About the service: Inwood house is a residential care home that was providing care to 19 people aged 65 and over at the time of this inspection.

People’s experience of using this service:

• We made recommendations about the management of some medicines.

• People told us they liked living at Inwood house and relatives told us that they knew their relatives were receiving good quality care.

• People told us they felt safe at Inwood House.

• Staff were safely recruited, they knew how to keep people safe from avoidable harm and there were enough staff available to meet people’s needs.

• Accidents and incidents were analysed to prevent re-occurrence.

• The premises was clean and followed infection control guidelines.

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

• People were very positive about staff and management and felt confident that concerns would be listened to.

• People were supported to pursue their hobbies and interests.

• People were supported to maintain relationships with those important to them, and develop new friendships with other people.

• People told us that staff were caring and always willing to support people.

• Rating at last inspection: This service was rated Good at the last inspection (published 22 December 2016).

Why we inspected: This inspection was scheduled based on the rating at the last inspection.

Follow up: We will continue to monitor this service to ensure people using this service receive high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inwood House provides accommodation and personal care for up to 20 older people. At the time of our inspection 19 people were living at Inwood House. The home was last inspected in August 2014 and was found to be meeting all of the standards assessed.

This inspection took place on 8 November 2016 and was unannounced.

There was a registered manager in post at 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 and associated Regulations about how the service is run.

People who use the service were positive about the care they received and praised the quality of the staff and management. Comments from people included, “Staff are very kind, they do things in the right way”, “I feel safe here and that is very important for me” and “The girls are lovely, there’s always someone available when you need them”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were providing care for. People told us staff provided care with kindness and compassion.

Staff were appropriately trained and skilled. They received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training relevant to their role and people’s feedback demonstrated staff put this training into practice.

The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback about their care and there was an effective complaints procedure. One person told us, “I would speak to (the registered manager) if I had a problem, they would sort it out”.

The provider regularly assessed and monitored the quality of care provided at Inwood House. Feedback was encouraged and was used to make improvements to the service.

One inspector visited the home and answered our five questions, is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with eight people using the service and receiving written comments from eight people using the service. We spoke with five staff, the manager and a director of the home. We reviewed six care plans and other relevant records.

Is the service safe?

Care plans instructed staff how to meet people’s needs in a way which did not always clearly describe how to minimise risks for the individual. They were not always detailed enough to ensure staff cared for people in the safest way.

We found that unexplained injuries or bruising were not fully investigated and it was not clear what action if any had been taken to minimise the risk of recurrence.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home understood when a DoLS referral should be made. The home had not made any DoLS referrals in 2014.

We found that medication was administered and recorded in a way which kept people as safe as possible. Staff were properly trained and their competence to administer medicines was checked.

The environment was suitably designed and well maintained. There were hand rails fitted throughout the building and enough space for people to use wheelchairs and other walking aids. Alarm bells were always available within people’s reach.

The home had enough trained staff to enable them to work safely with the people who lived in the home. People told us: ‘‘bells are always answered quickly’’ and ‘‘if anything goes wrong the staff are there to help you.’’

Systems were in place to make sure that the manager and staff continually monitored the quality and safety of care offered to people.

Health and safety was taken seriously by the home and most of the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.

People told us they felt very safe in the home. One person reflected the comments of everyone spoken with when they said: ‘‘I feel very safe, nobody’s ever nasty or unpleasant to you and I love it here’’.

Is the service effective?

People’s health and care needs were assessed with them, and/or their relatives, as appropriate. Care plans were detailed and clearly identified people’s needs and how they should be met. They were reviewed regularly and changes were made to meet people’s changing needs. We saw that staff gave support as described in individuals’ care plans.

We observed staff meeting people’s needs. Daily notes were detailed and of good quality, they described how staff met people’s needs effectively.

The home offered people a comfortable environment in which to live.

Is the service caring?

People were supported by kind, caring and patient staff. We saw that care staff were attentive, encouraging and positive. Staff communicated with people and encouraged interactions between people using the service. People described staff as: ‘‘good company’’.

People's diversity, values and human rights were respected. Care plans were individualised and person-centred. We saw that people were always treated with respect and dignity by the staff team. We saw that people’s choices and preferences were respected and their independence was supported.

Is the service responsive?

We saw that health care was sought in a timely way and the home co-operated with other health care professionals to make sure their healthcare needs were met. However, records of continued healthcare and appointments were not always properly recorded. It was not always possible to see if on-going healthcare was provided by the home.

The home had made changes and improvements as a result of ideas and discussions with people who lived in the home and their relatives.

We saw that the people were confident to approach any of the staff team or the manager if they had any concerns about their care. One person said: ‘‘I could talk to anyone, I trust them all’’.

The home demonstrated that they learnt from accident and falls investigations which they completed.

Is the service well led?

We saw that staff were well trained and meeting the needs of people was a priority of the staff team. We saw that communication amongst the staff team was good. Staff told us they all felt part of a strong staff team, whatever their role. They told us they felt: ‘‘valued’’ and felt their views were listened to.

The service had a quality assurance system which was generally effective. We saw records which showed that identified shortfalls and ideas people put forward were addressed. As a result the quality of the service was being maintained or improved.

People told us they were happy with the care they received.

Staff were caring and respectful in their interactions with people.

People looked well cared for and their rights to privacy and dignity were maintained.

People were encouraged to make decisions in their daily lives.

A comprehensive range of social and leisure opportunities were offered to people, both in-house and within the local community.

People felt safe within the home. Staff were aware of their responsibilities to recognise and respond appropriately to any suspicion or allegation of abuse.

Staff were given a range of opportunities to develop their knowledge and skills in a way which met their individual needs.

Staff were fully supported and worked well as a team.

People were encouraged to give their views about the service and its development. A clear auditing system was in place to monitor the on going quality of the service provided.