About the service:

Peasmarsh Place is a residential care home that provides personal care and accommodation. There were 18 people living at the service at the time of the inspection. Some people were more independent than others. Some people were living with early stages of dementia.

People’s experience of using this service:

•People told us that they felt safe living at the service.

•Staff administered people’s medicines and medicines were managed safely.

•Potential risks to people’s health and welfare were assessed and managed to mitigate further risk.

•Checks and audits had been completed ensuring the quality of the service was consistent.

•The service continuously improved the quality of the care being provided.

•Accidents and incidents had been recorded. Themes and trends were investigated to help reduce the likelihood of them happening again.

•People told us there were enough staff to support them. Staff had been recruited safely and received training and supervision so they could carry out their roles effectively.

•Staff and the registered manager understood their responsibility to protect people from abuse.

•People’s needs were assessed, care plans were reviewed regularly.

•People were encouraged to make decisions about their care and how they wished to spend their time.

•There were activities taking place during the inspection and people told us there was plenty to get involved with.

•People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

•When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act were followed.

•The registered manager understood their responsibilities under Deprivation of Liberty Safeguards (DoLS) and had applied for authorisations when there was a risk that people may be deprived of their liberty to keep them safe.

•People had access to healthcare professionals and were supported to be as active as possible.

•People knew how to complain and were comfortable to raise any issues with the registered manager.

•We observed people being treated with kindness and respect. People were supported to be as independent as possible.

•The service was clean and infection control and prevention procedures were followed.

Rating at last inspection:

Good (report published 18 October 2016).

Why we inspected:

This was a planned inspection planned on the rating of the last inspection. We found that the service continued to meet the characteristics of Good.

Follow up:

We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.

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

Peasmarsh Place provides care and support for up to 24 older people with care needs associated with older age. The needs of people varied, some people were mainly independent others had low physical and health needs and others had a mild dementia and memory loss. The care home provided some respite care and could meet more complex care needs with the support of community nurses which included end of life care.

At the time of this inspection 17 people were living in the service. This inspection took place on

28 July and 4 August 2016 and was unannounced.

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.

The quality monitoring systems needed further development to ensure they were used to ensure best practice and to identify shortfalls and demonstrate effective responses. This included the use of suitable guidelines for medicine administration and accurate records for the application of topical creams to demonstrate staff delivered these in a consistent way. In addition, some care documentation was not completed to record the care required and provided. This could lead to staff not having up to date information on people’s needs and care provided.

Organisational policies and procedures and supporting audit systems did not ensure best practice was followed in all areas. For example, satisfaction surveys were used but information gathered from these was not recorded and used in a systematic way to improve the service. This was identified to the registered manager as an area for improvement.

People were looked after by staff who knew and understood their individual needs well. Staff treated people with kindness and compassion and supported them to maintain their independence. People’s dignity was protected and staff were respectful. All feedback received from people and their relatives was positive about the care, the atmosphere in the service and the approach of the staff and registered manager.

All feedback from visiting professionals was positive. They told us staff worked with them to improve outcomes for people.

People were protected from the risk of abuse because staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and followed correct procedures to protect people’s rights.

Staff were provided with a full induction and training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people’s needs could be met in a timely and safe fashion.

People were given information on how to make a complaint and said they were comfortable to raise a concern or give feedback. A complaints procedure and comment cards were readily available for people to use.

Staff monitored people’s nutritional needs and responded to them. Preferences and specific diets were provided. People were supported to maintain their own friendships and relationships. Staff related to people as individuals and took an interest in what was important to them.

Feedback was regularly sought from people, relatives and staff. People were encouraged to share their views on a daily basis and satisfaction surveys had been completed. The management style fostered an open culture that listened to people and staff views.

We spent time talking to people who use the service. We spoke with people's relatives who were visiting the home on the day of our inspection. We spoke with staff and looked at some records. People who use the service told us "The staff are very nice and very caring." and "It's fantastic here."

We found that people were involved in decisions about the care and treatment they received. Care plans were detailed and person centred. We examined the systems and processes in place for the safe management of medicines and found these to be effective. There were sufficient numbers of staff with the appropriate skills to meet the needs of people who use the service. We found that there was an effective complaints system available.

We spoke to 10 people during our inspection. We also used a number of different methods such as observation of care and reviewing of records to help us understand the experiences of people who used the service.

People we spoke with who lived in the service told us they liked living at Peasmarsh Place. We were told "Nice staff and very comfortable," "Caring and kind staff," and "I go out and they support me to keep independent." We were also told that the food was good.

We saw that people were treated with respect and they were supported to be as independent as possible. We found that people and their families were involved in decisions about the support and care they needed. Staff we spoke with had a good understanding of how to safeguard people from harm. Training records showed that staff received a varied training programme that ensured peoples needs were met.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people were asked their views about the home in surveys.

People told us that they were given lots of choice in their everyday routine, for example, when to get up and go to bed, what to eat and how to spend their time. They told us that they felt they were treated with respect and that their privacy and dignity was maintained at all times. Comments from people that use the service included:

“I’m very lucky to be here”.

“Very happy”.

“We can always have a sherry or wine around dinner”.

“No complaints”.

“100%”.

“We have a very good life here”.

“They have treated me very well” and

“We are given plenty of choice”.

People told us that they got help with the things they needed and that the care they received met their needs. They said that the staff always offered them help with a bath or shower and that they could have this when they wished. People told us that they could see their GP or a nurse when they needed to and that there was a chiropodist that visited the home every four weeks. They also told us that there was a visiting dental service.

People using the service told us that there were activities provided in the home and that they could choose whether to join in with these or not. One person said “They always give us a list of what is planned for the month”. People told us about the range of activities that had taken place recently in the home which included afternoon teas, embroidery classes, a fete, visits from pet dogs and talks in the afternoon. Another person said “There are plenty of books around, I enjoy reading and can always find something new to read”

People told us they could have visitors whenever they wished. People that were visiting the service at the time of the inspection told us that there were no set visiting times and that they were always made to feel welcome. One person was having a meal with the person they were visiting and said that they were always made to feel welcome to have lunch.

People told us that they felt safe in the home and knew who they could talk to if they had any concerns about their care. They said that they would not be worried to tell the manager if they thought they were not being treated well. People that were visiting relatives in the home told us that they felt assured that the person was being well looked after. They said “They do a really fantastic job”.

People told us that they were very happy with their rooms and the facilities available in the home. They said that the home was kept clean and one person said “They clean my room every day and do a thorough clean every week”.

People told us that the staff treated them with respect and were kind and patient when providing care. Comments from people included:

“The staff are good, you get to know them” and

“The staff know us well, they always know about important things like your allergies”.