This inspection took place on 22August 2017 and was unannounced.

Moulsham home provides residential care for up to 23 people, some of whom may be living with dementia. There were 23 people living at the service at the time of our inspection two of these people were in hospital.

When we last visited the service it was rated good. At this inspection we found the service remained good.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were appropriate arrangements in place for medication to be stored and administered safely, and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLs and associated codes of practice.

People had access to healthcare professionals. A choice of food and drink was available that reflected their nutritional needs, and took into account their personal lifestyle preferences and health care needs.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support.

People were treated with kindness and respect by staff who knew them well and who listened to their views and preferences.

People were encouraged to follow their interests and hobbies. They were supported to keep in contact with their family and friends.

There was a strong management team who encouraged an open culture and who led by example. Staff morale was high and they felt that their views were valued.

The management team had systems in place to monitor the quality and safety of the service provided.

For a more comprehensive report regarding this service, please refer to the report of our last visit which was published on 6 August 2015.

This inspection took place on 6 August 2015 and was unannounced.

Moulsham home provides accommodation and care for up to 19 people, some of whom may be living with dementia. There were 19 people living at the service at the time of our inspection.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were appropriate arrangements in place for medication to be stored and administered safely, and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLs and associated codes of practice.

People had access to healthcare professionals. A choice of food and drink was available that reflected their nutritional needs, and took into account their personal lifestyle preferences or health care needs.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support.

People were treated with kindness and respect by staff who knew them well and who listened to their views and preferences.

People were encouraged to follow their interests and hobbies. They were supported to keep in contact with their family and friends.

There was a strong management team who encouraged an open culture and who led by example. Staff morale was high and they felt that their views were valued.

The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required.

At the time of this inspection there were 17 people living at Moulsham Home.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

This was an unannounced inspection. We spoke with six people who lived at the home and two relatives who were visiting. We could not speak with some people due to their needs. We also spoke with the manager and three other members of staff. We looked at written records, which included copies of people's care records, medication systems, staff personnel files and quality assurance documentation.

Is the service safe?

We found the home to be warm and clean. The accommodation was adapted to meet the needs of people living there, was suited to caring for people with limited mobility and was appropriately maintained.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. People were protected by safe recruitment practices. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents and understood people's needs, which enabled them to deliver appropriate and safe care. People were cared for by staff who were properly trained and supported to develop professionally.

People we spoke with were satisfied with the care and support they received.

Is the service caring?

We spoke with six people who used the service. One person said to us, "All the staff here are very kind. I am very well looked after." Another person said to us, "I have no complaints, but I could easily speak to any of the staff if I did." Another person said, "Everything is good. I love it here." One relative said to us, "This is a fantastic home." Everyone we spoke with told us that the food was good and echoed the sentiments expressed in the quotations above. Nobody we spoke with raised any concerns with us.

We observed a good rapport between staff and the people who lived at the home. We witnessed the care and attention people received from staff. Staff were friendly, were attentive to people's needs and people were treated with dignity and respect.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed. Activities took place, both planned and spontaneous, that were appropriate to people's needs.

Three staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns.

Is the service well led?

Three staff members said that they felt well supported by the manager and senior staff and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

We spoke with six people who use the service, a visitor and three members of staff. Some people were unable to communicate with us verbally. Where this was the case people were able to respond with smiles and facial expressions. They looked happy and relaxed.

During our inspection we saw a homely and clean environment. Staff knew people well and they were friendly and approachable. We saw staff were able to meet people’s individual needs and treated people with dignity and respect. One person told us: “All the staff are fine” and “I like the food.” The visitor told us that staff looked after their relative well.

We saw people were given a choice of activities during the day. We observed staff engaging with people in activities such as bingo, dancing and sitting and talking with them. There was also a visiting hairdresser and we saw many people having their hair styled during the morning. People told us they had trips out and some had recently been Christmas shopping and others for a Chinese meal.

We saw people’s nutritional needs were being met and there was a wide range of food available. However we found that people's care and support was not planned and delivered in a way that was intended to meet their individual needs and ensure their safety and welfare.

We saw the provider followed appropriate recruitment processes that ensured new staff were suitable for the role. Records showed us that staff received training that was appropriate to their role and that they were supported well through regular supervision.

We saw that all staff were given guidance on how to safeguard people and received training in this area.

People who use the service described the staff as caring and helpful. People using the service told us that there were enough staff on duty and that they responded to requests for help. People also told us that the meals provided at the home included enough variety and that the standard of the food was good.

People told us that they felt safe and that, if they had any concerns or worries, they would discuss them with their relative or a member of staff.

People we spoke with told us they had been able to visit the home on behalf of their relative as part of the decision making process about the person moving to Moulsham Home. They also told us that they had been asked about their relative’s needs, ways and abilities and felt that the person was provided with very good care there.

People told us they felt their relative was safe at Moulsham Home and that the staff were nice to them. They also said there were enough staff available to meet people’s needs and that staff did a good job in looking after people living there. People also told us they were satisfied with the quality of the service overall and felt able to talk to staff about any issues they had.

People who were unable to talk to us looked relaxed and at ease when staff were providing them with support.

We spoke with people who lived in the home. Everyone we spoke with told us that the staff were polite and kind. Comments included, “It’s lovely here.”

People told us how they felt that their needs were met in the home and that they were happy living in the home. They told us that the liked the food and they felt they were, “Looked after.”

People also told us that they liked the staff and felt safe in the home, they said that if they had any concerns they felt able to raise them.

When we spoke with a visitor they told us that they felt there were always adequate staff on duty within the home and they were happy that their relative was living in the home. They described the home as, “Nice” and said that they were kept up to date about their relatives needs. They also told us that they would approach the manager if they had any concerns regarding the home.