Housteads is registered to provide accommodation and personal care for up to 40 older people, some of whom are living with dementia. The home is situated in the Richmond area of Sheffield, close to local amenities and transport links. Accommodation is based on the ground floor. All of the bedrooms are single and communal lounges and dining rooms are provided. The home has a secure enclosed garden and car park.

There was a manager at the service who had been in post since December 2016 as acting manager. The manager took up the permanent manager role on1 April 2017. The manager had applied to register with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Housteads took place on 26 May 2015. We found a breach in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in regard to regulation 18; Staffing. The registered provider sent an action plan detailing how they were going to make improvements. At this inspection we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of Regulation 18: Staffing, as staff had been provided with supervisions and appraisals at the frequency set out in the registered provider’s policy.

This inspection took place on 23 May 2017 and was unannounced. This meant the people who lived at Housteads and the staff who worked there did not know we were coming. On the day of our inspection there were 39 people living at Housteads.

People spoken with were very positive about their experience of living at Housteads. They told us they were happy, felt safe and were respected.

We found systems were in place to make sure people received their medicines safely so their health was looked after. PRN (as and when needed) medicine protocols were in place to ensure staff knew when PRN medicine was required. One person’s PRN protocol could not be located and was forwarded to us during the evening of this inspection.

Staff recruitment procedures ensured people’s safety was promoted.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training so they had the skills they needed to undertake their role. Some staff had a basic understanding of the Mental Capacity Act and would benefit from further training to enhance their skills and knowledge in this area.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. The efficiency of the quality assurance monitoring systems would be further improved by including the fire risk assessment action plan so this can be closely monitored to make sure

Housteads is registered to provide accommodation and personal care for up to 40 older people, some of whom may be living with dementia. The home is situated in the Richmond area of Sheffield, close to local amenities and transport links. Accommodation is based on the ground floor. All of the bedrooms are single and communal lounges and dining rooms are available for use. The home has a secure enclosed garden and car park.

The service did not have a manager who was registered with CQC. 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 and associated Regulations about how the service is run. The previous registered manager retired on 17 April 2015. An experienced manager from a home within the same company was covering the vacancy whilst a new manager was recruited.

Our last inspection at Housteads took place on 29 June 2013. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 26 May 2015 and was unannounced. On the day of our inspection there were 34 people living at Housteads.

People told us they were well cared for and they felt safe. Comments included, “It’s good here, I am quite satisfied,” “The staff are lovely” and “I feel safe here.”

Two relatives told us, “We don’t have any concerns. The staff do their best and are very caring.”

We found systems were in place to make sure people received their medicines safely.

We observed the number of staff on duty and found that staff were visible in all areas of the home and available to respond to people’s needs and keep people safe. Some people living at the home said that they would like more staff.

In the main the home was clean and tidy. However, we found that two corridor carpets were stained, marked and worn. This did not create a positive impression of that area of the home.

Individual care plans and risk assessments were in place in order to identify people’s needs and manage risks to people. We found that some care plans required updating to make sure they contained relevant information. The manager had identified this and we saw evidence they were working through a programme of updating care plans.

Staff received training in safeguarding and knew how to identify and report abuse and unsafe practice. Incidents were assessed and monitored by the manager to try to prevent and reduce potential reoccurrence and identify any trends.

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. We found that significant changes to the senior staff team had taken place in the weeks before this inspection. Staff reported an improvement in morale since new senior staff had been working at the home.

Staff had not been provided with regular supervision for development and support.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home, and their relatives said that they could speak with staff if they had any worries or concerns and they would be listened to. Some people were unsure who the new manager was.

We saw people participated in a range of daily activities which were meaningful and promoted independence.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via surveys; the manager confirmed the results of these would be audited to identify any areas for improvement.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

In this report the name of the previous registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

People living at the home told us that they were happy and that they were satisfied with the care they received. They told us, "it’s alright here, the staff are kind," "the staff know me and try their very best" and "I feel well looked after."

Three relatives spoken with said that they were happy with the care their loved one received. They told us, “it is brilliant here. They (staff) can't do enough” and "we have no worries at all. I wouldn't hesitate to recommend this home."

We found that care and support was offered appropriately to people.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available.

We spoke to seven people that lived at Housteads. They told us that they liked living at the home, and the staff knew them well and supported them in the way they needed. Comments included; “It's lovely here, the staff are smashing.” “The staff are kind and helpful. I get on with them all.” “I am safe here; I feel safer here than when I was in hospital.” “They say laughter is the best medicine and you get plenty of that here.”

We spoke to two relatives visiting the home. They said that they had no concerns regarding their loved ones care and staff always kept them informed. Comments included; "My relative has not been here long, but the staff are great. They seem kind and are always respectful." "It is marvellous here. I have no worries at all. My relative is happy and that makes me happy."