David Gresham House is a 29 bedded residential care home. It is registered for Accommodation for persons who require nursing or personal care. There were 28 people living at the home on the day of our inspection.

At the last inspection on 10 December 2014 the service was rated ‘Good.’ At this inspection we found the service remained ‘Good.’

People continued to be kept safe because staff were knowledgeable about the processes to follow when they suspected abuse. Safe recruitment practices continued to be followed by the provider that ensured only suitable staff worked at the home. Risk assessments were in place to enable people to remain safe and they continued to provide guidance to staff about the risks and how to maintain people’s safety. Records of accidents and incidents were maintained and actions to help to prevent the re-occurrence of these had been implemented. There were sufficient numbers of staff to attend to the assessed needs of people. Medicines were managed and stored safely and people received their medicines on time and as prescribed by their GP.

Staff continued to receive training, regular supervision (one to one meeting) and annual appraisals that helped them to perform their duties. Staff understood the Mental Capacity Act 2005 (MCA) principals. There were no restrictions in place. Staff supported people to eat a variety of freshly prepared foods. People had access to all external healthcare professionals and their involvement was sought by staff to help maintain good health.

Staff showed kindness and compassion and people’s privacy and dignity were upheld. People were able to choose how they spent their spend time, could freely access all communal areas of the home and their personal care needs were attended to in private. People’s relatives and visitors were welcomed and there were no restrictions of times of visits.

Documentation that enabled staff to support people and to record the care they had received was up to date and continued to be regularly reviewed. People and their relatives were involved in the reviewing of their care. People took part in a variety of activities that interested them. A complaints procedure was available to people, relatives and visitors. Complaints received had been resolved in accordance with provider’s complaints policy.

The provider had an effective system in place to monitor the quality of care and treatment provided at the home. Staff were asked for their views about how the home was run during staff and daily handover meetings.

David Gresham House is a residential home which provides care, accommodation and companionship for up to 29 older people. The purpose-built house, is in its own landscaped grounds, and is within walking distance of churches, post office, local shops, bus stop and local train station.

On the day of our inspection there were 28 people living in the home. This inspection took place on 10 December 2014 and was unannounced.

We last inspected David Gresham House in September 2013. At that inspection we found the service was meeting all the essential standards we assessed.

The home had a registered manager who was present on the day of inspection. 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 told us care staff treated them properly and they felt safe. We read staff had written information about risks to people and how to manage these in order to keep people safe. Staff had received training in safeguarding adults and were able to evidence to us they knew the procedures to follow should they have any concerns.

Care was provided to people by a sufficient number of staff who were appropriately trained. People did not have to wait to be assisted.

Processes were in place in relation to the correct storage and audit of people’s medicines. Medicines were administered and disposed of in a safe way.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. The registered manager and staff explained their understanding of their responsibilities of the Mental Capacity Act (MCA) 2005 and DoLS and what they needed to do should someone lack capacity or needed to be restricted.

People were provided with homemade, freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. We were told by the registered manager that people could regularly go out for lunch if they wished.

People were treated with kindness, compassion and respect. Staff took time to speak with the people who they supported. We observed positive interactions and it was evident people enjoyed talking to staff. People were able to see their friends and families as they wanted and there were no restrictions on when people could visit or leave the home.

People and their families, had been included in planning and agreeing to the care provided. We saw that people had an individual plan, detailing the support they needed and how they wanted this to be provided. We read that staff ensured people had access to healthcare professionals when needed. For example overview of doctors or optician visits had been recorded in peoples care plans.

People’s views were obtained by holding residents meetings and sending out an annual satisfaction survey. Complaint procedures were up to date and people and relatives told us they would know how to make a complaint if they needed to.

The provider had quality assurance systems in place to audit the home. This included regular audits on health and safety, infection control and medication. The registered manager met CQC registration requirements by sending in notifications when appropriate. We found both care and staff records were stored securely and confidentially.

People who used the service and their representatives were given appropriate information regarding the service to enable them to make an informed choice about living there.

People's needs were assessed and care and treatment was planned and delivered in line with individual care plans. People told us that they were involved in their care planning.

One person told us that they expressed their views about their care and support needs and that they were involved in decisions about changes in their care and treatment. At this inspection we looked at the care plans for three people. We saw that people’s needs were assessed and that in each record we looked at the person themselves had made comments about their needs or care.

Systems had been put in place which evidenced that people’s care plans were reviewed to ensure they were up to date. We found that care plans provided detailed information and guidance for staff to be able to meet people’s needs. Care plans included risk assessments based on the persons emotional, social and health needs.

People were protected by the safeguarding procedures in place and staff were knowledgeable about these procedures.

The staff told us they felt they had the appropriate training and support to enable them to undertake safeguarding and whistle blowing if the occasion ever arose.

We saw people had access to the home's complaints procedure and they were confident their concerns and suggestions would be listened to and acted upon.

We spoke with four people who used the service, three members of staff, one valunter and the registered manager.

We found that the atmosphere of the home was extremaly relaxed warm and friendly.

We saw that staff treated people with respect and promoted their dignity.

Comments received from people using the service included "were supported to do things for ourselves and when we asked for help the staff were always willing to help", "I was so glad to move into the home, they look after us all very well and we are asked to let them know if there is anything they could do better and what we think of them" and "all the time if they had any feedback or comments that could improve the home". People told us that they had the opportunity to take part in meaningful activities and outings that they enjoyed. The food was of a good standard and "there was always lots of it".

Staff received a suitable range of training to ensure that they had the necessary skills to support the people who lived there.

People told us that their views about the home were regularly sought and taken into consideration in how the home was run.

You can see our judgements on the front page of this report.

We talked to residents during our visit in December 2010. All of the people that we spoke to were able to express their views and said that they were very well cared for at the home and that staff could not do enough to support and care for them.

The residents were content with their accommodation and the level of support they received. The food was extremely highly praised in quantity, quality and choice. There was high degree of independence when practicable. Where residents were less independent there were practical measures in place to maintain those levels. Residents said that their families and friends were able to visit at any time and were always made welcome. The residents spoke of activities such as bridge, gardening and art in which they were encouraged to participate. Residents’ art works were displayed around the home.