Gairloch Residential Care Home provides accommodation and personal care and support for up to 24 people, some who may have a mental health need, physical disability or may be living with dementia. At the time of our inspection there were 18 people who lived in the service when we visited.

At the last inspection, in February 2015 the service was rated Good. At this inspection we found the service remained Good.

The home had a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People continued to be safe at Gairloch. People were protected against the risk of abuse. People felt safe in the service. Staff recognised the signs of abuse or neglect and what to look out for.

There were enough staff to keep people safe. The provider had appropriate arrangements in place to check the suitability and fitness of new staff.

Medicines were managed safely and people received them as prescribed.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff received regular training and supervision to help them to meet people's needs effectively.

People were supported to eat and drink enough to meet their needs. They also received the support they needed to stay healthy and to access healthcare services.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

Staff were caring and treated people with dignity and respect and ensured people's privacy was maintained particularly when being supported with their personal care needs.

The registered manager ensured the complaints procedure was made available to people to enable them to make a complaint if they needed to.

Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support. The registered manager provided good leadership. People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

Further information is in the detailed findings below and you can also see our previous comprehensive inspection report for this service.

The inspection took place on 04 February 2015 and was unannounced. Gairloch Residential Care Home provides accommodation and personal care and support for up to 24 people, some who may have a mental health need, physical disability or may be living with dementia. At the time of our inspection there were 21 people who lived in the service when we visited.

The home had a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Health and social care professionals we spoke with were all positive in their comments about the support provided to people at Gairloch Residential Care Home.

The service was meeting the requirements of the DoLS. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The home had appropriate systems in place to keep people safe. Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

There was a process in place which ensured people’s health care needs were assessed appropriately and. that care was planned and delivered to meet people’s needs safely and effectively. People were provided with sufficient quantities to eat and drink and their nutritional needs were met. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately.

People were offered a variety of chosen social activities and supported to follow their interests and hobbies. People were encouraged to take part in activities that interested them and were supported to maintain contacts with the local community so that they could enjoy social activities outside the service. There were systems in place to manage concerns and complaints. There was an open culture and the manager and staff provided people with opportunities to express their concerns and did what they were able to reduce people’s anxiety. People understood how to raise a concern and were confident that actions would be taken to address their concerns.

The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits, completed by the provider and registered manager and subsequent actions had resulted in improvements in the service. Systems were in place to gain the views of people, their relatives and health or social care professionals. This feedback was used to make improvements and develop the service.

Some of the people who lived at Gairloch Residential Care Home had complex needs but some were able to speak with us. We spoke with four of the 24 people who used the service on the day of our inspection. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the home and with staff. We also spoke with three staff members. We looked at four people's care records. Other records viewed included staff training records, health and safety checks, staff and resident meeting minutes and satisfaction questionnaires completed by the people who used the service and staff.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns.

We saw that since our last inspection in February 2014 the provider had made improvements to the medication processes and practices within the service. Systems had been implemented to ensure that medication practices were monitored and standards achieved.

The service was safe. We saw records which showed that the hygiene and health and safety in the service was regularly checked.

We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said: "They are lovely here, I am treated very well.” People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People who used the service were generally provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People can therefore be assured that complaints are investigated and action is taken as necessary.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.

As part of this inspection process we spoke with the provider, manager, three members of staff and three people who used the service.

Our observations indicated that people living at the service were very happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them. Comments included, "The staff are lovely. They are very nice", "The girls are lovely. I am very happy with the care I receive" and, "Oh, I feel I get everything I need. The staff are very helpful."

People's health and personal care needs were assessed and there were detailed care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. Appropriate arrangements were in place for people to raise concerns and/or make a complaint. The home environment was seen to be clean and odour free. There was evidence to show that effective infection control measures were in place. We found that medication practices and procedures required improvement.

We spoke with five people who used the service who told us they were happy in the service. One person said, “We are one big happy family here.” Another said “They (care staff) cannot do enough for you.”

We spoke with three members of care staff and the cook. Staff spoken with told us they felt they were provided with the training that they needed to meet the needs of the people who used the service.

We observed the care provided to people and saw that staff interacted with people in a caring manner. However, we were concerned with the manner in which people were supported with moving and handling transfers and this was communicated to the manager and provider of the service during this inspection.