This inspection took place on 3 January 2019. It was an unannounced visit to the service.

Abbeyfield Haddenham Society Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It is registered to provide support up to 11 older people. At the time of our inspection 11 people lived at the home. The care home is in a rural village in Buckinghamshire. Accommodation was over two floors. Each room was en-suite with a level access shower room. People had hot drink making facilities and a fridge in their room. People had access to a dining room and a lounge. The home benefited from well-maintained gardens which could be accessed from some of the ground floor bedrooms.

At our last inspection carried out on 28 and 29 April 2016 we rated the service good. However, we made a recommendation about ensuring people’s current needs were reflected in care plans. At this inspection we found improvements had been made and the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People, their relatives and external community professionals were all happy with the service provided. We received lots of positive comments. “I love it,” “As soon as I walked in through the door I knew I would be happy,” “It really is a good place to live” and “Every time I visit, I feel there is always an open and friendly atmosphere at the home.”

People were protected from abuse and avoidable harm. Staff had received training and were confident to raise any concerns they had.

People were supported to live as independently as they could. Staff respected each person and people told us staff promoted their dignity. One relative told us “The staff thrive to provide a stress-free environment so that the residents can continue to retain their freedom of choice and individuality.”

People were supported by staff who had got to know their needs and wants. People told us they had a good relationship with staff and we saw this to be the case. We observed many people smiling. When people returned to the home from visiting the local community they were warmly welcomed.

Staff received training to ensure they were kept up to date with their skills and knowledge.

People and relatives described Abbeyfield Haddenham Society Limited as homely. Comments included “It is all you need and want,” “I have a very good life” and “Every time I visit, I feel staff are kind, pleasant and friendly and are respectful of the resident's choices and opinions.”

People had opportunities to engage in meaningful activities. People told us there were opportunities to meet with people within the home and the local community.

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 were supported by a well-established team of care staff, many of whom had worked at the service a long time. There was a long-serving management team in place. People’s relatives and external parties described the management and care staff as “A lovely balance of professionalism with human touch.”

Further information is in the detailed findings below.

This inspection took place on 28 and 29 April 2016. It was an unannounced visit to the service.

We previously inspected the service on 30 January 2014. The service was meeting the requirements of the regulations at that time.

Abbeyfield Haddenham Society Limited is a care home for older adults. It is registered to provide accommodation for 11 people. At the time of our inspection eight people lived at Abbeyfield Haddenham Society Limited.

The service had a registered manager in post. 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.

People received safe care and treatment in a homely environment. One person told us “When I came to look around, I stood on the front step and said to my son, this is it.”

Environmental risk and some personal risks were assessed and managed.

People received medicines on time, and the service had a good auditing system around medicine ordering.

People received personalised care and staff were knowledgeable about people’s likes and dislikes. However we observed people’s current level of need was not always reflected in individuals care plans. We have made a recommendation about this in the report.

We received lots of positive comments from people who lived at the home. Comments included “It was a good decision to come here,” “I am very happy, they [staff] are lovely people, I feel very lucky to be here, I get so well looked after.”

Staff had received training on how to recognise abuse and had access to the local safeguarding team contact details.

People were supported by staff who had received training and support to develop their skills. Robust recruitment process ensured that people were suitable to work with older people. One person who used the service stated “The staff are hand-picked.”

People were supported by staff who demonstrated compassion and kindness.

People were involved in decisions about their care and consent was gained from people.

People were supported to be part of the local community a number of people who lived at the service attended local social groups. The service featured on the local village website.

People were supported by a service that was well led. There was a very consistent staff team.

People told us they and/or their families were invited to visit the home, meet the staff and residents and view the facilities before they moved in. This enabled them to gain a 'feel of the home' and meet with the staff and people who lived in the home before making a decision as to whether the home was suitable.

Care plans were in place and any risks to the safe delivery of care had been assessed. This ensured the safety and welfare of the person receiving care and the carers supporting them. People's care and support was planned and delivered in line with their individual care plan. These were detailed, regularly reviewed and updated to reflect any changes in their needs.

People said they felt safe and staff looked after them well. They knew who to speak to if they had concerns.

We found people were treated with dignity and respect. We observed and spoke with people in the dining room during tea time. We saw staff offered people choice of food and they were able to eat their lunch at their own pace in an unhurried manner.

Activities were provided to those who wished to take part. These included activities both within and outside the home in the local community.

Comments from people we spoke with included ''I am being well looked after...I'm very happy here, wouldn't want to be anywhere else.'' ''The staff are lovely, all local people and they get on well together.'' ''I am lucky to be here and we have good management.''

During the insection we met and talked with people living at Stonehill House. We talked to staff and reviewed records including care plans and details of staff training. We found that people were able to consent to their care and that families were involved in the decision making process where appropriate. People were involved in their care plans which were person centred. A person who used the service told us that "They care for you and what you are like as an individual."

We observed positive interactions between people and staff. People were relaxed and keen to talk about the service with us. One person told us "It's very good. They're such lovely ladies - carers and residents." Someone else said "I just love it." Another person said "I recommend it."

We found that the service was staffed adequately by staff with suitable training, skills and experience and that the environment was safe and clean. The provider had appropriate mechanisms in place for seeking feedback on the quality of service that people receive.

People who use the service told us that staff were very good at respecting their privacy and would knock on doors before entering. When they needed assistance with such things as bathing they found it a dignified experience. They said they were encouraged to be independent and do as much for themselves as possible and respected the freedom they had at Abbeyfield Haddenham Society Limited. They said they felt listened to and had their decisions respected by staff.

People said they or their relatives had been able to visit the service to see if it was suitable for them. They said they had been asked about their needs and staff displayed a good awareness of their needs. They told us there were activities arranged for them at the service which they were encouraged to participate in and visitors were made welcome. They said that when they experienced periods of ill health staff were attentive towards them.

They told us they had no concerns about their safety and wellbeing at Abbeyfield Haddenham Society Limited and that staff were good at responding to call alarms when they needed them. They said that a member of staff could always be located when needed and were always able to do what was required of them. People said that staff were patient, polite and respectful with them.

The people we spoke with said they had never had the need to raise a concern, but if they did they would feel confident and comfortable in approaching the manager. They told us they were aware of meetings they could attend to discuss their views on the service and could also recall completing questionnaires. They also felt their relatives were very included in their care.

One person summarised her experience at Abbeyfield Haddenham Society Limited by saying: “I had a bad impression of going to live in a care home but so far my experience here has been very positive and I’ve been treated as an individual and that’s what I wanted”. Another person said: “I have no regrets about coming here. It’s like a family or as near to it as possible”.