About the service:

Gorway House is a residential care home that was providing personal care to 22 people aged 65 and over at the time of the inspection.

What life is like for people using this service:

• People continued to receive safe care. People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as prescribed. Staff followed infection control guidance and had access to personal protective equipment. Accidents and incidents were recorded and trends monitored to reduce the amount of accidents.

• People continued to receive effective care. Staff had the skills and knowledge to meet people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People's nutritional needs were met and they received enough to eat and drink to ensure they had a healthy diet. People accessed health care when needed.

• People continued to receive care from staff who were kind and caring and knew them well. Staff were patient, compassionate and empathetic. People's privacy, dignity and independence were respected by staff.

• People continued to receive responsive care. People's support needs were assessed regularly and planned to ensure they received the support they needed. People's support was individualised. People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaint process which people were aware of to share any concerns.

• The service continued to be well managed. The environment was friendly, warm, comfortable and very clean. The registered managers were known and made themselves available. People's relatives shared their views by completing provider feedback forms about the service. Spot checks and audits were carried out to ensure the quality of the service was maintained.

More information is in the Detailed Findings below.

Rating at last inspection:

• Rated Good overall (report published 18/08/2016)

Why we inspected:

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

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We carried out an unannounced comprehensive inspection of this service on 28 July 2016.

The home is registered to provide accommodation and personal care for adults who require nursing care and who may have a dementia related illness. A maximum of 28 people can live at the home. There were 20 people living at home on the days of the inspection. There was a registered manager in place. 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.

People felt safe in the home and relatives told us that they felt assured their family members were supported in a safe way. Staff told us about how they kept people safe from the risk of potential abuse. During our inspection staff were available for people and were able to support them by offering guidance or care that reduced their risks. People told us they received their medicines as prescribed and at the correct time. They also felt that if they needed extra pain relief or other medicines these were provided. People told us there were enough staff to support them when they needed or wanted help or assistance.

People told us staff knew what care they needed and relatives felt assured the staff were trained in how to look after the needs of people who lived at the home. All staff we spoke with felt supported by the manager and were able to discuss their role or training needs. People had been involved in the planning their care and relatives felt they were involved in any decision making where appropriate.

People told us they enjoyed the food and that it was well prepared. Where needed people were supported to eat their meal. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People told us and we saw that their privacy and dignity were respected and staff were kind to them. People received supported to have their choices and decisions respected and staff were considerate of promoting their privacy and dignity. Staff anticipated people’s care needs and attended to people in a gentle and unhurried way. Staff developed positive, respectful relationships with people and were kind and caring in their approach.

Staff knew the care needs of people who felt involved in their care and treatment. Staff were clear about the levels and expected care needs of people at the home. People and relatives we spoke with told us they happily raised any concerns or complaints with the management team.

People and relatives felt they were involved in the home and that it suited them well. The registered manager regularly checked that people and their family members were happy with their home and care. The management team were approachable and visible within the home which people and relatives liked.

We last visited Gorway House in June 2013 as part of our scheduled programme of inspections. This inspection found that: improvements were needed to ensure that people were fully protected against the risk of abuse; the risk of cross infection and confirmation that the building had been checked for gas and electrical wiring safety.

After our June 2013 inspection the provider of the service sent us an action plan that detailed the improvements that would be made. As part of this inspection we checked that the stated actions had been undertaken to ensure that risks to people were minimised.

Our visit to the home on 8 January 2014 was unannounced so neither the provider, managers or staff knew that we would be visiting. During this inspection we spoke with both the registered managers, one staff member, two people who lived in the home and one relative.

One person told us: "The staff are all very kind and patient".

We found that service had made all required improvements and was compliant with the regulations.

During our visit we spoke with five people who lived at, or were visiting Gorway House, one staff member and both care managers.

People told us that they were happy with the care they received. One person said, "It's lovely here, the staff are very good they cannot do enough for you". We saw that people received the care they needed and wanted.

People told us that they felt safe in the home and that the staff were kind. When we visited last time we found that improvements were needed to ensure that people were more fully protected against the risk of abuse. This inspection found that this had not been fully addressed and there was a need for further improvement.

People who lived and visited the home all told us that the home was always clean. One person told us: "It's always very clean and there is no smell". We also found the home was clean; however improvements were needed to protect people against the risk of cross infection.

We found the home was homely and appeared to be well maintained. However we had concerns about the safety of the building as records which would confirm that required safety checks had been completed were not available.

The service had a system in place for people to raise and address any concerns or complaints.

During our visit we spoke with four people who lived at, or were visiting Gorway House, five staff members and both care managers. Through a process called 'pathway tracking' we looked at care plans, spoke with people about the care they received and asked staff about how they provided support. This helped us establish that people were getting appropriate care that met their needs and supported their rights.

People told us that they were happy with the care they received and that staff always treated them with respect. One person said, "It's lovely here, the staff are very good they cannot do enough for you". We saw that people received the care they needed. A relative told us, "I cannot fault the care they provide here it's excellent. They always get the doctor when my relative needs it and they let me know when they are unwell".

People told us that they felt safe in the home and that the staff were kind. We found that improvement was needed to ensure that any allegation of abuse was appropriately reported and to ensure that the further risk of abuse was minimised.

The home had appropriate arrangements in place to ensure that there was sufficient and appropriate skilled and trained staff available to provide support to people at Gorway House.

Systems were in place for auditing and monitoring the quality of the service provided to ensure that people received appropriate and safe care.