Friary House is a residential care home registered to provide accommodation and personal care for up to 16 people in Weymouth. At the time of our inspection there were 15 older people living in the home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last 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 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 had a good understanding of how to safeguard people and how to raise concerns either internally or externally if they suspected harm or abuse. There were enough staff to meet people’s current and emerging needs. A dependency tool was used monthly to ensure that staffing levels continued to match the needs of the people living there. People’s individual risks are assessed and reviewed. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported to have choice throughout their day and have care in line with what they needed and wanted. People expressed confidence in the skills and competence of the staff supporting them. Where people lacked capacity to make particular decisions they were supported by staff who were trained and worked in line with the principles of the Mental Capacity Act 2005.

Staff consistently demonstrated a kind and caring approach towards people. Interactions were unhurried, attentive and friendly. People were encouraged and supported to maintain their independence. Staff understand what each person could still do and how much support they wanted to accept. People were respected and treated as individuals with distinct preferences, likes and dislikes.

People produced their own monthly newsletter which is widely distributed and read. People and relatives told us this created a sense of community and ownership over what happened at Friary House. People and relatives said that they feel listened to and are confident that anything they raise is resolved. One person said, “I’m so happy here. I’ve only got to ask for something and it’s done.”

There was a positive and open culture at the home where everybody’s views were considered. Staff felt supported and that their work was recognised. They received regular supervision where they received both praise and suggestions where they could improve their practice. The home had established good working relationships with health professionals who were helping people to stay well for longer and prevent unnecessary admission to hospital.

Further information is in the detailed findings below

The inspection took place on 12 and 15 March 2016.

Friary House is registered to provide accommodation and personal care for up to 16 people in a residential area of Weymouth. At the time of our inspection there were 14 older people living in the home.

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 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.

Deprivation of Liberty Safeguards had not been applied for where a person who needed to live in the home to be cared for safely did not have the mental capacity to consent to this. The registered manager ensured that this was addressed immediately and the application was made during our inspection.

People were engaged with activities that reflected their preferences, including individual and group activities both in Friary house and the local area. Activities were provided by an activities coordinator and people’s individual preferences were sought.

Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills. There was a plan in place to ensure staff received refresher training as deemed necessary by the provider.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their lives. Care plans did not all reflect that care was being delivered within the framework of the Mental Capacity Act 2005 when people did not have clear capacity to make decisions for themselves. However, staff showed they understood the importance of enabling people to make their own decisions wherever possible and understood the need to provide care that is in a person’s best interests.

People had support and care when they needed it from staff who had been safely recruited.

People felt safe. They were protected from harm because, although relevant care plans were not always in place, staff understood the risks people faced and how to reduce these risks. They also knew how to identify and respond to abuse. Information about how to report abuse was on a noticeboard in a prominent position and available to staff, people and visitors.

Quality assurance had led to improvements being made and people, relatives and staff were invited to contribute their views to this process. Where improvements were identified as necessary following feedback from external agencies action had been taken. Staff, relatives and people spoke positively about the management and staff team as a whole.

People told us they received the care and support they needed. They told us they usually didn’t have to wait long for staff and that staff explained if they were delayed. They also told us they saw health care professionals when necessary and were supported to maintain their health by staff. People’s needs related to ongoing healthcare and health emergencies were met and recorded. People received their medicines as they were prescribed.

Everyone described the food as good and there were systems in place to ensure people had enough to eat and drink. When people needed particular diets or support to eat and drink safely this was in place.

People were positive about the care they received from the home and told us the staff were kind. Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection.

Our inspection set out to answer five questions: is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well-led?

Below is a summary of what we found. It is based on our observations during the inspection, discussions with people living in the home, and with the staff supporting them, and on looking at records.

Is the service safe?

Staff treated people with respect, and made sure they kept their dignity. People told us they felt safe living at Friary House. Equipment was maintained regularly and staff were trained to use it correctly.

Recruitment practice was thorough, and staff were supervised until they were competent to work alone.

Accidents and incidents were monitored and changes made to reduce the chance of them happening again. The registered manager knew about the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS), and how to get further advice about using them.

Is the service effective?

People’s health and care needs were assessed with them and they were involved wherever possible with their care plans. Specialist support and care was identified in care plans. People at risk of falling were monitored closely to reduce the risk of further falls. Where people's needs changed, care was changed to meet need and reduce risk.

The service was effective in meeting people’s mobility needs because there was a range of equipment available for them to use.

Is the service caring?

People told us that staff were “excellent”. They said that they were well-cared for and that the home was friendly. One person said, “It’s like a large family – I’m so happy here”. Relatives of a person who used Friary House for regular short stays told us that this was “the best home in terms of care and staff”.

People’s preferences, interests and needs were recorded, and care and support was given in accordance with their wishes.

Is the service responsive?

People knew how to make a complaint, although no-one had needed to recently. The home responded to complaints and suggestions. People living at Friary House held regular residents’ meetings that gave them an opportunity to share their views.

Staff worked closely with other agencies and services to make sure that people received the most appropriate care and treatment when their needs changed. A visiting health care professional told us that the home communicated with them well when a person needed an assessment.

Is the service well-led?

The service had ways of monitoring quality on a regular basis. Senior staff used this information to make changes to care.

People living Friary House told us that the registered manager was present regularly. They described them as being “very hands-on”. One person said that the registered manager “always does the right thing”.

During our visit we spoke with three people who live in the home. We also observed people taking lunch in the home, and observed people who were involved in a crossword activity in the afternoon. People told us that they were asked for their consent when making choices and decisions about their daily lives; and that their choices and decisions were respected by the staff. A person told us, "They always ask my permission and explain things."

People told us that they felt positive about the quality of care they received and with their relationships with the staff. We saw people moving freely around the home and interacting with the staff in a relaxed way. A person told us, "They really are polite and respectful.” Another person told us, “The food is very good. We get choices.”

We found that the home's staff had the right competencies, and that staff were supported to provide care and support to people. A person told us, "I have no concerns about the staff."

People told us they felt safe living in the home. A person told us, "On the whole we are a pretty friendly and compatible group."

The home was taking account of people's comments or complaints. People told us that they could be sure that their comments were listened to, and responded to appropriately.

During the visit, we spoke with three people who were using the service and two visitors. They told us the staff kept them involved in the review of their care and always asked for permission before they delivered care.

The people we spoke with told us they were happy with the care they received. They told us the staff discussed their care needs with them on a regular basis.

They told us the staff were very friendly, caring and responsive. One person said “The staff are excellent, they treat me with dignity and respect.” A visitor told us “The staffing is 100% perfect, they are well mannered, helpful and polite.”

Everyone we spoke with told they had no concerns about the care they received and would speak to the senior staff or the registered manager if they had any concerns.