This unannounced inspection was conducted on 5 September 2017.

Situated in Southport and located close to public transport links, leisure and shopping facilities, Good Companions EMI Residential Care Home is registered to provide accommodation for up to 26 people living with dementia. There is a lounge on the ground floor and an open-plan lounge and dining area in the basement. Bedrooms are located on the ground and upper floors. All floors can be accessed by a passenger lift if people have mobility needs. There is a large garden to the rear of the property and car parking to the front.

At the time of inspection 24 people were living at the home.

A registered manager was 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.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

Each of the relatives that we spoke with was very complimentary regarding safety at Good Companions. We also saw clear evidence of safe practice.

We saw that people were protected from the risk of abuse or harm because staff knew people well and were vigilant in monitoring risk. Risk assessments had been regularly reviewed and changes applied where necessary.

Medicines were safely managed within the home by trained staff and in accordance with best-practice guidance for care homes.

Staff were recruited safely and deployed in sufficient numbers to meet people’s needs. The people that we spoke with were clear that staff had the right skills and experience to provide the specialist care required. Staff were trained in subjects relevant to the needs of people living at Good Companions. Subjects included; adult safeguarding, mental capacity and moving and handling. This basic training was supplemented with additional, specialist training. For example, in dementia and end of life care.

People’s capacity was assessed and consent sought in accordance with the Mental Capacity Act 2005 (MCA). The processes and records relating to the assessment of capacity and consent to care were extremely thorough and well-detailed. Consent was sought and recorded in care records.

People were supported to maintain a varied and healthy diet in accordance with their preferences and healthcare needs. The home operated a rolling menu which offered good choice.

We saw from care records that staff supported people to access a range of community based healthcare services on a regular basis. Some people were also supported to access specialist healthcare services where there was an identified need. We saw examples of the positive impact that the home had on people’s health and wellbeing.

Good Companions was specifically adapted to meet he needs of people living with dementia. Adaptations and décor had been developed with the support of specialists in dementia care.

People living at Good Companions, their relatives and professionals were complimentary about the quality of care provided and the positive impact that the home had on people’s lives. We saw staff support people with their personal care in a manner that was respectful and discrete. When staff delivered care and support they explained what they were doing when supporting each person.

Some people living in the home were involved in the planning and review of their care. For other people this was not practical because their health conditions limited their understanding of the process. Where this was the case information from relatives, professionals and staff was used to update care plans. Care records provided evidence of regular review and personalised approaches.

Relatives and staff spoke positively about the management of the home. The regi

This unannounced inspection took place on 14 April 2015.

Good Companions EMI Residential Care Home is registered to accommodate up to 26 people. who have dementia. There is a lounge on the ground floor and a recently refurbished open-plan lounge and dining area in the basement. Bedrooms are located on the ground and upper floors. All floors can be accessed by a passenger lift if people have mobility needs. There is a large garden to the rear of the property and car parking to the front. The home is located on the outskirts of Southport and is close to public transport links, and local community facilities.

A registered manager was 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 2008 and associated Regulations about how the service is run.

People said they felt safe living at the home and were supported in a safe way by staff. Families that we spoke with also told us they thought the home was a safe place to live. They said there was good security in the home. We observed staff constantly checking on people throughout the day especially the people who liked to walk about the building frequently throughout the day.

The staff we spoke with could clearly describe how they would recognise abuse and the action they would take to ensure actual or potential abuse was reported. Staff confirmed they had received adult safeguarding training. An adult safeguarding policy was in place for the home and the local area safeguarding procedure was also available for staff to access.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People living at the home, families and staff told us there was sufficient numbers of staff on duty at all times.

Staff told us they were well supported through the induction process, regular supervision and appraisal. They said they were up-to-date with the training they were required by the organisation to undertake for the job. They told us management provided good quality training.

A range of risk assessments had been completed depending on people’s individual needs. Care plans were well completed and they reflected people’s current needs, in particular people’s physical health care needs. Risk assessments and care plans were reviewed on a monthly basis or more frequently if needed.

Safeguards were in place to ensure medicines were managed in a safe way. Medicines were administered individually from the medication room to people living at the home. The care manager said it was safer and less distracting this way, and reduced the risk of errors occurring. Staff wore a red tabard to highlight they must not be disturbed while giving out medicines. The care manager said that people living at the home seemed to know what this meant and they were less likely to approach the member of staff wearing the tabard.

The building was clean, well-lit and clutter free. Measures were in place to monitor the safety of the environment and equipment. An extensive refurbishment programme was in place to ensure the home provided a dementia friendly environment. Recently completed work in the basement provided people with a spacious and airy environment that they could walk about in safely without losing their bearings.

People’s individual needs and preferences were respected by staff. They were supported to maintain optimum health and could access a range of external health care professionals when they needed to.

People told us they were satisfied with the meals. A family member had tested the food and said it was good. We observed that people had plenty of encouragement and support at meal times. People living at the home and their families were invited to contribute when the menus were being revised.

People and families described management and staff as caring, respectful and approachable. Families said the service was well managed and a family member told us they had recommended the home to other people. Staff had a good understanding of people’s needs and their preferred routines. We observed positive and warm engagement between people living at the home and staff throughout the inspection. A full and varied programme of recreational activities was available for people to participate in.

Staff sought people’s consent before providing support or care. The home adhered to the principles of the Mental Capacity Act (2005). Applications to deprive people of their liberty under the Mental Capacity Act (2005) had been submitted to the Local Authority.

The culture within the service was and open and transparent. Staff and people living there said the management was both approachable and supportive. They felt listened to and involved in the running of the home.

Staff were aware of the whistle blowing policy and said they would not hesitate to use it. Opportunities were in place to address lessons learnt from the outcome of incidents, complaints and other investigations.

A procedure was established for managing complaints and people living at the home and their families were aware of what to do should they have a concern or complaint. No complaints had been received within the last 12 months.

Audits or checks to monitor the quality of care provided were in place and these were used to identify developments for the service.

During our visit we spoke with four people living in the home and with four visitors. We also spoke with two members of staff.

People told us they were happy with the care and support they received and had no concerns or complaints. Comments included, "It's a very nice place; just smashing", "I can choose what I want to do", and "Staff are very good to me; I am very well looked after". Comments from visitors included, “The home is very family orientated” and “I have no concerns at all and would be happy to recommend the home to anyone”.

We were told there were opportunities for involvement in suitable activities both inside and outside the home and activities were tailored to people’s individual needs and preferences. During our visit we observed people participating in and enjoying a number of meaningful activities.

People told us they were happy with the staff team and they said there were enough staff. Comments about staff included, “Staff are very kind and understanding”, “Staff are approachable; nothing is too much trouble” and “Staff are marvellous”.

On the day of the visit people who lived in the home, their relatives and visitors were interviewed and asked their views about how the service involved them and kept them informed. Feedback was limited from people living at Good Companions due to their level of communication but we were able to make general observations of people's wellbeing, as further evidence of inclusion.

People spoken with confirmed they were encouraged to express their views openly. They said staff were friendly and always on hand to talk to. One person said. ''Staff are lovely and very caring.'' A visitor told us ‘’staff are excellent. They treat everybody as individuals.’’

People spoken with expressed the view they were treated with respect and dignity. They said their wishes were listened to.

People were relaxed and talked freely. We spoke with one person who said ''The staff look after me very well. They are very kind.'' We spoke with a relative who said that staff worked well with them and reported any changes in the care very quickly. They reported that their relative had settled well into the home and staff had spent a lot of time being positive and reassuring which had helped immensely. Another visitor told us that the standard of care was consistent and their relative was being well cared for.

We received positive comments about the staff which helped evidence their competency and approach to care. Comments include:

‘’Staff are very good. They always make sure they spend time with [my relative] and are very patient.’’

‘’Staff are fantastic – they create a good atmosphere for people.’’

‘’Staff always let me now what’s happening with [my relative] and let me know if a doctor is needed. I see how they look after other people – very good care.’’

People reported that staff numbers were consistent and staff said there was a good morale, so staff supported each other and worked well together.

All the people spoken with, who were able to express an opinion, knew how they could make their views known if they were not happy with the service provided. They said they would speak to the staff, the manager or a relative.

The relatives spoken with knew how to make their views known if they were not happy with the service provided. One told us that the staff and manager were very approachable. The manager had also held relative meetings, a forum by which they could raise any issues.