We inspected Colne Place Residential Care Home on the 25 March 2019.

About the service: Colne Place Residential Care Home caters for up to 33 older people. At the time of our inspection 28 people were using the service. The service was set in a residential area with easy access to the local community and had large gardens. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

People’s experience of using this service: People and relatives were very complimentary of the service and staff.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received the appropriate training. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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 support this practice.

People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of people.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner. Support was given to people at the end of their life.

The service was well-led. The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection: Good (report published 26 May 2016)

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

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

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

Colne Place Residential Home provides accommodation for up to 33 older people. The service provides care and support to people with a range of needs which include; people living with dementia, those who have a physical disability, and/or a sensory impairment.

There were 29 people living in the service when we inspected on 26 April 2016. This was an unannounced inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 care that was personalised to them and met their individual needs and wishes. Staff respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people’s choices, views and preferences and acted on what they said. The atmosphere in the service was friendly and welcoming.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

Care and support was based on the assessed needs of each person. People’s care records contained information about how they communicated and their ability to make decisions. People were encouraged to pursue their hobbies and interests.

People or their representatives were supported to make decisions about how they led their lives and wanted to be supported. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. The service was up to date regarding the Deprivation of Liberty Safeguards (DoLS).

People’s nutritional needs were being assessed and they were supported to eat and drink sufficiently. People were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

Processes were in place that encouraged feedback from people who used the service, relatives, and visiting professionals. There was a complaints procedure in place and people knew how to make a complaint if they were unhappy with the service.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities. Audits and quality assurance surveys were used to identify shortfalls and drive improvement in the service.

We carried out an unannounced inspection on the 23 April 2015. Colne Place Residential Care Home provides care for up to 33 older people who may be elderly and or have a physical disability. Some people are living with dementia. There were 32 people living in the service when we inspected.

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.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to protecting people by ensuring the premises were well maintained and safe. Improvements were also needed to ensure people were consistently supported by sufficient numbers of staff with the knowledge and skills to meet their needs. You can see what action we told the provider to take at the back of the full version of this report.

Procedures and processes were in place which safeguarded people from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to. Appropriate recruitment checks on staff were carried out.

People received care that was personalised to them and met their needs and wishes. The atmosphere in the service was friendly and welcoming. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff listened to people and acted on what they said. Staff understood how to minimise risks and provide people with safe care. Care and support was individual and based on the assessed needs of each person. Appropriate arrangements were in place to provide people with their medicines safely.

Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to attend appointments with other healthcare professionals to maintain their health and well-being.

People were supported by the manager and staff to make decisions about how they led their lives and wanted to be supported. People were encouraged to pursue their hobbies and interests and participated in a variety of personalised meaningful activities.

People voiced their opinions and had their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. People knew how to make a complaint and any concerns were acted on promptly and appropriately.

People were provided with a variety of meals and supported to eat and drink sufficiently. People enjoyed the food and were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities.

Processes were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was acted on. Systems in place to monitor the quality and safety of the service provided were not robust. Improvements were needed to drive the service forward.

One inspector carried out this inspection. We considered our findings to answer the questions we always ask. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff who supported them and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

On our arrival to the service a staff member looked at our identification and asked to sign in the visitor’s book. This showed that they knew what actions to take to ensure that people were protected from others who did not have the right to access their home.

We saw that potential risks to people were appropriately assessed and planned for. The service routinely screened for risks associated with mobility, falls, nutrition and additional risks specific to the individual. There were instructions for staff on how to reduce risks to people in these areas of care delivery.

People were protected against the risks of abuse as the provider ensured staff received appropriate training. Staff we spoke with knew the different types of abuse that might occur and the signs that might indicate abuse. Staff were aware of their responsibility to report abuse and told us they felt confident to do so. We saw information was displayed within the service with contact details for external agencies such as CQC and the local authority safeguarding team.

Recruitment practice was safe and thorough. We looked at staff records and found that appropriate checks were made before staff began work. We found that the provider had taken appropriate steps to ensure staff were qualified and competent to carry out their role.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted the manager demonstrated that they knew their responsibilities in respect of this.

Is the service effective?

People confirmed that they were happy with the care and support provided. One person told us, "The staff are all very nice. I always have help.” Another person told us, “It works well.”

People's health and care needs were assessed and people and their relatives were consulted in planning their care. Daily records showed that care was delivered in line with people's care plans. Staff we spoke with demonstrated that they knew people’s care and support needs well and the way in which individuals preferred their care to be delivered.

Specialist needs such as dietary needs and pressure care had been identified in care plans where required. We saw that people received visits from health professionals such as district nurses and their GP.

Is the service caring?

People told us, “The staff are all very nice. They talk to me nicely." Another person told us, “I do like this place very much.”

Staff told us they enjoyed working at the home as it was a small home and they were able to get to know people who used the service very well. They told us, “It is family orientated, we all sit together.”

People were treated with respect and dignity by the staff.

People were supported by kind and attentive staff. We observed staff asking people if they needed any help, engaging in conversations, joining in singing with one person and offering reassurance to another. We observed staff and people shared a joke and laughed together. There was a positive and warm atmosphere.

We saw in the minutes of a staff meeting that staff who supported people with morning routines were encouraged to, ‘Spend time chatting about day to day things that might be happening that day.’

Is the service responsive?

We found that there were regular meetings held for people who used the service. In addition there were also relatives meetings that took place. We saw that regular satisfaction surveys were undertaken and evidence that the provider had acted upon feedback received.

The provider undertook regular health and safety audits in order to identify assess and manage risks relating to the health, wealth and safety of people who used the service. We saw that the provider took action to ensure people were supported within a safe service.

Is the service well-led?

The staff we spoke with were clear about their roles and responsibilities. They told us that they felt confident in being able to deliver the care and support people needed. Staff told us they felt supported in their role.

Relatives described the management team as very approachable and told us action was taken if they raised an issue.

We found that people had appropriate assessments and were cared for according to their needs. We spoke with four people living in the service who told us that they thought the food was good. People said their rooms were comfortable and all areas were kept warm for them.

We saw there were appropriate arrangements to ensure cleanliness and reduce the risk of cross infection. The provider maintained the premises appropriately. We saw there was an effective repair and redecoration programme. We found that equipment and fittings were checked regularly to safeguard people’s health and welfare.

We found that there were effective systems to monitor the quality of the service.

People were asked for their consent about treatment and they were cared for according to their wishes. We found that people were assessed appropriately and care was provided according to their needs. One person told us the "Carers are kind and helpful." Another person said "The food is very good, there is a good chef here."

People told us they felt safe at Colne Place and we saw that appropriate arrangements were in place to safeguard vulnerable adults.

Staff received appropriate training and support to deliver safe care to people. We saw there was a clear system for people to comment or complain about the service. The manager maintained appropriate records of care and of the management of the service.

We spoke with one person about the management of the service. The person told us they were happy with the service, knew who the manager was, and felt able to tell the manager if there were any problems. We did not speak with people who lived in the service about the other regulations we reviewed during this inspection visit.

People we spoke with said they were happy with the way that the service manages their medicines.

People told us they were very happy with the standard of care they received. People told us that the staff were lovely and could not do enough for them. People said they were well cared for and nothing was too much trouble. One relative told us that in the past they had had concerns about the quality of care and support provided for their member of family however this had improved.

People we spoke with said they were satisfied with the way that the home manages their medicines for them. Although one person told us that "you can't always rely on them [being given] at the same time every day."

We did not speak with anyone who uses the service about the way their medicines are handled.

People told us they were happy living in Colne Place Residential Care Home and that they felt the staff cared for them well. People said they were generally satisfied with the care and support provided by staff in the home. They said “They look after us very well “ and “I get up when I want to.”

People told us they were very happy with the improvement in the social activities provided in the home. One person said “A few of us went out to lunch a couple of weeks ago, it was really nice to get out and about” and “We often have a quiz in the afternoon, about half a dozen of us.” Another person told us “We do like to walk around the garden.”

People told us they feel safe living in the home and were generally complimentary about the staff that supported them. Comments included: “They are helpful and caring” and “They take care of my needs.”

People with whom we spoke told us that they had no concerns regarding their care. They said that they would tell some one if they had any issues. A visitor with whom we spoke told us they would feel able to express their views and concerns if the need arose.

We spoke with some of the people living in Colne Place. One person with whom we spoke said “I am very happy with the care I am getting; I have nothing to complain about.” Another person said “I get up in the morning when I am ready to do so. They bring me a cup of tea.”

People with whom we spoke said that overall they enjoyed the food provided at Colne Place. One person said “I do like the food, I look healthy on it don’t I?”

One area that both people living in the home and their visitors identified for improvement was activities and opportunities for stimulation. People told us “We don’t have enough to do, for me time seems so long” and “When I first came here they used to take us into the village now and again, to the shops. That kept us in touch with the world but that doesn’t happen anymore.”

People living in Colne Place and regular visitors to the home told us they didn’t see the manager very often. A person living in the home with whom we spoke said “The new manager started off well but we never see her.” A regular visitor to the home told us “Today is the first time I have seen the manager for five weeks despite visiting frequently.”

People with whom we spoke said that overall they found the staff to be pleasant. One person said “Generally speaking, I am full of praise for them” and another person said “I am very happy here.”

People we spoke with were not confident that they knew how to make a formal complaint or that they would be listened to. People said “I have never had to make a complaint so I don’t know what they would do about it” and “I don’t see the point of complaining, I don’t reckon anyone would listen to me anyhow.”