About the service

Palmerston House Care Home is a residential home in Westcliff-on-Sea close to the sea front. The service provides accommodation and personal care for older adults, some of whom have mental health and dementia related needs. The care home can accommodate 22 people in one adapted building. At the time of our inspection, 21 people were using the service.

People’s experience of using this service

People told us they liked living at the service, there was a homely atmosphere and staff enjoyed working at the service and caring for the people they supported. The management team and staff knew people well, understood their likes and dislikes and provided safe and compassionate care. People’s care was personalised to their individual needs, and people had an active say in how the service was operated and managed. Relatives told us they were made to feel welcome and any concerns were taken seriously and responded to.

People were protected against abuse, neglect and discrimination. Staff knew how to keep people safe and acted when necessary to prevent harm. People were assisted to have choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems at the service supported this practice.

Staff were supported to carry out their roles by induction, training, supervisions, appraisals and staff meetings. They could raise concerns and be involved in the development of the service. Regular quality audits were carried out to ensure high quality care and identify any areas for improvement.

The service met the characteristics of good in all areas; more information is in the full report

Rating at last inspection:

At our last inspection, the service was rated “good.” Our last report was published on 1 September 2016.

Why we inspected

This inspection was part of our scheduled plan of inspection to check the safety and quality of care people received.

Follow up

We will continue to monitor the service to ensure that people receive high quality care. Further inspections will be planned in line with our scheduled programme of inspections.

The Inspection took place on the 3 and 4 August 2016.

Palmerstone House Care Home provides accommodation and personal care without nursing for up to 22 older persons some of whom may be living with dementia. At the time of our inspection 22 people were living at the service.

The service had 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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager had made appropriate referrals to the local authority.

People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including GPs and district nurses.

Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs. People knew how to make a complaint and complaints had been resolved efficiently and quickly.

The service had a number of ways of gathering people’s views including using questionnaires and by talking with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.

On the day of our inspection there were 21 people living at Palmerston house. We spoke with six people who used the service. We also spoke with the manager and two members of the staff team. We looked at four people's care records and the quality checks.

We thought about what we found and asked the questions that we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service we were asked to sign the visitor's book and our identity was checked. This meant that people were protected from unwanted visitors such as others who posed a risk to their safety.

The manager had carried out regular safety checks to ensure that systems, practices and the building itself were safe for people who used the service.

People told us that they felt safe living in Palmeston house. One person said, “I love it here, I have no worries while I am here.” Another person said, “I know they look after me and keep me safe."

Staff had received training in safeguarding vulnerable adults from abuse (SOVA), the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that staff had been given the information that they needed to ensure that people were cared for safely. Health and safety checks had been carried out and issues had been dealt with appropriately. This showed that the service was safe.

Is the service effective?

People told us that they felt that the service met their needs. One person who used the service said, “The staff are good, they get me anything I want.” Another person said, “This is very good, I am really happy.”

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The care records were well written and had been reviewed and updated monthly. This meant that staff had up to date information about how to meet people's needs.

Is the service caring?

Staff’s interaction with people who used the service was good. They spoke with people respectfully and supported them in a kind and caring way. Staff had a good knowledge of people’s likes and dislikes. People told us that all of the staff treated them well. One person said, “The staff are kind and caring, they pay attention to people." People told us that the staff treated them respectfully. People’s preferences and diverse needs had been recorded in their care files and care and support had been provided in accordance with their wishes. This showed that people were cared for by kind and caring staff.

Is the service responsive?

People told us that they had enough to do. One person said, “I like to watch my television, in my room as I like my own space but I know lots there are things to do if I wanted to do them.” People told us that staff were quick to respond to their needs.

People were supported to see other professionals such as a general practitioner, community dentist, chiropodist, optician, and district nurse. This showed that people’s general health care needs were met and that the service responded to people’s changing needs.

Is the service well-led?

There was a good quality assurance system in place. People had been asked for their views and opinions on a daily basis. People told us that they received a good quality service. When asked if Palmerston house was a nice place to live, one person said, “I love it here, the staff are very good and caring. They get me anything I want whenever I want it."

People who used the service and their relatives told us that the staff and manager asked them for their opinions on the quality of the service. This showed that there was an effective quality assurance system in place and that the service was well-led.

People we spoke with told us that they were happy with the care and support they received from staff.

We saw that people's needs in relation to their health, personal care, social and emotional needs were identified and care was planned and delivered to support people effectively and safely. Staff we spoke with had a good understanding of people's needs and how each person wished to be cared for and supported.

The service was clean and free from unpleasant odours. There were robust procedures in place for protecting people from the risks of health associated infections.

Medicines were handled safely and appropriately and people received medicines as prescribed for them as part of their care and treatment.

The provider had arrangements to ensure there was appropriate equipment to support people and for the safe operation of the service. Equipment was regularly checked, serviced and repaired to ensure that it was safe and fit for purpose.

People were supported by suitably skilled, experienced and knowledgeable staff because there were robust practices in place for recruiting new staff and supporting them in their roles within the service.

Records in relation to people's personal information and other records necessary for the effective operation of the service were well maintained, accurate and up to date.

The service was compliant and meeting all of the essential standards for quality and safety in each of the areas we inspected.

People told us that they were treated well, respected and that they were well cared for. We saw that staff had access to accurate and up to date information about the needs of people who were using the service. We observed staff supporting people in a sensitive and proper way when providing assistance.

People said that they felt safe and staff treated them well. We found that staff were trained to identify risks of abuse and they understood their responsibilities to minimise these risks and to report any concerns appropriately.

People told us that staff met their needs and cared for them well. We saw that there were appropriate numbers of skilled, qualified and experienced staff available to meet the needs of people who were living in Palmerston House Care Home.

There were effective systems in place to regularly monitor, and improve where necessary the services provided. People told us that they were very happy living at the care home and that their comments and suggestions for improvement were acted upon.

People who use the service told us that they were happy with the care they received. Some people told us that ''They could not fault the care.'' and that the ''Care is excellent.''

People told us that staff were attentive, listened to them and acted on their wishes. We were told that there were always enough staff available to assist and support people as required.

People told us that they enjoyed the meals provided by the service and they always had a choice of food and drinks.

People told us that they were happy with their accommodation at Palmerston House Care Home.

We did not speak to anyone who uses the service about the way that the home manages their medicines.

During our visit we spoke with five who use the service and one relative. People with whom we spoke told us that they were happy and well cared for. One person told us ‘’The staff here are very nice and ever so considerate to me.’’ This person also said ‘’There is always someone available when I need any help.’’

One person said ‘’Nothing seems to be too much trouble for staff to do. Staff come very quickly when I need them, which is important as my room is on the second floor.’’ Two people told us that they would like to go out more. One person said ‘’ I would like to go out shopping or to the beach perhaps when the weather is good.’’

People told us that they had no complaints about the service. One person told us ‘’I have had no complaints whatsoever since I have been here.’’ Another person said ‘’I cannot think of anything they could improve for me.’’.