About the service: Driftwood House a residential care home for older people. It is situated in Hunstanton. The accommodation is located over two floors. There were 25 people living at the service on the day of inspection.

People’s experience of using this service:

People’s medicines were not always managed safely. Cleaning products were not always securely stored to prevent possible injury to people.

People and their relatives were positive about the registered manager and the owners of the service. There was a positive caring culture within the service. Systems were in place to monitor the quality of the service provision and to make any necessary improvements when shortfalls were identified, however these were not effective during the registered managers absence.

People and their relatives were complimentary about the care provided at Driftwood House. The environment was clean and comfortable.

People received effective care from staff who understood how to recognise and report issues of concern and potential abuse.

People were supported by sufficient and competent staff who knew people well and cared for them according to their needs and preferences.

The registered manager and staff were encouraged to maintain and develop their knowledge and skills.

Staff respected people's privacy and dignity and interacted with people in a caring and compassionate way.

People's health was well managed and staff had positive relationships with professionals which promoted people’s wellbeing.

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 encouraged to maintain their independence and to make their own choices about where they spent their time and how. People were offered activities which they had the opportunity to join in.

The owners of the service had a visible presence and provided good support to the registered manager.

There was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to medicines management and unsafe storage of cleaning products.

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

Rating at last inspection: Good (report published 28 September 2016)

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

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

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

This inspection took place on 16 August 2016 and was unannounced.

Driftwood House provides accommodation and residential care for up to 28 older people, some of whom may be living with dementia. At the time of our inspection, the home was providing support to 22 people.

The home had 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.

People were safe living at Driftwood House and there were enough staff to meet their needs. Effective systems were in place to help keep people safe. Staff had received appropriate support and training which enabled them to identify the possibility of abuse and take appropriate actions to report and escalate concerns. Risks to people were assessed in detail, and plans to mitigate risk were responsive to people’s needs and managed appropriately. There were safe staff recruitment practices in place and appropriate recruitment checks were conducted before staff started work. This ensured people were supported by staff that were suitable for their role.

There were systems in place to monitor the safety of the environment and equipment used within the home, minimising risks to people. Medicines were managed, stored and administered safely.

There were processes in place to ensure new staff were inducted into the home appropriately and staff received regular training, supervision and appraisals. Staff were aware of the importance of gaining consent for the support they offered people. The registered manager and staff were able to demonstrate their understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation.

People were supported to maintain good health and had access to a range of health and social care professionals when required. People received enough to eat and drink to meet their individual needs.

Staff demonstrated a good understanding of the needs of the people they supported and could describe people’s preferences as to how they liked to be supported. Staff spoke with and treated people in a respectful and caring manner and interactions between people, their relatives and staff were relaxed and friendly.

People received care and treatment in accordance with their identified needs and wishes. Care plans documented information about people's personal history, choices and preferences, preferred activities and ability to communicate. Staff respected people's privacy and dignity. People were supported to engage in a range of activities that met their needs and reflected their interests.

The atmosphere in the home was open, friendly and welcoming and the registered manager and staff were approachable. Visiting professionals found the registered manager and staff to be approachable and easy to work with.

There were systems and processes in place to monitor and evaluate the quality of the service provided. There was a complaints policy and procedure in place.

We looked at this standard to follow up concerns from our previous inspection. Staff members received supervision and training from the provider or from external sources to ensure they had the skills and support to properly carry out their roles and care for people.

We looked at how medicines were managed because we found shortfalls when we visited the home in June 2013. Managers had developed an action plan to help make improvements and we found appropriate arrangements for the recording, handling, safe keeping and safe administration of medicines. We noted improvements had been made to the way medicines were administered to people. Our checks found medicines were given to people correctly.

We spoke with six people using the service and found all their comments about the home to be positive. People told us that they were happy living there. One person described Driftwood House as, “Lovely” and another said, “I would recommend it to anyone.”

The people we spoke with said that they received the right level of care to meet their needs. One person told us, “If you can’t do something they (the staff) will soon do it for you.” However, we found that there was a lack of assessments and care plans, which could result in people receiving inappropriate or unsafe care.

People using the service told us that they thought there were enough staff on duty. One person confirmed that they did not have to wait long when they needed help. Another person said that staff tried to make time to talk.

People we spoke with told us that they had never had cause for complaint but, if they should need to in the future, they knew who to speak with. People told us they felt confident that any complaints would be dealt with.

The people we spoke with during our inspection on 16 November 2011 told us that they were involved in making decisions about their care. People said that staff were very good at supporting them to remain independent. Everyone we spoke with said that staff were polite and respectful. They also commented that staff were friendly and they could have a laugh and a joke together.

There were no strict routines at Driftwood House and people said they had choices about all aspects of their daily lives. For example, they chose when they wanted to get up and how and where they spent their day.

People using the service told us that they were happy with the care they received. They told us that staff understood their needs and several commented that staff went out of their way to help people. One person said, "Most of them go the extra mile." We were told that staff were attentive if people were unwell and they made sure that people received medical help whenever they needed it.

With the exception of one person, who said they would like more things going on, everyone told us that there were enough activities for them to join if they wished. A number of people told us they went out regularly.

People told us that they felt safe living in the home. None of the people we spoke with on the day of our inspection had ever had to make a complaint about the service but said they would feel comfortable talking to any of the staff. One person said, "Minor hiccoughs get sorted out without any fuss." Family carers also told us that they had never had any concerns about poor care or about poor attitudes of staff.

People said that most staff members were polite, kind and respectful.

People received the care and support they required to improve their health and well-being. Care records were in the process of being updated and those that had been updated had been written in detail and provided clear guidance to staff members.

Medicines were not stored safely and checks were not maintained to show all storage areas were kept at the correct temperature. Administration records were kept, although people did not always receive their medicines from staff who had received appropriate training. We found that secondary dispensing was being carried out. This was an unsafe practice as the staff member administering the medicine did not have sight of the original container and therefore could not guarantee that they were giving the correct medicines.

Staff members had not all received supervision and training from the provider or from external sources to ensure they had the skills and support to properly carry out their roles and care for people.