The Inspection took place on 24 April 2017 and 2 May 2017 and it was unannounced.

Biffins Care Home is registered to provide care and accommodation for up to 14 older people some of whom may be living with dementia. When we inspected there were 13 people living in the service.

At the last inspection, the service was rated good and at this inspection we found the service remains good.

There was 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 a safe service and were protected from the risk of harm. There were enough staff that had been safely recruited to help keep people safe and meet their needs. Medication management was good and people received their medication as prescribed.

People were cared for by experienced, supported and well trained staff. The service supported people to have as much choice and control over their lives in the least restrictive way possible. People received sufficient food and drink to meet their needs and preferences and their healthcare needs were met.

Staff knew the people they cared for well and were kind, caring and compassionate in their approach. People were encouraged and supported to remain as independent as possible. Staff ensured that people were treated with dignity and respect and their privacy was maintained at all times.

People were fully involved in the assessment and care planning process. Their care plans had been regularly reviewed to reflect their changing needs. People were encouraged and supported to participate in a range of activities to suit their individual interests. Complaints were dealt with appropriately in a timely way.

People were positive about the quality of the service. The care manager, registered manager/provider and staff were committed to providing people with good quality person centred care that met their needs and preferences. There were effective systems in place to monitor the quality of the service and to drive improvements. The service met all relevant fundamental standards.

Further information is in the detailed findings below.

We spoke with five people who used the service, the registered manager and three staff members. We looked at four people's care records and also looked at other records including quality audits and health and safety checks.

During our inspection and through analysis of our inspection findings we considered the questions we always ask, is the service safe, effective, caring, responsive and well led?

This is a summary of what we found

Is the service safe?

We found that the service was safe. When we arrived our identification was checked and we were asked to sign the visitor's book. This showed that the staff took the security of the building and the safety of the people who lived there seriously.

When we spoke with people they told us they felt safe living in the service and that they would speak with the staff if they had concerns.

We examined medication records, how the medication was stored and observed the way medication was administered to people. We found that the medication was managed and administered in a way that ensured peoples safety and wellbeing.

We found that staff received appropriate training, professional development and supervision. We saw that there were enough qualified, skilled and experienced staff to meet people’s needs.

We saw records which showed that health and safety checks were carried out in the service regularly and action was taken if equipment was found to be faulty or unsafe. This included regular visual checks and servicing of equipment such as hoists, the fire alarm panel and wheelchairs. Regular fire safety and legionella tests and checks were carried out, which showed that people were protected from unsafe or poorly maintained equipment.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Is the service effective?

The people we spoke with told us that they were happy living in the service, one person told us, “I like it here, nothing is too much trouble.” During our observations of the care and support staff gave to people, we saw that the service was effective in meeting people’s needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

We saw that the service was effective in assessing people’s nutritional needs and offered a good and varied menu, while ensuring that health needs and preferences were met.

Is the service caring?

We saw that the staff interacted with people who lived in the home in a caring, respectful and professional manner. During the time we spent at the service we saw that people were comfortable, looked smart and that staff were committed to caring for the people they supported.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People told us that the staff listened to their choices and acted on what they said. One person said, “I do what I want to.” Another person told us that, “I’m treated well, I get up when I want to and go to bed when I choose.”

The people we did speak with told us that they found the staff friendly and caring. One person told us, “They (the staff) are genuinely caring and relaxed.” Another person said, “It’s lovely here, I have all I want.”

Is the service responsive?

People's care records showed that, where concerns about their wellbeing had been identified, the staff had taken appropriate action to ensure that people were provided with the support they needed. Support and guidance was sought from health care professionals, including the doctor, the speech and language team and the dietician.

The people who used the service and their relatives were given the opportunity to complete annual satisfaction questionnaires. The operations manager said that the service responded to concerns raised with it through the survey. People and their families were also provided with the opportunity to participate in the running of the service by attending house meetings.

Is the service well led?

The service had an effective quality assurance system in place. The records we examined showed that identified shortfalls were addressed promptly. This ensured that the quality of the service was maintained.

The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The deputy manager told us that they felt supported by the provider, who is also the manager.

People told us that they were very happy living in Biffins Care Home. One person said, “All the staff are gorgeous and nothing is too much trouble for them, they make sure that I get everything what I need and I feel safe in their care.” Another person said, “I have been here a few years now and I can say that I am treated really well, I get out and about with staff and they are all lovely.”

People’s needs had been fully assessed and their care plans clearly described the support that they needed. People told us that their care plans and risk assessments had been regularly reviewed and that any changes to their needs were noted and responded to quickly.

People were cared for in a clean, hygienic environment. People told us that the home was always clean, tidy and fresh.

People were made aware of the complaints system and given support where needed to make any comments or complaints.

People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.

People told us that they were treated with dignity and respect and that staff were kind, pleasant and approachable. They said that they had received good information about the home before they moved in. They told us regular meetings had taken place.

People told us that they had received a full assessment of their needs before they moved in. They said that their care plans met their needs and had been regularly reviewed.

People told us that the food was home cooked and that they were given plenty of choice. They said that additional drinks and snacks were available should they want them. One person told us that they regularly participated in the weekly shop at a local supermarket.

People told us that they felt safe. They said that the staff were very supportive and that nothing was too much trouble for them. People were very relaxed and happy in the company of staff. They told us that the staff gave them their medication and that they were happy for them to do so.

People told us that they were happy with their rooms. They said that Biffins Care Home felt more like their own home as they had been able to bring their own possessions into their room. Another person said that they could get some exercise walking around their room as there was plenty of space and good views out of the windows.

People told us that the staff treated them well. They said that they felt that the staff must be well trained, as they were very competent at what they did. People said that they were happy with the quality of care provided at Biffins Care Home.

This inspection took place on 9 and 19 November 2015.

Biffins Care Home is registered to provide accommodation and care for up to 14 older people some of whom may be living with dementia. There were 13 people living in the service on the day of our inspection.

Prior to the inspection we had received concerns about people being washed and changed into their nightclothes at 3.30pm and that they were woken up, washed and dressed early the next morning. We visited the service at 6am on 9 November and at 5pm on 19 November to check if this was happening and if people were happy to go to bed early and to get up early. At our first inspection visit there were no people up on our arrival and on our second visit no one was changed into their nightclothes.

There was 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 their care and support in a way that ensured their safety and welfare. There were sufficient numbers of staff who had been safely recruited, were well trained and supported to meet people’s assessed needs. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed.

Staff had a good understanding of how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely.

People had sufficient amounts of food and drink to meet their individual needs. People’s care needs had been assessed and their care plans provided staff with the information needed to meet their needs and preferences and to care for them safely. People’s healthcare needs were monitored and staff sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and knew the people they cared for well. They ensured that people’s privacy and dignity was maintained at all times. People expressed their views and opinions and they participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were made to feel welcome.

People were confident that their concerns or complaints would be listened to and acted upon.

There was an effective system in place to assess and monitor the quality of the service and to drive improvements.