About the service: Pavilion Care Centre is a residential care home registered to provide personal and nursing care for up to 30 people aged 65 and over or people living with mental health issues. There were 27 people living there at the time of the inspection. The accommodation is based across three floors, with communal areas on the ground and first floors and more independent living in flats on the third floor.

People’s experience of using this service:

The service met the characteristics of good in all areas.

People continued to receive safe care. There were enough staff to support them and they were recruited to ensure that they were safe to work with people. People were protected from the risk of harm and received their prescribed medicines safely. Lessons were learnt from when mistakes happened.

The care that people received continued to be effective. They 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. Staff received training and support to be able to care for people well. They ensured that people were supported to maintain good health and nutrition; including partnerships with other organisations when needed. The environment was adapted to meet people’s needs.

People continued to have positive relationships with the staff who were caring and treated people with respect and kindness. They were able to get involved in activities and pursue their interests. Staff knew them well and understood how to care for them in a personalised way. There were plans in place which detailed people’s likes and dislikes and these were regularly reviewed. People knew how to raise a concern or make a complaint and the registered manager managed any complaints in line with the provider’s procedure.

The registered manager was approachable and there were systems in place which encouraged people to give their feedback. There were quality structures in place which were effective in continually developing the quality of the care that was provided to them.

More information is in the full report.

Rating at last inspection: Good: report published on 5 May 2016

Why we inspected: This was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 19 January 2016, it was unannounced. The service was last inspected on 23 September 2013 when all standards were met.

The service offers personal and social care for a maximum of 32 people, at the time of the inspection 28 people were living in the Pavilion Care Centre, some of them were living with dementia. Nursing care is provided from the local community nursing teams.

The service had a registered manager. 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 happy, comfortable and relaxed with staff and said they felt safe. They received care and support from staff who were appropriately trained and confident to meet their individual needs. Staff supported people to access health care as required. Staff received one to one supervision sessions with their line manager to support them in their caring responsibilities.

There were policies and procedures in place to keep people safe and there were sufficient staff on duty to meet people’s needs. Staff told us they had completed training to provide them with the skills and knowledge they needed to look after people. We saw good relationships between people and the staff caring for them and also that consideration was given to people’s privacy and dignity. Safe recruitment procedures were followed and appropriate pre-employment checks had been carried out, including evidence of identity and satisfactory written references.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure medicines had been stored, administered and reviewed safely.

People were supported to make decisions in their best interests. The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People enjoyed a nutritious and varied diet and were involved in the menu planning to ensure they enjoyed the meals that were offered.

There was a formal complaints process in place and people were encouraged and supported to express their views. Staff were responsive to comments about the way people wanted to receive their care.

At our visit there were 32 people accommodated. We spoke with six staff and three people and a visiting relative about their care and looked at four people’s care records. We were not able to hold discussions with many people because of their conditions, such as dementia. We observed staff interacting and supporting people respectfully and found they delivered care and managed people’s medicines in a way that was safe and appropriate to their assessed needs.

Three people told us they were generally satisfied with their care, support and the meals provided and we found people were supported to eat and drink sufficient amounts to meet their needs. Two people felt menus lacked variety. However we saw that arrangements were made to review these in consultation with people.

Three people told us, that activities and entertainments were organised, which they choose whether to join. One person told us, “Staff respect my privacy and uphold my choice to do what I want, when I want and as I am able.” Another person said, “Staff are caring and kind, they help me and listen when I am not having a good day.”

People we spoke with told us the home was usually kept clean, tidy and fresh from odours and we found that that risks to people’s safety were properly managed. We also found people’s comments and concerns were often taken into account to improve the service.

People told us they received the information they needed about the home to assist them in their admission and their daily lives there. All said their care and personal support needs were discussed and agreed with them and where appropriate with their representatives, including by way of regular care reviews.

People generally felt that their rights to privacy, dignity, independence and to make choices about their daily living arrangements were respected. All said that activities were usually organised that they could choose to join, along with social events and seasonal celebrations. Two people told us about arrangements to enable their regular access to the local community and we saw that another regularly attended a luncheon club outside the home.

People told us they were comfortable in the home. That they were satisfied with the care and support they received and that activities were usually organised, which they could join if they chose. One person told us, ‘Staff is really caring, nothing is too much trouble.’ Another said, ‘Some of us have a regular scrabble group, we laugh a lot and have a lot of fun.’ We were also advised of suitable arrangements for people to practise their religious faith.

All people spoken with said they enjoyed the meals provided and were regularly consulted with by the cook. One person said, ‘I get a very good diet, the cook comes to see me every morning about the menu choice for the day.’ Another said, ‘Staff regularly bring round hot and cold drinks and they always leave a fresh jug of water each day, labelled with the time and date so I know it’s fresh.’

People described satisfactory arrangements for their medicines and to enable their access to outside health and social care professionals. Both for the purposes of routine health screening and specialist care and advice when required.

People told us that they were involved in making decisions about the care they received. We saw that regular reviews took place with people who use the service and consent was obtained before any care and support was carried out.

People told us that staff were friendly and always provided care and support that met their needs. One person told us "I'm pretty independent and do a lot myself but the staff are giving me the support and company that I need".

We found that there were issues relating to the safe storage, recording, handling, dispensing and safe administration of medicines within the home. People were not protected against the risks associated with medicines because the provider was not effectively managing medicines.

We saw that the provider had effective recruitment and selection procedures in place when staff were employed at the home.

Staff were supported by the provider and received regular supervision and access to training. Staff we spoke with said that they felt supported and enjoyed working at the home.

We saw that care plans and personnel files were accurate, fit for purpose, stored securely and remained confidential.