We carried out this inspection on 13 December 2018. The inspection was unannounced.

This service was last inspected in April 2016 and was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Hinderton Mount Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There were 15 people living in the home at the time we carried out our inspection.

There was an experienced registered manager responsible for the day-to-day management of the service. 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 been working at the service for over 11 years.

We looked at how the service managed its recruitment of new staff and saw that this was done well and all of the required checks were carried out before staff commenced working at the home. The home had an established staff team. Many staff had worked at the home for a number of years.

We spoke with five people who lived in the home and seven relatives and all gave positive feedback about the home and the staff who worked in it. They told us that the staff supported people well. We saw that warm, positive relationships with people were apparent and one person described the staff as “our extended family”.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected. The home recognised that some people in the home were starting to need more support with decision making and they were ensuring that this was done safely, maximising the person’s abilities to make their own decisions.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw that staff were very thoughtful in their approach to people.

We found medication procedures at the home were safe. An external audit conducted by the local Clinical Commissioning Group (CCG) had commended the home for the good management of medicines.

Care plans were clearly recorded. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required. We saw that relatives were involved in supporting staff to understand how people wished to be cared for. Life histories were present in all of the care plans we looked at. We spoke with staff and found them to be knowledgeable about people and their lives prior to living in the home.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. They also regularly spoke with the people who lived in the home. Feedback about the registered manager was excellent from the people who lived in the home, relatives and all the staff we spoke with.

The inspection took place on 5 and 7 April 2016 and the first day was unannounced.

Hinderton Mount has been operating as a care home since 1985. Weatherstones House Care Limited has owned and run it since 1998. The home is a large house that has been converted and provides 25 places for older people who require personal care. It is situated on Chester High Road, a mile-and-a-half from Neston town centre on the Wirral.

At the time of our inspection 24 people were living at the service.

There was a registered manager in place. 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.

We last inspected the service on 11 April 2014 and found that it met all the regulations assessed at that time.

People told us that they were supported by staff that was kind and caring. Relatives of the people who used the service felt welcomed and supported by all of the staff. Staff had time for people and treated them with respect. People received care in a dignified manner that protected their privacy. Staff encouraged people to be as independent as possible and offered them choices in their day to day living.

People told us that staff knew them and their needs well and responded to their wishes promptly. People had been involved in planning the care and support they received from the service. Their needs had been identified, assessed and reviewed on a regular basis. People’s care plans were accurate but required more detail in order to make them more in a person-centred.

Everyone we spoke with, including people who used the service, their relatives and external professionals said people received individualised care. A wide and varied range of activities was on offer for people to participate in if they wished. Regular outings were also organised outside of the service.

People were protected from the risk of abuse as staff could demonstrate they understood what constituted potential abuse or poor care. Staff knew how to report any concerns and they felt confident the service would address these appropriately.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Although the service had not recorded the mental capacity assessments they had made on the people they supported, the principles of the MCA had been adhered to. Applications had been made to the supervisory body for consideration under DoLS.

Staff told us they worked as part of a team, that Hinderton Mount was a good place to work, that they felt supported, morale was good and people were happy in their work. Staff received the training they needed to deliver a high standard of care. They told us that they received lots of training and were actively encouraged to access any training specific to their job.

Staff communicated with others in a respectful and professional manner. The service worked with other healthcare professionals to ensure people’s health and wellbeing needs were met. People received prompt medical and wellbeing services and staff assisted people to follow recommendations in relation to their health.

Staff had been employed following appropriate recruitment checks that ensured they were safe to work in health and social care. We saw that staff recruited had the right values and skills to work with people who used the service. Staff rotas showed that the staffing remained at the levels required to ensure all peoples needs were met and helped to keep people safe.

People had confidence in the management team and saw them on a regular basis. They found the manager to be approachable, supportive and available as required. People felt listened to and told us they had confidence that any concerns they may have would be addressed. The registered manager continuously assessed and monitored the quality of the service

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?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) and the Mental Capacity Act 2005. While no DOLs applications have needed to be submitted, proper policies and procedures were in place. We discussed this with the deputy manager who understood when an application should be made, and how to submit one.

People had been cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly.

We noted that each file did not contain evidence that Criminal Record Bureau(CRB) disclosure checks, and more recently Disclosure and Barring Service checks(DBS) had been completed for all members of staff. Following our inspection, the manager provided us with this information that confirmed these checks had been carried out. This ensured that people were supported by people of a suitable character.

Is the service effective?

People told us they were happy with the care provided and their needs had been met. Our observations and discussions with staff showed they were knowledgeable about the people they supported and what people's care needs were. One person told us; "The staff are very pleasant. I am superbly looked after".

Is the service caring?

We saw that people were supported by staff who were kind and caring towards them. We saw staff and people who used the service interacted well with each other during games of skittles and cards. Staff were seen to keep people involved and encouraged participation from all people that were present. A visiting relative told us; "They have been brilliant with Mum since she moved in. The difference in her has been amazing to see".

Is the service responsive?

We saw that before a person started to use the service, an assessment of their needs and abilities was undertaken. The care plans showed how the needs of the people who used the service were to be met, including any risks to their well-being. Each person was allocated a key worker and reviews of each person's care took place on a monthly basis or sooner if required. People’s personal preferences such as their daily and bedtime routines were also taken into account. This had been done with the involvement of the person where possible as well as their relatives.

Is the service well led?

The management team had been in place for a long period of time at the home. Staff, people who used the service and the relative's spoken with spoke highly of them and said they were listened to when concerns or suggestions were made.

We saw the service carried out monthly audits of various aspects of the service’s operations such as medication management, care planning, people's finances and the homes environment. Where concerns were identified, processes were in place to enable appropriate changes to be made.

We found that the people who lived at Hinderton Mount had no concerns with the care provided. Comments from them included: “It’s excellent. It’s important to give praise (to the staff) and “The staff are very kind and caring.”

People who used the service told us they felt safe at the home. The relatives we spoke with told us that they considered Hinderton Mount a safe place to live. We contacted Cheshire West and Chester Local Authority prior to our visit to the home. They told us they had no concerns with the service.

We sat in the lounge for a period of one hour after lunch. We saw that staff were always available and responded quickly and efficiently to tend to the needs of people who used the service at all times. We saw that staff responded promptly when call bells were activated throughout the day of our visit.

We found that staff were supported by the company to gain National Vocational Qualifications (NVQ) levels 2,3,4 and 5 in social care.

The manager told us the service had not had any recent complaints. We found there was an effective system in place to deal with complaints should they be made. One relative of a person who used the service told us: "I've no complaints. I don't think there is anywhere as good as this."

We spoke to three residents during our visit. Comments made included:

"I am confident that complaints I had would be dealt with"

"Staff are excellent"

"I feel safe and the care is pretty good"

"I feel involved, they discuss things with you not just do them without asking"

"They are very good but let me do as much as I can"

"I feel safe here"

"Everyone is very good"

"I am happy living here"

"They are very good, I feel respected"

"The home is very nice"

Comments from relatives included:

"The home is really good"

"I have peace of mind"

"Staff are approachable and their level of knowledge is really good"

"I feel very involved, if there is a change to the care plan, it is discussed with me"

"There is good communication with the Manager"

"It is a different place and much improved from how it was years ago"

"People here are comfortable and happy"

"They listen to us"

"My relative is safe"

"We are always invited to discuss changes to care plans"