This inspection took place on 8 November 2016 and was unannounced.

Colne House provides accommodation and personal care for up to 38 older people, some of whom have dementia care needs.

At the time of our inspection the provider confirmed they were providing support to 32 people.

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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed. They knew how to report abuse use whistleblowing procedures. People had detailed risk assessments in place to support their safety whilst also enabling them to be as independent as possible.

Staffing levels were adequate to meet people's current needs. There were enough staff regularly on shift within the service and contingency plans were in place for any staff absence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out so that only suitable staff worked at the service.

Staff received an induction training package when they joined the service, and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Staff felt confident in their roles because the training had equipped them well.

People told us that their medicines were administered safely and on time. We saw that the medication administration systems in place were accurate and up to date, and that all medication was stored securely.

Staff were well supported by the registered manager and senior team, and had regular one to one

supervisions. Staff were confident that they would receive the support they needed from management at all times. The management team were very knowledgeable about the people within the service and the staff team skills.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 (MCA) were met. We saw that where appropriate, best interests meetings had been held and capacity assessments had been completed in line with MCA.

People were able to choose the food and drink they wanted and staff supported people with this. Fresh food was prepared and cooked on site and any dietary needs were catered for. People were supported to access health appointments when necessary, and health professionals came in to the service to visit people when required.

Staff treated people with warmth, kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. All the staff had an excellent knowledge of people’s likes and dislikes, and were able to engage with everyone in a person centred manner.

People or their family were involved in their own care planning and were able to contribute to the way in which they were supported. Staff had keyworker responsibilities which included checking and reviewing care with people and their family.

The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.

The people we spoke with knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed. Audits were in place for many areas of the service and questionnaires were in use to collect opinions from people, family, and staff on the care received in the service.

We spoke with three people using the service, two relatives and one healthcare professional who regularly visits the service. They all confirmed to us that they were satisfied with the standards of care at Colne House. One person told us, " The staff are kind and helpful. I enjoy outings on the minibus. I am teaching one staff member to crochet." A visiting relative confirmed to us, "Staff invite me to have lunch with my relative which I enjoy. I think this is a good service and staff work hard." The healthcare professional confirmed to us that they thought that the service was meeting the health and social needs of the people using the service.

Appropriate support plans were in place to provide person-centred care which met both the physical and emotional needs of people living at Colne House. Risk assessments had been completed to protect the health and welfare of people using the service.

People were supported to access adequate hydration and nutrition. Mealtime assistance was adequate to ensure that everyone requiring additional support received it.

Medicines were stored and administered safely and staff maintained accurate medication records.

There was an appropriate complaints policy in place. People we spoke with knew how to complain if they needed to.

Many people in the service were living with dementia and we found they were not able to clearly articulate their needs or wishes. We used SOFI to assess the experience of people and their interaction with staff. We saw that care was provided in a relaxing environment that did not overly stimulate people who may be living with dementia. We saw that people were calm through the meal times and supported as required. People had plenty of time to eat their food unassisted. We saw their independence was promoted where possible.

We found that assessment and care planning was effectively managed so that care and treatment was provided according to people’s wishes and needs. We saw that there were regular quality checks including gaining the views of people living in the service or their relatives.

Staff were trained appropriately and supervised regularly to maintain competence. Staff told us they had training to provide safe care including to people living with dementia.

Most of the people who use this service have difficulty understanding and responding to verbal communication. During our visit we were able to hold a verbal conversation with two people. Other people were able to make comments about specific issues, such as the meals. However most of the information about people's experiences of Colne House was gathered through our observations, discussions with visitors, review of records and discussions with the manager and care staff.

Those people with whom we spoke confirmed that they felt respected and involved by staff. They also confirmed that they were satisfied with the care and attention provided by staff. Two people said that they enjoyed being able to walk around the gardens and appreciated the fresh air. Three people said the food was “Nice”.

Visitors with whom we spoke confirmed that they were consulted with about the care that their relative were receiving and felt able to talk to senior staff if they had any concerns. One visitor reported that they considered that individual’s choices and rights are respected and promoted by staff in this home.

Visitors confirmed that they were pleased with the care and support that they had observed and that they if they had any concerns were able to approach staff and were confident that these would be addressed appropriately.