About the service:

Friarn House is a care home that provides personal care for up to 16 older people. At the time of the inspection, there were 15 people living at the service.

People’s experience of using this service:

People who were able to communicate with us told us they felt safe. People who were not able to tell us about their experiences looked comfortable and relaxed in the presence of staff.

People were cared for by a consistent staff team who had received sufficient training to carry out their roles. People received assistance to take their medicines as prescribed.

People were supported to access health care services. People’s dietary needs were assessed and where needed, people received support to eat and drink.

People received care that was kind, respectful and responsive to individual needs. Care plans were comprehensive and reviewed each month. People and their relatives knew how to complain. No people were receiving end of life care at the time of our inspection visit.

The registered manager worked in partnership with other organisations to make continuous improvements and develop best practice.

More information is in detailed findings below.

Rating at last inspection:

Good (report published in September 2016).

Why we inspected:

This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up:

We will monitor information received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

This inspection was unannounced and took place on 29 July and 2 August 2016.

Friarn House is registered to provide accommodation and personal care for up to 16 people. It specialises in the care of older people who have a dementia. On the days of the inspection there were 16 people living at the home.

The last inspection of the home was carried out on 18 February 2014. No concerns were identified with the care being provided to people at that inspection.

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. The registered manager had managed the home for a number of years and had a good knowledge of the needs of the people who used the service. Everyone described the registered manager as open and approachable. People and staff said they felt able to discuss any issues with them.

We were unable to speak with some people in this home due to limited verbal communication.

We therefore gathered information by talking to staff, observing care and reading relatives' satisfaction surveys. We saw kind, caring and compassionate interactions from staff. Staff we spoke with were happy in their work, enthusiastic and confident. This was reflected In the atmosphere of the home. People who could not speak with us appeared happy and relaxed.

People were supported by sufficient staff numbers and staff told us they were always willing to cover shifts to ensure people received a consistent and reliable service. On both days of the inspections we saw people did not have to wait long for staff assistance. People and the staff knew each other very well and these relationships were valued.

Whilst the staffing structure was clear, improvements were needed in the supervision process for all staff. Although staff said they received supervisions, there were no records which showed appropriate on going and periodic supervisions were taking place. However staff appeared motivated and supported. The registered manager said supervisions were currently linked more to information sharing for all staff, or “Informal chats”, but would review the process with immediate effect.

Evidence showed that staff were suitably qualified, skilled and experienced. Staff had nationally recognised qualifications. One member of staff who had recently been through an induction period commented the induction process had been “good”. They said they felt they had learnt a lot more about people’s rights under the Mental Capacity Act (MCA).

Most people who lived at the home were supported to make decisions about the care and treatment they received. Where people were unable to consent, records showed any decision made on their behalf had been done in their best interest and ensuring their legal rights were protected.

Care plans were personalised and contained information to assist staff to provide care in a manner that respected their needs and individual wishes. Risk assessments which outlined measures to minimise risks and keep people safe were held in people’s care plans.

People’s nutritional needs were assessed to make sure they received a diet in line with their needs and wishes. Where concerns were identified with people’s nutrition, staff sought support from professionals such as GP’s and speech and language therapists

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice.

The provider sought people’s feedback and took action to address issues raised. Any issues raised from the feedback questionnaires were dealt with and people and relatives informed of the issues raised and action taken. People and their relatives all felt the leadership of the home w

We were unable to speak with people in this home due to limited verbal communication. We therefore gathered information by talking to staff, observation and relatives' satisfaction surveys. We saw evidence of comments from peoples' relatives, examples include, "Mum is happy, safe and looked after by staff who understand her needs" and "My family are very satisfied with the care provided for our father." One member of staff we spoke to told us "Because this is a small home we have more time with individuals, we get chance to have one to one interactions." Another staff member told us "We know everybody well, we know their likes and dislikes, its like a big family."

We saw evidence which showed that staff were suitably qualified, skilled and experienced. Staff we spoke to were happy in their work, enthusiastic and confident. This was reflected in the atmosphere of the home.

All staff were trained in safeguarding. The staff we spoke to were all knowledgeable regarding different types of abuse and demonstrated a confidence in reporting procedures.

At lunch time we observed well balanced nutritious meals being served in a relaxed dining room.

The provider had systems in place to regularly monitor and assess the service provided. Regular audits and satisfaction surveys allowed for continuous assessment and improvement of the service.

Some of the people who lived at the home were unable to fully express their views because of their dementia. We therefore spent time talking with staff and observing practices as well as talking to people who used the service. There was a calm and relaxed atmosphere in the home. People appeared very comfortable with the staff who supported them.

We saw that staff spoke with people in a friendly and polite manner. We noted that staff were sensitive and discreet when offering assistance which helped to maintain people’s dignity.

People we spoke with were happy with the care that they received. Comments included “It’s a nice place to live” and “I’m very well looked after.”

Care plans that we read contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure that they reflected people’s up to date needs. This meant staff had up to date guidance on how to support each individual.

People said that they thought that there was always enough staff on duty. One person said “The staff are lovely and chatty” another person told us “They always have time to help me when I want help, they’ll do anything for you.”

No one we spoke with had any complaints about the service they received. People who were able to express an opinion said that they would be comfortable to speak with a member of staff if they were unhappy about the service they received.

This inspection was to follow up on the compliance actions issued at the inspection carried out in March 2011.

Friarn House specialises in the care of people who have a dementia and many people living at the home are unable to fully express their views on the care that they receive.

As part of this inspection we spent time in the main lounge area observing care and support. We noted that interactions between staff and people living at the home were good and people responded positively. Everyone appeared very comfortable and relaxed with the staff supporting them.

People living at the home said that all the staff were kind and helpful. One person said “Staff seem very nice, there’s no unpleasantness” another person said “Staff are kind and they help you.”

People said that they were happy with the food at the home and we noted that people were given choices about lunch time food and drinks. One person said “There’s plenty to eat and it’s nice enough.”

The home cares for people who have a dementia. Many of the people who live at Friarn House are unable to fully express their views about the service which they receive.

On the day of the visit there was a calm quiet atmosphere in the home. We observed that people appeared comfortable and relaxed with the staff who supported them. One person said “Staff do what they can to help you, they are always sociable,” another said staff were “helpful and kind.”

Most people asked said that they were able to choose what time they got up and when they went to bed. We noted that the majority of bedroom doors were locked during the day and the manager stated that this was at the request of people living at the home. It was stated that people could ask to go to their rooms at any time. When we asked people living at the home if they were able to spend time in their room one person said “It’s not advisable to go back to your room.”

We observed the main meal of the day and noted that it appeared to be enjoyed. People asked said “The food is nice,” “Dinner is alright” and “There’s always plenty to eat.” One person said “If you don’t like what’s for dinner, they always find you something else.”

People said that staff arranged for them to see healthcare professionals and assisted them to attend appointments outside the home.

No one living at the home expressed any concerns about equipment in the home or the comfort of furnishings. People asked said that they were happy with their personal rooms. One person said that it was nice living at the home because “There’s always someone to talk to in the lounge.”