About the service:

Charnwood House is a residential care home that was providing personal care to 61 people aged 65 and over who were living with dementia at the time of the inspection.

People’s experience of using this service:

¿ People liked living in the service and the home had a warm, friendly atmosphere.

¿ People told us they felt safe. They were protected from abuse and discrimination.

¿ People told us that staffing levels were appropriate and staff responded in a timely way to people's needs.

¿ We saw that accidents and incidents were managed appropriately.

¿ Assessments and care plans were in place and staff knew the people they cared for well. Following on from our site visit the registered manager ensured specific risk assessments and strategies were in place.

¿ Medicines were being managed safely and were given by staff who had completed relevant training and had their competencies checked.

¿ Staff told us they received a comprehensive induction and had the right skills and experience.

¿ People were supported to have meals that met their dietary needs and preferences and the dining room experience was pleasant.

¿ Staff had appropriate knowledge of the Mental Capacity Act (MCA)and appropriate Deprivation of Liberty Safeguards (DoLs) applications had been made.

¿ We observed staff to be kind, caring and empathetic. We saw that they treated people with dignity and respect.

¿ People were consulted about their care and families were involved in reviews.

¿ The management had a visible presence within the home and positive feedback was given about them, in particular the registered manager.

¿ Staff told us they felt well supported by the management.

Rating at last inspection: This service was last inspected on 10 August 2016 when we undertook a comprehensive inspection. The service was rated Good. The report was published on 27 October 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Charnwood house provides accommodation and personal care for up to 57 older people who live with dementia. 57 people were living at the home at the time of our inspection.

The inspection took place on 10 August 2016 and was unannounced. The service was last inspected on 18 December 2013 when we found the provider was meeting the regulations.

The registered manager had been in post for the past 12 years. 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 were at the heart of the service. The provider's vision and values were understood and shared by the management and staff team. Staff spoke very passionately and demonstrated their commitment to provide high quality personalised care to people. There was a strong person centred ethos, which was embedded throughout the home. This ethos helped to make people feel important, supported and included.

All of the people we spoke with and their relatives told us they felt very safe and were extremely happy with the service they received because they continued to live their lives how they wished to do so. We observed staff always took opportunities to talk with people which encouraged meaningful conversations. Staff were highly motivated to empower people to maintain a sense of purpose and achievement in their lives. People told us staff always showed them respect and encouraged them to maintain their independence and this made them feel valued.

People told us they had built up strong and meaningful relationships with the staff who supported them which was built on trust and respect and care for each other. Staff always spent time with people to listen to their opinions and people were always involved in the planning and review of their care. Care records were very detailed and personalised and people told us they always received their care in line with their wishes. Relatives and visitors were welcomed at the home and were encouraged to be actively involved in people's lives.

Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. They understood the risks to people's individual health and wellbeing and risks were clearly recorded in people’s records. Our discussions with staff demonstrated a consistent approach to the management of risks. Accurate and detailed plans were in place to ensure people would receive continuity of care if an unexpected event occurred such as, fire.

The provider's recruitment procedures minimised the risk to people's safety. There were enough qualified, skilled and experienced staff to meet people's needs. People were very complimentary about the support they received from the consistent staff team.

Staff completed training to obtain the skills to effectively support people who lived with dementia. We saw staff put their learning into practice and offered reassurance and comfort to people throughout our visit. Staff told us the provider proactively ensured they had many opportunities to further develop their skills and knowledge.

All of the staff demonstrated an understanding of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) so that they could ensure peoples' rights were being protected. The registered manager understood their responsibility to comply with these requirements. For people who were assessed as not having the capacity to make all of their own decisions, records showed their families and health care professionals were involved in making decisions in their best interests. Staff always obtained people's consent before they provided care and support.

Mealtime experiences were enjoyable for people and they received a varied and n

We visited Charnwood House from 9.30am to 4.30pm. Two inspectors and one “expert by experience” supported the inspection. We were informed all people living at the home had some form of dementia.

Charnwood House has four units. Three of the four units specialise in dementia care. These are Oak, Willow and Sycamore. The forth unit, Beech, is for short term placements. We focused on the support provided to people in the dementia care units. There were a total of 44 people living in these units.

We saw staff being supportive and kind to people with dementia living at Charnwood House. They were aware of the importance of preserving people's dignity and respect and their actions demonstrated this. Visiting relatives told us,

“I’d like to come here when the time comes, it’s fantastic.” A person living at the home told us, “You get plenty of rest and friends.”

Five people left comments on our comment cards. They were all very positive about the service provided to people with dementia. A typical comment was, “The home delivers exceptional care for the residents. Most show a high level of knowledge and understanding of dementia.”

We saw people with dementia were engaged in different activities which held their interest and which they appeared to enjoy.

We saw people with dementia had good access to health care professionals such as their GP, district nurses, and speech and language therapists.

We looked at care records of people with dementia. We saw there were systems for reviewing and updating care plans and risk assessments. Staff we spoke to knew the people they were caring for well. Care was individualised to the needs of each person.

We saw the environment was beneficial in supporting people with dementia.

We looked at how the quality of dementia care was monitored. We were satisfied there were good systems in place to monitor the quality of dementia care.

We saw that Charnwood House had four units known as Willow, Sycamore, Oak and Beech with a total of 57 beds. Each unit had dedicated staff so that people had familiar staff supporting them with their care needs.

Most people living at Charnwood House had dementia and were limited in their responses to questions asked. We therefore spent a period of time observing them in the lounge and dining areas across the home to establish what it was like for them living there.

We were able to speak with four people and five visitors about their experiences of the home. We received positive responses about the care and services provided from all those people we spoke with. They told us: “I think it’s very good.” “I think X gets good care here. I think X settled quite quickly.” “Personal care is fantastic."

People told us they enjoyed the meals provided. Comments included: “Up to today I wouldn’t criticise anything.” “The food is excellent.” We saw that people had access to a range of social activities and these were advertised on notice boards within the home.

We observed staff to be kind and respectful towards people. People told us they were happy with the staff that supported them. We were told: “They are smashing you can talk to them.” “The ones here that look after you are really nice.”

People told us they felt at ease to raise any concerns with staff and were confident any concerns they raised would be dealt with effectively.

On the day of the visit on 11 August 2011, we spoke with people living in the home, visitors, staff and health care professionals.

Due to the needs of some people living at the home who were unable to verbally share

their experiences, we spent time observing the support given to people and how they spent their day.

We observed how staff offered them care and how staff spoke with them. We looked at how staff treated them to ensure that they were treated with dignity, were able to stay as independent as possible and if they were offered privacy. We found that staff treated people kindly and demonstrated that they knew them as individuals and understood their care needs.

People living in the home, who were able to do so, told us that they were happy with the care they received. “People are very kind, they don’t over fuss”. They said that the food provided was good and that they were happy with their rooms and the level of cleanliness.

Visitors said that the care was ‘”fantastic” and “It’s a great place”. One relative told us that people received plenty of drinks and that the food was always well presented with a varied menu.

Visitors also told us that there was plenty for people to do, such as music and singing as well as creative activities like making sweets and flower arranging.

A nurse visiting the service told us that the staff were helpful, and always had “people’s best interests at heart.”

We asked about making complaints and what people would do if they felt unhappy about anything. We were told that they would see the manager or talk to staff on the unit where anything would be resolved.

Staff spoken with told us that they were well supported by senior staff. They felt that they received a good level of training to ensure that they knew how to deal with incidents and understood how to keep people safe. One staff member said “This is best place I have worked, it’s run well there is good team work.”