About the service:

Falcon House Care Home is a residential care service for older people and those with dementia. Falcon House can accommodate up to 46 people. At the time of our inspection there were 45 living there.

People’s experience of using this service:

People’s experience of the service was positive. People felt safe and the registered manager ensured that enough staff were deployed to meet people’s needs. Staff were well trained and training was kept up to date and monitored by the registered manager.

Systems were in place to support people to take their medicines safely. Staff received relevant training and felt well supported. People were asked for their consent to their care and appropriate steps were taken to support people who lacked capacity to make decisions.

People were consulted on all aspects of their care and support and they were involved in their care planning. Relatives were also asked to contribute and discuss care needs where appropriate.

People had excellent relationships with the staff and the registered manager. They felt happy with their care and felt that the staff understood their needs and what aspects of their care they would like support with.

People told us they felt well cared for by staff who treated them with dignity and respect. People enjoyed the range of activities on offer and they were always given a choice of things to do.

An open and transparent culture enabled people and staff to speak up if they wished to. The registered manager provided goof leadership and understood the needs of the service and the people living there.

Rating at last inspection: Good (Published October 2017)

Why we inspected: This was a planned inspection.

This inspection took place on 10 and 12 October 2017 and the first day was unannounced.

Falcon House Care Home was last inspected in August 2015 and was rated Good. At this inspection, the service remained Good.

The provider is registered to provide accommodation for up to 46 older people living with or without dementia in the service over two floors. There were 45 people using the service at the time of our inspection.

A registered manager was in post and was available throughout the 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.

Staff knew how to keep people safe and understood their duty to protect people from the risk of abuse. Risks were mostly well managed so that people were protected from avoidable harm, though falls risk assessments were not always accurately completed and the bedrails risk assessment required development to effectively consider all risks of the use of bedrails. Mattresses to minimise the risk of people acquiring skin damage were not always set to the weight of the person using them.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Medicines were managed safely and staff mostly followed correct infection control practices.

Staff received induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005.

People received sufficient to eat and drink but their mealtime experience in one part of the service could be improved. External professionals were involved in people’s care as appropriate and adaptations had been made to the design of the home to better support people living with dementia.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received care that respected their privacy and dignity and promoted their independence. People could receive visitors without unnecessary restriction.

People received personalised care that was responsive to their needs. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and that appropriate action would be taken.

The registered manager and provider were meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided. New more detailed audit tools were to be introduced to further improve monitoring of the quality of the service.

We spoke with six people about their experiences of the care and support they received. All of them told us they were very happy and settled and staff looked after them well. One person said, “I am happy and settled, I am independent but the staff do help me to have a bath.” Another person said, “I have no problems, it is a lovely home and a lovely atmosphere. The staff are wonderful.”

We saw care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People using the service offered many positive comments about the care and support they received. One person told us that staff were nice and respectful. Another person told us that they felt a lot better since they came to live at the home.

We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

All five people spoken with told us they were happy with the environment and they felt that it was well maintained. One person said, “It’s a nice environment, I can look out the windows and see a long way, we have a good view. It is comfortable here.”

We looked at the recruitment records of five members of staff. We saw appropriate checks were undertaken before staff began work.

We spoke with four people about the recruitment processes. They all told us that new staff were introduced to them when they first started working at the home. One person said, “”New staff are introduced, which is good as we can get to know them.”

We saw the complaints procedure and found this to be clear and it contained sufficient information to enable people to make a complaint if they wished to do so. All six of the people we spoke with told us they were happy but if they needed to make a compliant they felt this would be listened to and acted upon.

We found there had been an improvement in record keeping and these were now more accurate and fit for purpose.

During this visit we spoke with five people using the service and one relative. We also spoke with three members of staff and management.

We found there had been improvements since we last visited in respect of care planning, medicine management and the quality monitoring systems.

People spoken with were happy and settled living at the home. One person said, “Its OK I have no where else to go,” The food is OK you get a choice what you want to eat.” Another person said, “I dress myself, but can get help when I need it.”

We spoke to one relative during our visit. They told us they were involved with the care planning and felt their family member’s needs were being met. They said they had no concerns regarding the care and would raise it with the manager if they did. The relative told us their family member was well kept and they knew they had two care workers to assist them.

We saw that people were able to make their own choices and decisions and spend their time as they wished.

We found some records were not always maintained as required and there were some gaps in the daily reporting logs.

We visited the location to carry out a planned review. We also looked at the compliance actions that had been set at the previous inspection to see if these had been addressed and improvements had been made.

Due to the complex needs of some people living at Falcon House Care Home they were unable to talk with us. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We carried out this observation for a period of one and a half hours.

We also spoke with two relatives, three people using the service and three members of staff.

One person said staff had asked them about the things they liked when they first moved into the home.

One relative said they were involved in any decision making and they gave us an example of how they had been involved in making important decisions for their relative’s care.

All three people said they could make their own choices and decisions about their lives and the care and support they received. They also said that staff were kind and respectful towards them.

All three people living at Falcon House said they were happy and settled and that staff supported them appropriately.

One person told us: “I am happy here and they care for me how I like it.” Another person said, “The staff are very kind, they help me when I need it, they help me to walk with my frame.”

One relative said, “My relative is well looked after and they are always clean and tidy. They call the doctor as needed and care for them if they are unwell.”

One person using the service said there were activities for them to join in if they wanted to; however they tended not to join in that many.

When the activities coordinator spent time with people they acknowledged people’s uniqueness and valued them as individuals. The activity was personalised to each person’s needs and skills. They celebrated people’s achievements and took delight in people’s enjoyment. This empowered people and enabled their personhood to be facilitated and they spent time in a positive mood and showed obvious enjoyment and pleasure.

During our SOFI observations with the exception of one incident the atmosphere in the home was calm and friendly and staff supported people as needed.

One person said, “I get my medicine when I need it.”

One relative also confirmed that their relative received their medication when they needed it.

People using the service and relatives’ said there were enough staff available to meet people’s needs.

One person using the service said that meetings took place, however they did not attend the one that had taken place recently. Another person said they could make comments about their care and these would be listened to and acted upon.

Both relatives said they could provide feedback about the service and that this would be listened to.

Two people, who use the service, told us about the support with medicines that they received from staff. One person said that they did not always receive their medicines or inhalers regularly, particularly at night. The other person said, “They are not bad. I get my medication and they are very good”.

People told us they were treated with respect at Falcon House and they felt safe living there. They were also positive about the activities arranged by the activity co-ordinator. One person said, “I very much like (the activity co-ordinator’s) activities”.

Several people spoke of there being insufficient staff to meet their needs and of having to wait for staff to answer the call bell. Comments made by people included, “we need more staff”.

We asked people if their opinions were sought on the service they receive. Their responses included, “not very often” and “not really”. Some said they had seen improvements after sharing concerns at residents’ meetings.

We did not speak in depth, on this visit, to any person who uses the service. Many of the people living in the home had dementia and we decided to talk to the personal representative of one person, who was visiting.

The close friend of a person who uses the service thought that her friend’s care plan was an accurate reflection of the person’s needs. She told us, “I have total respect for the staff here”.

The close friend told us she felt her friend was safe at the service.

The close friend also told us that she felt staff are competent, including an understanding of the needs of people with dementia.

The close friend told us that the acting manager responds well to any concerns raised with her and will communicate any concerns the service has about the person to this friend.

This inspection took place on 26 and 27 August 2015 and was unannounced.

Accommodation for up to 46 people is provided in the home over two floors. There were 46 people using the service on the day of our inspection. The service is designed to meet the needs of older people.

There is a registered manager and she was available during the 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 felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. The premises were managed to keep people safe. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Medicines were safely managed.

Staff did not always receive appropriate induction, training, supervision and appraisal. Some adaptations had been made to the design of the home to support people living with dementia; however the premises required updating in places. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care.

People’s needs were promptly responded to. Care records provided sufficient information for staff to provide personalised care. Activities were available in the home. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the management and that the registered manager would take action. There were systems in place to monitor and improve the quality of the service provided.