North Bay House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. North Bay House is registered to provide personal and nursing care to a maximum of 29 older people. At the time of inspection there were 26 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. 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.

The service continued to protect people from the risk of abuse or avoidable harm. Staff knew how to identify and report potential abuse and risks to people were identified and planned for. Medicines were managed and administered safely. The premises remained clean and there were processes in place to reduce the risk of the spread of infection.

The service continued to deploy enough staff to meet people’s needs in a timely way and to practice safe recruitment procedures.

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 continued to support this practice. Staff understood and promoted independent decision making.

The service provided people with a choice of adequate food and drink. Support people required to maintain good nutrition and hydration was reflected in care planning. People were supported to have contact with other health professionals where appropriate.

People received care from staff who had the training, skills and experience for the role. The service continued to offer staff extra training sessions so they could offer people enhanced levels of support.

People told us staff were kind to them and the service continued to promote a culture of kindness, with the registered manager, provider and all staff leading this practice.

The service continued to offer people personalised care based on their individual preferences and to involve people and their representatives in the planning of care. Peoples’ wishes were adequately reflected in care planning, including their wishes when coming to the end of their life.

People were provided with adequate sources of meaningful engagement and were supported to feedback their views and experiences through meetings and surveys. People were made aware of how they could complain.

The registered manager and provider continued to operate an effective system to monitor the quality of the service provided to people. Areas for improvement were identified and acted upon. Staff, people using the service and their relatives were enabled and empowered to be involved in the ongoing development of the service. Changes were made based on suggestions from people using the service, their relatives and staff.

Further information is in the detailed findings below.

North Bay House is a care home providing care and support to a maximum of 29 older people. At the time of our visit there were 27 people using the service.

The inspection was unannounced and took place on 25 January 2016.

The service had in place a registered manager. 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 and their representatives told us they felt the service was safe. There were clear plans in place to reduce the risks of people coming to harm. Staff, the registered manager and the provider understood their role in keeping people safe.

People told us and our observations confirmed that there were enough suitably qualified, trained and supported staff to meet people’s needs. We observed that staff were competent in providing safe and effective care to people. Staff told us they received the training they needed to carry out their role effectively, and that they were supported to do their job.

There was a robust recruitment procedure in place to ensure that prospective staff members had the skills, qualifications and background to support people.

Medicines were stored and administered safely. There was a system in place capable of identifying errors. Plans were in place to improve medicines administration paperwork.

The service had made the appropriate Deprivation of Liberty Safeguards (DoLS) referrals for people using the service and was complying with the principles of the Mental Capacity Act 2005 (MCA).

People were supported to remain independent, and live full and active lives. People were supported to engage in meaningful activity by staff who understood the importance of this.

We observed, and people told us, that the staff were caring, kind and treated them with respect.

People told us they were involved in the planning of their care. However, improvements were required to ensure that people’s views on their care were reflected in their care records and that their records were personalised to them as an individual.

We observed that people were supported to eat and drink sufficient amounts.

There was a robust quality assurance system in place which we saw was capable of identifying shortfalls in the service so these could be addressed.

There was a complaints procedure in place and people knew how to complain if they were unhappy. People and their representatives were supported to feed back their views on the service and these were acted on by the manager.

Further consultation was required to ensure that the decision to have CCTV in place in some parts of the service was appropriately discussed with people using the service and their representatives to promote openness and transparency.

During our inspection we spoke with five of the 26 people who were using the service at that time. We also spoke with three relatives who were visiting a family member at the time of our inspection and two members of staff as well as the provider and the registered manager.

People told us that the care and support they received was very good. One person told us that the staff, "Do everything that I want them to do, they are all so kind and helpful." Another person we spoke with told us that they enjoyed the food. They told us that, "There is always a choice if I don’t like the set meal." They also told us that staff helped them with their medication. We were told that the service identified people's routines for example one person told us that they, "Always have a cup of tea first thing in the morning before they got up, something they had always been used to."

We looked at the care records of four people who used the service. These contained details about the needs of people who used the service and how those needs could be safely met. The records also detailed the health needs of the person and showed where professional medical support was needed.

The staff team operated a flexible shift pattern which meant that at the busier times of the day there were more staff available to help people. One person we spoke with told us staff always came quickly if they used the call bell.

We spoke with people who told us what it was like to live at this home. They described

how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met. The inspection team was led by a CQC inspector and an "expert by experience" (people who have experience of using services and who can provide that perspective).

We spoke with five people who were using the service and two visitors. Everyone we spoke with confirmed that the staff treated them with respect and provided them with choices wherever possible. People spoken with were complimentary about the care and attention that they received.

One person told us, “Staff are very good, I enjoy a laugh and a joke with them and they always treat me with respect”. Another person told us that, "I am very happy here" and they went onto say that, "The staff always have time for us". A visitor told us that, “My friend gets very good care, the staff are very good with them, they know their likes and dislikes and always observe their dignity. They are always friendly and have a laugh and a joke with them. Their room is very nice and the food is good”.

A visitor told us that, “Staff are absolutely brilliant, they always make me feel welcome and they are very attentive to my friend”. Another person told us that, "There is a good mix of young and older carers with the young benefiting from the older carers' wisdom".

One person commented that, "We have a varied choice of food with plenty of fresh vegetables and it’s always hot when served. They confirmed that hot and cold drinks were readily available in between meals and overnight. Everyone told us that finger foods were available between meals and overnight if required.

None of the people that we spoke with had any concerns about their safety in the service and were confident that the manager would resolve any concerns they might have.

For example, one person told us that, “Staff are very good, I don’t have anything to worry about” and added, “I feel very safe here”. Another person commented, “if I had any concerns I would speak to the manager and I know it would be resolved very quickly, they (staff) make me feel safe”.

Everyone that we spoke with assured us that the care they received was unhurried and that they were involved in making choices about the care they received. Everyone that we spoke with told us that they knew their care records are kept in the office and that they had regular discussions with staff about the care that they were receiving.

We spoke with six people who lived at the home. They told us that their needs were met, that they were consulted with about the care that they were provided with and that they were provided with the opportunity to participate in activities that were of interest to them. They told us that the staff always treated them with respect and that their privacy was respected. People were complimentary about the home's environment, the staff that worked at the home and the quality of the food that they were provided with.