About the service:

Pedmore House is a residential care home that was providing personal care to 11 people with learning disabilities or a diagnosis of Dementia at the time of the inspection.

People’s experience of using this service:

¿People were supported by staff who knew how to report concerns of abuse and manage risks to keep people safe. Staff had been recruited safely and there were sufficient numbers of staff to support people. Medicines were managed in a safe way.

¿People were supported by staff who had been trained. People’s dietary needs were met and they had access to healthcare services where needed. People’s rights had been upheld in line with the Mental Capacity Act.

¿Staff were kind and caring to people. Staff respected people’s dignity and supported people to be independent where able. People had access to advocacy services where required.

¿People were supported by staff who knew them well. Activities were available that met people’s individual interests. Complaints made were investigated and resolved.

¿There were systems in place to monitor the quality of the service. People were given opportunity to feedback on their experience of the care. People spoke positively about the leadership at the service.

Rating at last inspection: Good (Report Published 03 December 2015)

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

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

Our inspection was unannounced and took place on 28 October 2015. The inspection was carried out by one inspector. We started our inspection early in the morning so that we could meet and speak with the people who lived there and staff in case they were out of the home later.

The provider is registered to accommodate and deliver personal care to ten people who lived with a learning disability or associated need. Ten people lived at the home at the time of our inspection.

The manager was registered with us as is required by law. 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.

Where people received support from staff with taking prescribed medicines records were not always up to date and accurate.

Staff knew the procedures they should follow to ensure the risk of harm and/or abuse was reduced.

Staff were available to meet people’s individual needs. Staff received induction training and the day to day support they needed to ensure they met people’s needs and kept them safe.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This ensured that people received care in line with their best interests and would not be unlawfully restricted.

People were enabled and encouraged to make decisions about their care. If they were unable to their relatives were involved in how their care was planned and delivered.

Staff supported people with their nutrition and dietary needs to promote their good health.

People were supported by an adequate number of staff who were kind and caring.

Staff felt that they were trained and supported to enable them to care for people in the way that they preferred.

All people received assessments and/or treatment when it was needed from a range of health care and social care professionals which helped to promote their health and well-being.

Systems were in place for people and their relatives to raise their concerns or complaints.

People and their relatives felt that the quality of service was good. The management of the service was stable. The registered manager and provider undertook regular audits and took action where changes or improvements were needed.

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with one person that lived at the home, two relatives, the registered manager and two care workers. We also spoke with the local commissioner of the service.

We also reviewed records relating to the management of the home which included, two care plans, daily care records, accident /incident records, complaints records, audits, safeguarding files, staff training records and notification records.

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

Is the service safe?

All of the people and their relatives spoken with told us that they felt that the care provided was safe. A relative told us, “I give them ten out of ten for the care they provide.”

Procedures were in place to ensure that any risks associated with people’s care were identified and managed so as to promote people’s safety and independence. Where necessary appropriate health professionals were involved in supporting people’s care, this ensured that people were supported safely and their health needs met where required.

Systems were in place to make sure that managers and the staff team learnt from events such as accidents and incidents, complaints and concerns.

We saw that people were cared for in an environment that was safely maintained and suitable to meet their needs.

All the relatives that we spoke with told us that the home was clean and tidy and there were no offensive odours in the home. A relative told us, “X’s room is clean and the home is clean.”

We saw that the home was clean and free from offensive odours. There were systems in place to manage infection control to ensure that people were safe from cross infections.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. We saw that the appropriate application was made where it was deemed necessary to deprive some one of their liberty. Staff working at the home had the knowledge and training to ensure that people’s rights were protected in line with the legislation.

We found that the home was meeting the requirements of the regulations to ensure that people living there were safe.

Is the care effective?

Everyone that lived at the home and relatives that we spoke with told us they were happy with the care and that their needs were being met. A relative told us, “X is always nicely dressed, her key worker takes her shopping to buy clothes and she knows what she likes.”

Procedures were in place to support people in giving consent to their care. People were able to participate in different activities in the community. One person told us, “I go out to the pictures and the pub.” People had individual activity plans and all staff spoken with told us about a variety of activities that people were involved in.

We saw that people’s nutritional needs were being met, so as to promote their health and wellbeing. A person that lived at the home told us, “The food is lovely and I can choose what I like to eat and they provide it.”

We contacted the local commissioner of the service and they had no current concerns about the service being provided by the home.

We found that the home was meeting the requirements of the regulations to ensure that people received an effective service.

Is the service caring?

Everyone that lived at the home and relatives that we spoke with told us that the staff were caring. One person that lived at the home told us, “The staff are caring. They give me a bath when I want one.” A relative told us, “The team of staff looking after my daughter are superb. I rate them as first class. They always have time to talk.”

We saw that people were well groomed and dressed in clothing appropriate to their age, gender and the weather, so that their dignity was maintained. Throughout the day we saw that staff knew people well and there were good interactions between people and staff.

We found that the home was meeting the requirements of the regulations to ensure that people received a service that was caring.

Is the service responsive?

People’s needs were assessed and planned in an individual way; this ensured that the way each person’s care was delivered was personal and individual to them. This ensured that people’s preferences, likes, dislikes and diverse needs were taken into account in the way the service was delivered.

People and their relatives were involved in reviewing the quality of their care, so that the home could respond to any concerns raised about the quality of the care provided.

Where incidents or accidents had occurred we saw that the home had acted to ensure that they did not reoccur.

People knew how to make a complaint if they were unhappy and were confident that their concerns would be addressed. Whilst the home had not received any complaint since our last inspected, we saw that procedures were in place to act on people’s concerns. A relative told us, “I can talk to the manger if I am concerned and she would deal with it.”

We found that the home was meeting the requirements of the regulations to ensure that people received a service that responded to their needs.

Is the service well led?

People and their relatives were confident about the quality of the service provided by the home. They had absolutely no concerns about the care that was provided.

We saw that the home had a staffing structure that would enable the service to be managed appropriately. This included a manager that we have registered to be responsible for the running of the service. We saw that there was a good atmosphere in the home. People were consulted about the quality of service they received and staff were able to contribute to suggestions about improving the service.

We saw that there were procedures in place for monitoring the quality of the service. Appropriate reporting procedures were in place to ensure that the provider had an overview of the quality of the service provided.

We found that the provider was meeting the requirements of the regulations to ensure that the service was well led.

During the inspection we spoke with one person that lived at the home, two relatives, the manager and two care staff. Some people that lived at the home could not communicate with us verbally, so we spend time observing how staff interacted with them.

Relatives that we spoke with told us that they were involved in agreeing how their relatives were cared for and that their dignity was being maintained. One relative told us, “I was involved in her care plan. They asked me her likes and dislikes.” We found that people’s privacy, dignity and independence were respected.

We saw that staff talked to people about their care and staff gave us good examples of how they ensured that they gauged people’s consent to care and treatment. We found that where people did not have the capacity to consent, the provider did not act in accordance with legal requirements.

People that we spoke with and their relatives that we spoke with told us that they were happy living at the home. One person told us, “I am happy and I don’t want to move out.” We found that people experienced care, treatment and support that met their needs.

Everyone that we spoke with told us that people were safe living in the home. We found that people were protected from the risk of abuse, because the provider had systems in place to identify the possibility of abuse and prevent abuse from happening.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs.

People that lived at the home and relatives that we spoke with told us that they had no concerns whatsoever about the care provided. We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.