Doric View is a purpose built bungalow providing short break accommodation for people who require personal care. The service can accommodate up to seven people. The number of people staying at the service at any one time varies due to the short term nature of the service.

At the last inspection in April 2015, the service was rated Good. At this inspection we found the service remained Good.

Relatives told us they happy with their family member’s care and support. They also told us staff members were kind and caring towards their family member. Both relatives and staff said they felt the service was safe. From speaking with staff and our own observations we concluded there were enough staff on duty to meet people’s needs.

Staff showed a good understanding of safeguarding and were aware of the provider’s whistle blowing procedure. Staff also knew the process for reporting concerns and said they would not hesitate to raise concerns if required.

There were effective recruitment procedures in place to ensure staff were suitable to work at the service.

Medicines were managed safely. Only trained staff administered people’s medicines. We found one person’s medicines had not been administered in line with the prescriber’s guidance. However, this had only just occurred at the time of our inspection and records had not yet been audited. The provider immediately invoked the medicines error procedure and commenced a full investigation.

The provider carried out regular health and safety checks. Procedures were in place to deal with emergency situations.

Staff were well supported and received the training they needed.

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 supported this practice.

People were supported to meet their nutritional needs.

People’s needs had been assessed both before and after they started using the service. This information was used to develop personalised care plans. These were reviewed so that they reflected people’s current needs.

People had opportunities to participate in their preferred activities, such as outings, jigsaws, crafts, painting and DVDs.

Although relatives gave positive feedback about their family member’s care, they also knew how to raise concerns if required.

The service had a registered manager. Relatives and staff said the registered manager was approachable and supportive.

Staff had opportunities to provide feedback about the service, such as one to one supervision and staff meetings.

The provider carried out a range of internal and external quality assurance checks to ensure people received good care.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We inspected the premises and saw that there were systems and safety precautions in place to protect staff and people using the service. Relatives we spoke with told us they thought Doric View was a safe place for their family member to visit. A relative told us, “If I had any doubts, I wouldn’t send him.”

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no applications had been submitted, best interests assessments had been carried out and risk assessments were in place to help ensure people’s safety.

Is the service effective?

People’s health and care needs were assessed with them and they were involved in writing their plans of care. Relatives we spoke with told us they were also involved in the planning of care and we saw they were invited to annual review meetings. We saw that support plans and risk assessments were up to date and reflected people’s individual needs.

Is the service caring?

People were supported by kind and attentive staff. Care records were accurate and up to date. People and their relatives told us they were happy with the care provided at Doric View. A relative told us, “We have total faith in them.”

Is the service responsive?

People were given the chance to make decisions for themselves. Records showed that people’s preferences, interests and needs had been taken into account and care and support had been provided in accordance with people’s wishes. We saw that the service responded to individual needs.

Is the service well-led?

The provider gathered information about the safety and quality of their service from a variety of sources. People and their relatives were asked their opinions on how the service was run. Regular checks of the premises took place to ensure it was safe and suitable for the people who lived there.

Some of the people using the service had complex needs which meant they were unable to tell us their views. Because of this we used a number of different methods to help us understand their experiences.

A relative we spoke with told us “the staff are brilliant”. Another relative we spoke with said the manager and staff were “very approachable and I can pick up the phone anytime”.

We saw that staff supported people in a sensitive and engaging way. Care plans were written to meet the needs of the individual and regular activities were arranged, including day trips.

The home had systems in place to regularly check the quality of care and other services and actions had been taken where issues had been identified. Residents and relatives were regularly consulted for their views about their care and treatment.

People we spoke with were positive about the service they received at Doric View. People confirmed that they had enjoyed their visit and staff had made them feel safe.

Relatives we spoke with told us they trusted the staff at the service and thought the accommodation was always clean and well maintained.

One person told us "They really try to make sure she is as independent as possible" and "I know they go out a lot".

We observed staff talking to people respectfully and engaged in conversation throughout our inspection.

People using the service and relatives were unable to communicate verbally their views of the service but one service user communicated, when asked, that they enjoyed their visit and liked the staff.

We were shown comments from a 2011 questionnaire sent out to relatives of the users of the service. The comments were all positive and included;

“…makes him feel confident and safe”

“listen to all questions or worries”

“very friendly, like part of a family”

The inspection took place on 7 and 9 April 2015. The first visit was unannounced and the second visit was announced. We last inspected the service on 25 April 2014. At that inspection we found the service was meeting all the regulations that we inspected.

Doric View is a purpose built bungalow providing short break accommodation for people who require personal or nursing care. The service can accommodate up to six people, at the time of our inspection there were four people using the service.

A new manager was in place at the time of our inspection. The manager was aware of their responsibility to apply to become a registered manager. 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.

We did not see evidence of MCA assessments and ‘best interests’ decisions being carried out for people who lacked capacity to make decisions for themselves. This meant people’s rights against inappropriate restriction of liberty were not protected because appropriate measures were not in place to make the required assessments and applications, in line with MCA and DoLS legislation.

People using the service told us they felt safe. One person said, “Yes safe, they look after me.” Another person said, “I’m happy here, I’m safe.” A relative told us, “I have no worries when [my relative] is here they are very safe.” Staff had a good understanding of safeguarding. We saw training records that showed all staff had received training relating to safeguarding.

Medicines records were up to date and accurate. This included records for the receipt, return, administration and disposal of medicines. This showed that people’s medicines were managed to enable them to receive them safely.

The service undertook very careful and detailed assessments of risks related to the care of people who lived there. The assessments showed that people using the service and their families were involved in assessments and their contribution was recorded.

We examined staffing rotas. People told us and our observations concluded there were enough staff to meet people’s needs.

Recruitment records for recently recruited staff held completed reference checks and a Disclosure and Barring Service (DBS) check dated prior to their start date. This meant the provider had undertaken the necessary checks to ensure staff were suitable to work with vulnerable people.

We saw it detailed action to be taken in the event of an emergency and was accessible to staff. This meant the provider had suitable plans to keep people safe in an emergency.

We looked at the accident and incident records. We saw information was collected, including types of incidents and times they occurred. As no trends were identified from the information analysis had been conducted.

We looked at record relating to the safety and upkeep of the premises. Records we viewed showed regular health and safety checks were undertaken. This included checks of gas safety, electrical safety, electrical appliances, fire safety and water safety. At the time of this inspection these checks were up to date. We asked people about meals. One person told us, “I like the food.” Staff told us that people can have their meals in a number rooms, it’s their choice. We saw a menu was available. Staff told us if a guest didn’t like the menu they would cook whatever they wanted for them.

We found that training and development was up to date. Training records contained a comprehensive record of appropriate courses with copies of training certificates. We also saw records of assessment of competence in regard to the management of medicines.

We saw records of supervisions and appraisals held, discussing working practices and training needs. Staff confirmed that appraisals were conducted annually and supervisions monthly.

At the entrance to the service a welcome book that gave details about the service including mission statement, aim and objectives, accommodation, medication, staffing and complaints and compliments. This information was also readily available in people’s rooms. This meant that people using the service and their families had access to up to date information about the service.

People told us the staff were caring and treated them well. One person said, “[Staff member] is lovely,” and “[Staff member] works really hard.” Another person said,” The staff are great and look after me.”

The atmosphere was happy and calm. All activities and chats involved the people who used the service. We saw people receiving plenty of attention from staff. Staff took the time to sit with people and chat and watch television with them.

We observed staff in many interactions with people who lived there. We saw that they were friendly and caring. Staff gave people time to express themselves and communicate. They ensured that people’s wishes were carried out.

People had diaries about their stay to show their parents or relatives where they had visited and what they have achieved. We saw one diary held postcards from the seaside and tickets from the show. A relative told us, “[My relative] can’t tell me what they have done during their stay, the diary gives me the information then I can talk to [my relative] about it”.

We examined records relating to compliments and complaints. The manager advised that no complaints had been received last year. However, the provider had a system in place to log and investigate complaints. We saw that a complaints policy and procedure was in place and was available to all within people’s room book.

The atmosphere in the home was friendly and relaxed and it was noted all staff were supportive of each other and clearly had positive working relationships. Staff told us they enjoyed working at the home. Staff told us they felt supported by the manager.

The manager had a comprehensive system to audit various aspects of the running of the service. These included checks of the medication systems, infection control, health and safety checks, audits of care plans and risk assessments and equipment checks.

We saw team meetings were held monthly to discuss issues within the service. Staff told us regular staff meetings were held. They said they were able to make comments and suggestions during these meetings.

You can see what action we told the provider to take at the back of the full version of this report.