respect. They knocked on people's doors and gained permission before entering. This showed they respected people's privacy. People were allowed their own space but staff were on hand when they were needed.
Is the service responsive?
The service was responsive to people's needs and preferences. We spoke with two people who lived in the home. They told us they were able to make their own daily living choices such as meal choices and activities. One person said 'I decide what I want to do each day. I like having something to do and I like to keep busy doing my jobs around the house and in the garden'. The other person said 'We can decide to stay in our room or meet in the lounge, whatever we want'.
The manager said they had conversations with each of the individuals on a daily basis as well as more structured individual care plan review sessions. This enabled people to discuss any aspects of their care and to express their views and preferences. People also met together at monthly meetings to discuss issues of general interest such as menu choices, future trips, leisure and social activities.
We saw care plans reflected people's personal choices such as when they preferred to get up and go to bed, their hobbies and leisure interests. This information helped the service to plan ways of improving people's quality of life. For example, one person was a very keen football fan and had been supported to go to watch their favourite premier league football team.
The manager said feedback from relatives and visiting professionals also played an important part in ensuring people's care and support needs were met.
Is the service safe?
People told us they felt safe and the manager and staff treated them well. One person said 'X (the manager) looks after us and I feel safe here'. The other person said 'All the staff are nice to us. Nobody ever treats me badly'. People told us they would speak with the manager, their relatives or their social worker if they had concerns.
Staff knew about the different types of abuse, how to recognise the signs of abuse and how to report any concerns. They said the manager had provided in-house training in protecting vulnerable adults from abuse. Staff knew to call social services or the police if they suspected any abuse.
We saw relevant employment and criminal record checks were carried out when new staff were recruited. This helped to protect people from the risk of abuse.
Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw care plans included a range of individual risk assessments and actions for managing these risks. This included risks associated with people's mobility needs, traffic awareness, food and drinks preparation.
There were arrangements in place to deal with foreseeable emergencies. The provider had an emergency evacuation plan and monthly fire drills took place. Staff received first aid training and they were instructed to call the emergency services if they had any concerns.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager said they had never needed to make a Deprivation of Liberty Safeguards application. However, the manager was aware of the circumstances when an application should be made and the procedures to follow. This helped ensure people's freedom and human rights were protected.
Is the service effective?
The service supported people who were relatively independent but needed some prompting and support with daily living skills. The home was effective in meeting these support needs.
People who lived in the home told us they were happy with the care and support they received. One person said 'I'm happy to stay here, it's very good. If I need to see the doctor, X (the manager) takes me'. The other person said 'If I need anything I just ask X (the manager) and they always sort it for me'.
The manager said they encouraged people to be as independent as they were able, both in the home and in the wider community. People told us they regularly went out into the community to work, swimming, shopping, meals, social nights out and shows. One person said 'I go to work three days a week and we usually go out somewhere a couple of times a week'.
Care plans contained information about meeting people's health and support needs as well as their personal preferences. We saw up to date records of appointments with health care professionals, including the GP, speech and language therapist, podiatrist and dentist.
The manager said they ensured staff were able to carry out their roles competently by providing regular staff supervision and training. One member of support staff had worked in a larger residential care home where they had obtained a national vocational qualification level 2 in health and social care. This meant staff had relevant qualifications and training to carry out their roles to an appropriate standard.
The provider identified, assessed and managed risks to the health, safety and welfare of people. In addition to individual risk assessments in people's care plans we saw environmental risk assessments for areas such as fire safety and domestic water temperatures. The home had recently received a local authority 5 star environmental health rating which demonstrated good hygiene and catering standards.
Is the service well led?
This was a small homely service run in a way that met the needs of the people who lived in the home. The manager was clearly committed to achieving the best lifestyle and outcomes for the people in their care.
An annual satisfaction questionnaire was given to people who lived in the home and their relatives. We saw the returned questionnaires from the January 2014 survey and each rated the service as excellent.
The manager was the owner of the home and lived on the premises. They were registered with the Care Quality Commission as the registered manager for the service.
We could tell from our discussions with the manager and staff that they were knowledgeable about each individual's support needs and personal preferences.
The member of staff we spoke with said the manager was always available for support and advice. They said 'The manager is wonderful and very easy to get along with. We all get on pretty well together'. They said the manager and their colleague were extremely supportive and they all worked well together as a small dedicated team. This ensured people who lived in the home were appropriately supported at all times.