Ideal Home is a care home which provides residential care for up to 50 people. People living in the home have a mixture of needs, from requiring support with personal care to requiring support with mental health and dementia needs. At the time of the inspection there were 42 people living at the home.

This was an unannounced inspection that took place on 6 December 2016. The home has a registered manager who was present during the inspection. 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.

People were supported by staff who understood how to recognise and report abuse. The risks connected with people's care and support needs had been individually assessed and plans introduced to manage these. People were involved in decisions about the risks affecting them.

The provider assessed and organised their staffing requirements based upon people's care needs. They followed safe recruitment practices that ensured that those staff who were providing care were suitable to be working at the home.

Systems and procedures were in place designed to ensure people received their medicines safely. Staff followed the provider’s procedures in administering medicines and medicines were stored safely.

Staff had the necessary skills and knowledge to meet people's needs. They received effective induction, training and support from the provider. People's rights under the Mental Capacity Act 2005 (MCA) were protected by the provider. The staff were aware of when people may be restricted and the need to submit applications to the supervisory body in relation to this.

People were provided with a choice of meals each day and those who had dietary requirements received appropriate foods. Staff followed the guidance of healthcare professionals where appropriate. People received the level of support they needed with eating and drinking. Staff helped people to access healthcare services.

There was a caring and calm atmosphere in the home where people and staff interacted together well. People and relatives were very happy with the care provided. Staff adopted a caring approach towards their work and took the time to get to know people as individuals. The provider encouraged people's involvement in care planning and decision-making. Staff protected people's dignity and privacy.

Staff supported people to take part in various activities. Staff were attentive to people and knew them well.

People received care and support that was tailored to their needs and preferences. Staff had the time to read and followed people's care plans. People and their relatives knew how to complain about the service and felt comfortable about doing so.

Care plans contained information to guide staff on how someone wished to be cared for. Staff had a good understanding of people's needs and backgrounds as detailed in their care plans.

The registered manager encouraged an open, on-going dialogue with people, their relatives and the staff team. Quality assurance checks were carried out to help ensure the environment was a safe place for people to live and they received a good quality of care. People and relatives were given the opportunity to provide feedback on the care they received.

The inspection took place on 27 October 2015 and was unannounced.

Ideal Home is registered to provide accommodation with personal care for up to 50 people. There were 42 people living at the home on the day of our inspection.

There was a registered manager in post who was present during the inspection. 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’s rights were not always protected because people’s ability to make their own decisions about their care had not been appropriately assessed. Where decisions had been made on people’s behalf there were no records to show why these decisions were in their best interests.

The provider had checks in place to assess and monitor risks associated with people’s care and treatment. People’s care plans and risk assessment were regularly reviewed. These records were not always accurate or up to date.

People felt safe living at the home and there enough staff to meet their needs in a timely manner. Staff had received training on how to keep people safe. They knew how to identify signs of abuse and who to report concerns to. Risks were managed appropriately promoting people’s rights and independence.

People received support from staff that had the training and knowledge to meet their needs. Staff had received training which was relevant to their role and the people they supported. Appropriate checks had been made to ensure that staff were suitable to work at the home.

Staff sought people’s consent before supporting them and respected their wish if they declined support. We saw that people were given choice about day to day decisions such as when they would like to get up and where they would like to sit.

People received their medicines safely and when they needed them. The provider had checks in place to ensure ongoing safe management of medicines. People were supported to see health care professionals as and when required.

People’s nutritional health needs had been assessed and they were given a choice of what they would like to eat and drink. People told us they had enough to eat and that they enjoyed the food.Staff were aware of individual dietary needs.

People were treated with kindness and compassion. Staff had good working relationships with people and were aware of their likes and dislikes and how they preferred their care and support to be provided. People were treated with dignity and respect and were supported to remain as independent as possible.

People were able to choose how they spent their time and were encouraged and supported to do things that they liked doing. People told us they could go out to the shops and pub or they could remain at home and take part in activities of their choosing.

People told us they felt confident and able to raise any concerns or complaints with staff. The registered manager had systems in place to gather people’s views on the quality of the service provided.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service caring?

• Is the service responsive?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

Risks to people had been identified, assessed and kept under review. Staff had undertaken training pertinent to their role including manual handling and infection control in order to care for people safely.

Appropriate arrangements were in place to manage medicines. This meant that people were protected against the risks associated with medication.

People’s personal records were kept securely. Staff demonstrated an understanding of the need to maintain people’s confidentiality.

Is the service caring?

People spoken with were positive about the care and treatment they received. One person told us, “Staff treat me with respect, I have nothing to worry about here.” Staff told us, “Residents always come first” and felt they delivered a “Wonderful service”.

Staff interactions with people who used the service were both supportive and respectful. Staff demonstrated a good understanding of people’s needs and preferences.

Is the service responsive?

People’s views about care and treatment were acted upon. People using the service contributed to decisions relating to food and activities. People told us that they felt confident that any concerns raised would be acted upon.

The service responded to people’s changing needs. People had access to support and advice from the multidisciplinary team.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual needs. People told us that they felt the service met their needs.

It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well.

Is the service well led?

The provider had an effective system to regularly assess and monitor the quality of service that people received. Satisfaction surveys had been sent out to people who used the service and relatives. The feedback gained from the surveys was positive. This meant that people's views about the service they received were represented.

A senior manager visited the home every two weeks to support the home and performed a number of checks on the quality of the service. This ensured that people using the service received a good quality service.

Suitable arrangements were in place to make sure that staff received appropriate training and professional development. Staff had received induction training to enable them to understand the requirements of the job. Staff felt well supported to do their work and people received care from a team of staff who were well trained and well supported.

We spoke with five people during our visit. All five people spoken with were positive about the care and treatment they received. One person described the care as “wonderful”. People were able to move around freely within the units and could choose where and how they preferred to spend their time.

People's needs were assessed and care and treatment was planned and delivered in line with their individual needs. Care plans were detailed and covered the psycho-social, religious as well as physical aspects of care and treatment. This helped ensure that all the needs of people were met.

There were arrangements in place for the safe storage and administration of medication. The recording of medication could however be improved.

People using the service commented positively about the support they received from the staff. We observed a calm and relaxed atmosphere in the home. People were supported in a relaxed and unhurried way.

People using the service and their relatives were asked for their views about care and treatment and they were acted upon where necessary. Systems in place for auditing the record keeping in the home was not robust enough to ensure standards were maintained. We noted a number of records that were either out of date or required reviewing.

We spoke with eight people who lived at Ideal Home. There were 45 people living at the home on the day of the inspection. We also spoke with the manager, four members of staff and a healthcare professional.

Everyone spoken with was satisfied with the way they were cared for at the home. One person told us that, "Staff are very kind and look after me". People were supported to be involved in decision making.

We saw that people were offered choices about how their care was delivered and how they spent their time. People told us that they liked the activities provided. We observed staff being kind and courteous towards people.

Care records were kept securely and were well organised. Staff knew how to find information about each person's care needs in the care plans.

Measures were in place to keep the home clean, tidy and to reduce the risk of healthcare associated infections.

The service provided an adequate environment for people to live in. People's bedrooms reflected their taste and preferences.

The service had recruitment processes to make sure they employed the right people. People told us that they liked the staff and they felt well looked after. Staff told us they enjoyed their work and said they were well supported.

Measures were in place to monitor the quality of the service provided.

People we spoke to said they were happy with the care they received and that staff treated them very well.

Some people told us the food was nice and that they enjoyed the activities at the home.

People told us they were satisfied with the standard of cleanliness.