The home is located within a care centre owned by the local authority, (the provider) that offers a number of difference facilities. For example restaurant facilities, meeting rooms and an information centre for people living at the home and visitors to the centre to access should they wish. Ann Marie Howes provides residential accommodation for adults living with dementia and/or a physical disability, with a maximum capacity for 32 people who require support and personal care. At the time of our visit 30 people were living at the home.

At the last inspection, the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

People were kept safe because staff had a good knowledge of current, good safeguarding practices and how to apply this when supporting people. People received safe care because risks had been identified and were managed effectively. Although people living at the home, relatives and staff felt there insufficient numbers of staff available, this was not evidenced on the day of our visit and we found there were sufficient numbers of staff available to ensure people received support as they wanted. People were supported to receive their medicine safely.

People were assisted by suitably trained and supported staff that had the knowledge and skills they needed to do their job effectively. People felt staff had a good knowledge of their support needs.

People were supported to have 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. The provider had taken suitable action when they had identified people who did not have capacity to consent to their care or treatment. Applications had been made to authorise restrictions on people's liberty in their best interests.

People were complimentary about the quality of food and were supported in their choice of meal. Health care professionals were involved in supporting people to maintain peoples’ health and wellbeing.

People were supported by caring and kind staff who demonstrated a positive regard for the people they were supporting. People had been encouraged to be as independent as much as possible. Care was reviewed, where possible, with the person and their relatives to ensure the care provided continued to meet people’s needs.

People and their relatives were aware of how to raise concerns or make complaints and were happy with how the service was managed. There were systems in place to monitor the quality of the service to ensure people received a good quality service.

We visited Ann Marie Howes Centre on 8 October 2014: there were 31 people living in the home, this included two people who were in hospital due to ill health. To find out about people's experiences and what it was like to receive care from this provider we spoke with six members of staff, six people using the service, two relatives, one visiting healthcare professional and one visiting chaplain.

We saw that people using the service were asked in a number of ways how they wanted their care to be delivered so they were able to influence how their care is provided. We saw that dignity and privacy was promoted and maintained. One person we spoke with said, ‘I can have what I want for breakfast and at the time I want it’.

Effective, safe and appropriate care was received by people using the service, to meet their needs. One relative spoken to said, ‘The staff were all very good and they were happy their relative was safe here’.

There are suitable arrangements in place to ensure that people are safeguarded against the risk of abuse. People living at the home feel safe, and are confident that staff will protect them.

There were systems and procedures in place so that medicine was administered, stored and disposed of safely.

Evidence we gathered indicated that staffing levels were adequate and that staff were supported through appropriate training, so that people’s needs were met by appropriately trained staff. Some people using the service told us that there was enough staff to meet their needs. One member of staff told us they ‘really liked working here’.

We visited Ann Marie Howes Centre on 13 June 2012; we spoke with five people who lived at Ann Marie Howes Centre and four relatives. We also spoke with four members of staff and the registered manager.

On the day of our visit there were a total of 31 people living at Ann Marie Howes centre which included two people who were in hospital due to ill health.

There were two units within the service each with a separate lounge and dining area. The manager explained people had a choice of the two units and people where able to sit and eat where they pleased.

Some people were unable to verbally share with us their views about the care they recieved due to their health conditions or complex needs. We were able to look at other areas for evidence to support their experience such as sampling a set of care records, speaking to relatives and staff. We also used a short observational framework for inspection (SOFI).This is a specific way of observing care to help us understand the experience of people who could not talk with us. We used SOFI with four people living at Ann Marie Howes Centre.

We observed that people were relaxed and appeared settled and happy with their care. People reported that staff were caring and approachable. One person commented about staff and said they were "Very caring”.

People told us there were activities they could participate in like games and singing sessions. People commented they did not have to take participate in activities that they did not enjoy.

People said they enjoyed their meals and they were offered choice, one person told us the food was "Brilliant". During lunch time staff ensured that people were comfortable and had an adequate meal. We saw there was choice on the menu and people enjoyed their meals.

The relatives we spoke with were happy with the care received by their family members. We saw staff attended to people in a caring, considerate manner and responded appropriately to their needs. Staff were knowledgable about the needs of the people they were caring for. Staff were able to identify people who needed extra support as reflected in their care records.

Staff we spoke with showed understanding in areas of privacy and dignity. Staff understood what constituted abuse and said that they would be able to recognise and report poor practice. Staff were aware of their role in respect of prevention of falls and of how to respond to any difficult to manage behaviour, areas relevant to the people they cared for. This demonstrated people were cared for by appropriately trained staff.

Staff told us they were happy working at Ann Marie Howes Centre Home. One staff member we spoke with said "We are a good team". Staff felt trained and supported to provide good care.

We found the service was improving as a result of findings from their own audits. For example a team system was introduced so where possible people were cared for by the same group of staff.

The inspection took place on 5 and 9 of March 2015 and was an unannounced inspection. We last inspected the service on 8 October 2013. At the last inspection the provider was meeting all regulations inspected.

The home is located within a care centre which has other facilities available for people who live in the home to access if they wish.

Ann Marie Howes Centre provides accommodation for 32 people. The service did not have a registered manager in post. An application had been submitted to us for the current acting manager to become registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People felt safe with the staff that supported them because staff knew how to protect people from harm. Procedures were in place that ensured the service was safe and that people’s rights were protected.

There were sufficient numbers of suitably recruited staff available to support people. Staff had received training that ensured they had the skills and knowledge to care for people.

People were consulted about their care so their wishes, choices and preferences were known so they could receive care on an individualised basis.

People were supported to access health care services and timely referrals were made to ensure people remained healthy.

People were supported to undertake activities of their choice in the home and out in the community. Facilities were available for activities and included computers and an activity centre.

Systems were in place to monitor and check the quality of care provided and where changes for improvement were required we saw that action was taken. External reviews by the provider was completed regular to support the manager of the service which included gathering people views about the service provided.