This was an unannounced inspection carried out on 10 March 2017.

Fotherby House can provide accommodation and personal care for 20 older people. There were 17 people living in the service at the time of our inspection visit.

The service was run by a company who was the registered provider. 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

Care staff knew how to keep people safe from the risk of abuse and improvements had quickly been made to address a shortfall in how people were helped to manage their personal money. Suitable steps had been taken to avoid most preventable accidents. Medicines were safely managed and there were enough staff on duty. Although some background checks had not been completed, in practice the recruitment procedure had ensured that only suitable care staff were employed.

Staff had received the training and guidance they needed so that they knew how to care for people in the right way. People enjoyed their meals and were assisted to eat and drink enough. Staff ensured that people received all of the healthcare they needed.

The registered persons had ensured that whenever possible people were helped to make decisions for themselves. However, when this was not possible the registered persons had ensured that decisions were taken in people’s best interests.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had ensured that people only received lawful care.

People were treated with kindness and their right to privacy was usually promoted. Confidential information was kept private.

People had been consulted about the help they wanted to receive and they had been given all of the practical assistance they needed. Care staff promoted positive outcomes for people who lived with dementia and people had been supported to pursue their hobbies and interests. Complaints had been quickly and fairly resolved.

Quality checks had been completed and the registered persons planned to introduce additional checks to further strengthen how they monitored the service. People had been consulted about the development of their home and the service was run in an open and inclusive way. Good team work was promoted and staff were supported to speak out if they had any concerns. In addition, people had benefited from staff acting upon good practice guidance.

During our visit we spoke with ten people, two relatives who visited the home, four staff members and the registered manager, who was also one of the home owners.

People we spoke with said they were happy with the care they received. They made comments such as, "I am care for in the right way, I feel safe and that’s what makes the difference", "I have all my belongings in my room and I feel it’s the next best thing to being home" and "You can tell the staff care about the work they do."

Throughout our visit we saw staff were responsive and supported people in a safe dignified and respectful way. They also showed us they knew about people's needs, likes and dislikes and supported people to take part in a range of activities.

We found people were provided with a good choice and a variety of food and drink that met their individual needs. One person told us, “The food is very good,” whilst another person said, “I like the range of meals provided. I am a vegetarian and they cater for me.”

Records showed the home was maintained to an appropriate standard and the layout of the premises met people’s individual needs. We also found there was an effective system in place for the provider to monitor and assess the quality of services within the home.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. One relative told us, “I have absolutely no concerns. XX is very happy here. XX’s care is very well planned.”

We found people were cared for in a clean, well presented home. People’s care was based about their individual needs. The staff provided care in a pleasant and professional manner. One person living at the home said, “The staff are excellent. They will do anything for you.”

We saw staff had time to interact with people. The home had an activities coordinator who organised a wide range of activities.

We saw the cook provided a choice of hot and cold foods at each mealtime and snacks throughout the day. One relative told us, “The food has always been good here.”

We observed staff provided support and engaged with people who lived at the home positively. People appeared relaxed and comfortable in the presence of their support staff. In discussion, it was evident staff understood the needs of people they supported.

This inspection was carried out on 16 October 2014.

Fotherby House provides care and support for up to 20 people, some of whom may experience memory loss associated with conditions such as dementia. There were 18 people living at the service at the time of our inspection.

There was a registered manager in post at the time of our inspection. 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 the 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 happy with the service they received and we received many positive comments about the care and support provided. Staff treated people with respect and were kind and compassionate towards people who used the service. The staff and management approachable and people who used the service could speak with them if they were concerned about anything.

Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s diverse needs and work in ways that were safe and that protected people.

Staff had also been trained and had the skills and knowledge to provide support to the people they cared for. They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards, which meant they were working within the law to support people who may lack capacity to make their own decisions.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan.  A care plan is a document which details people’s assessed social and health care needs and informs staff how to meet those needs. The information and guidance provided to staff in the care plans was clear. Any risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to keep people safe.

Throughout our inspection visit we saw that staff knew how to provide care in the ways people had said they wished to be supported. We also found that sufficient numbers of staff were available to meet people’s needs.

People could make their own decisions about what they wanted to do, their preferences had been recorded and we saw that staff respected these.

Records also showed that people were able to raise any concerns or more formal complaints if they needed to. Where people had raised issues that these were taken seriously and dealt with appropriately. People could therefore feel confident that any concerns they had would be listened to. 

The provider used a variety of ways to assess the quality and safety of the service that it provided. People and their families and representatives were consulted with. The provider undertook a range of monitoring and areas such as health and safety and medication were regularly audited.

The management at the service was well established and provided consistent leadership.