Frenchay House is registered to provide accommodation and personal care for up to 30 people. At the time of our inspection, 26 people were living at the service.

We carried out an unannounced inspection of the service on 28 June 2017.

At our last inspection in October 2015, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not always fully assessed the risks to the health and safety of people using the service. At this inspection, we saw the provider had taken the action they had identified in their action plan. As a result, improvements had been made and the service was no longer in breach of this regulation.

At the last inspection, the service was rated overall as Good.

As a result of this inspection, we have rated the service Good.

Why the service is rated good.

We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

Frenchay House was described by people, relatives and staff as homely. The atmosphere at the home was calm and relaxed. People were treated as individuals and received safe, high quality care.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see healthcare professionals including a GP when they needed to do so. The service complied with the requirements of the Mental Capacity Act 2005 (MCA).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager and deputy provided good leadership and management and were supported by the quality and training manager and the provider. A comprehensive quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified, they were acted upon.

We undertook an unannounced inspection of Frenchay House on Tuesday 6 October 2015. When the service was last inspected during January 2014 no breaches of the legal requirements were identified.

Frenchay House provides accommodation for people who require personal care to a maximum of 30 people. At the time of our inspection, the service was undergoing significant refurbishment and maintenance so had reduced admissions to allow for this. At the time of our inspection, 23 people were living at the service.

A registered manager was in post at the time 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.

The service had not ensured that all risks associated with people’s individual medical conditions had been assessed or care being appropriately planned to ensure their safety. The absence of care planning had resulted in staff having conflicting knowledge that placed people at risk.

People and their relatives felt safe at the service and spoke positively about their relationships with staff. Staff understood how to respond to suspected and actual abuse. There were sufficient staff on duty to keep people safe and recruitment procedures were safe. The service was clean and people’s medicines were managed safely. Equipment was regularly maintained to ensure it was safe to use.

People and their relatives said staff at the service provided effective care. Staff received appropriate training to provide a good standard of care. Additional training to meet the needs of people at the service was provided. Staff were supported through supervision and the registered manager told us an appraisal programme would soon be commenced. Staff had the opportunity to obtain national qualifications with support from the provider.

The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the mental capacity to consent to treatment or care and need protecting from harm. Staff were aware of how the Mental Capacity Act 2005 impacted on their work and demonstrated how they empowered people through choice. People received appropriate support with their nutrition and hydration and had access to healthcare professionals where required.

People and their relatives gave good feedback about care the staff at the service provided. The services compliments log also contained similar positive information. Staff knew people well and we made observations to support this. People’s visitors were welcomed to the service at any time and staff told us they had good relationships with people’s relatives.

People and their relatives felt the service was responsive to their needs and we made observations to support this. Care records contained personalised information and staff used this information to provide person centred care to people. The service provided activities for people to partake in within the service itself and in the local area. The service had a complaints process which people and their relatives felt they could use.

People and their relatives knew the management structure within the service. Staff told us they worked in a positive environment and that they could raise suggestions. The provider and registered manager had systems to monitor the quality of care provided and auditing systems to monitor records and documentation used by staff.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

At our last inspection in October 2013 we found that people were not protected from the risks associated with the administration of medicines. The provider sent us an action plan explaining how they would address this. During this inspection we found significant improvements had been made, so people were protected.

We saw some people being given their medicines in a safe and respectful way. We spoke to three people about their medicines. They told us staff looked after their medicines well. Medicines training had been provided for staff. This meant more staff were able to give people their medicines. Staff told us people received their medicines more quickly because there were usually two members of staff giving people their morning and lunchtime medicines. Medicines administration records showed that people were given their medicines as prescribed for them.

We inspected Frenchay House in August 2013 and found that the provider was not meeting Regulation 9 relating to the care and welfare of people that use services. This was because the care some people received was not being regularly reviewed to ensure it was suitable and met their needs. In addition some people’s end of life plans were also not reflective of their current level of need.

The provider sent us an action plan that detailed how they would achieve compliance. During our inspection we found that the actions the provider told us they were planning to take, had been implemented within the service.

During our inspection we looked at records held within the home that included people’s individual care plans. We spoke with people that lived in Frenchay House, visiting friends and relatives and staff that were on duty. Comments we received were positive and people we spoke with felt there had been improvements in the service provision since our last inspection.

Comments from people that used the service included; “it’s lovely here now, things are more relaxed”. “I am very happy here they are nice girls here”. A member of staff told us “it has improved here, we have more time to sit and talk to residents. That’s all we ever wanted as residents love to chat”. Comments from people that used the service included; “it’s lovely here now, things are more relaxed”.

We found that people were not fully protected from the risks associated with medicines. Improvements were needed to a number of aspects of how people's medicines were looked after in the home.

At the time of our inspection 29 people were living in Frenchay house. During our inspection we spoke with people living in the home, staff, the provider and examined the care records for people living in the home.

We were supported on this inspection by an expert-by-experience. This is a person who had personal experience of using or caring for someone who used this type of care service. This person gained the views and experiences of people living in the home.

Not all people were able to verbally tell us about the care they received or if they were happy. This was because some people were living with a form of dementia. Therefore we observed how staff interacted and supported people in communal areas and crossed referenced this with their individual care plans. This enabled us to make a judgement on how their needs were being met.

Overall people we spoke with who used the service were happy with the care they received. Comments included; “I am very lucky to be here, everyone is very kind and very generous, I have nothing but praise for it”. “I have the highest regard for the staff this is a wonderful place to live. The food we get is good, especially the porridge with honey at breakfast. We don’t join in the activities, we prefer to be together”.

We found the provider had systems in place to effectively monitor the service provided.

We spent time with people that lived in the home. The atmosphere was calm, happy and relaxed. People told us that they were very happy living there and that they were looked after by 'super staff'. We saw staff talking to people in a sensitive way and supporting people with their needs.