The inspection took place on 7 September 2016, and the visit was unannounced.

Pendene provides residential care to older people including people recovering from mental health issues and some who are living with dementia. Pendene is registered to provide care for up to 17 people. At the time of our inspection there were 15 people living at the home.

A registered manager was in post. 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.

At the last inspection of the service in May 2015 we asked the provider to make improvements in the storage of and administration of people’s medicines. We received an action plan from the provider which outlined the action they were going to take. This advised us of their plan to be compliant by January 2016. At this inspection we found that improvements had been made. Medicines were ordered, administered and stored safely, and staff were trained to administer the medicines people required. Staff sought medical advice and support from health care professionals where needed.

At the last inspection we also asked the provider to take action to make improvements in staff knowledge of the pressure relieving equipment. We found staff were now aware of how the equipment was monitored and had set up a programme of regular checks to ensure it was used safely.

At the last inspection we also asked the provider to make improvements to the audits, checks and governance in the home. We received an action plan from the provider. A series of checks had been introduced that were overseen by the registered manager and then checked by the provider.

Staff told us they had access to information about people’s care and support needs and what was important to people. People felt staff were kind and caring, and their privacy was respected in the delivery of care and their choice of lifestyle. However some of entries made by staff in the daily records did not always use the correct terminology and could be improved upon.

Relatives we spoke with were complimentary about the staff and the care offered to their relatives. People were involved in the review of their care plan, and when appropriate their relatives were involved. We observed staff positively interacted with people throughout the day and through the SOFI at lunch, where people were offered choices and their decisions were respected. People’s care and support needs had been assessed and people were involved in the development of their plan of care. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to peoples care and treatment and people attended routine health checks.

People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs, and sought people’s opinions to meet their individual meal choices. There were sufficient person centred activities provided on a regular basis. Staff had a good understanding of people’s care needs, and people were able to maintain contact with family and friends. Visitors were welcome without undue restrictions.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. There were sufficient staff available to meet people’s personal care needs and we saw staff worked in a co-ordinated manner.

The provider had a clear management structure within the home,

This inspection took place on 13 May 2015 and was unannounced.

Pendene House is a care home that provides residential care for up to 17 people. The home specialises in caring for older people including those people living with dementia. At the time of our inspection there were nine people in residence.

A registered manager was in post. 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 were happy and told us that they felt safe. Staff were able to explain how they kept people safe from abuse, and knew what external authorities were available to report concerns on to. Staff were knowledgeable about their responsibilities and were trained to look after people and protect them from harm and abuse.

Staff were recruited in accordance with the provider’s recruitment procedures that ensured staff were qualified and suitable to work at the home. We observed there to be sufficient staff available to meet people’s needs and worked in a co-ordinated manner.

People received their medicines when prescribed. The provider assured us that they would make the required improvements were needed to ensure medicines were stored or managed safely.

Staff received an appropriate induction and ongoing training for their job role. Staff had access to people’s care records and were knowledgeable about people’s needs that were important to them.

Staff communicated people’s dietary needs appropriately, which protected them from the risk of losing weight. People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs.

People’s care and support needs had been assessed and people were involved in the development of their plan of care. People told us they were satisfied with the care provided.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Relatives we spoke with were also complimentary about the staff and the care offered to their relatives.

We observed staff speak to, and assist people in a kind, caring and compassionate way, and people told us that care workers were polite, respectful and protected their privacy. We saw that people’s dignity and privacy was respected which promoted their wellbeing.

Staff had a good understanding of people’s care needs, though some documents within the care plan document lacked detail and explanation. There was an absence of instruction on how staff should monitor and when necessary adjust pressure relieving equipment.

Relatives and people using the service told us that they had developed good relationships with staff.

People were involved in the review of their care plan, and when appropriate were happy for their relatives to be involved. We observed staff offered people everyday choices and respected their decisions.

People told us that they were able to pursue their hobbies and interests that was important to them. These included the opportunity to maintain contact with family and friends as visitors were welcome without undue restrictions.

Staff told us they had access to information about people’s care and support needs and what was important to people. Care staff were supported and trained to ensure their knowledge, skills and practice in the delivery of care was kept up to date. Staff knew they could make comments or raise concerns with the management team about the way the service was run.

The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals.

Staff sought appropriate medical advice and support from health care professionals. Care plans included the changes to peoples care and treatment, and people had access to regular health checks.

People were confident to raise any issues, concerns or to make complaints. People said they felt staff listened to them and responded appropriately.

People who used the service and their relatives spoke positively about the open culture and communication with the staff. We noted that the provider interacted politely with people and they responded well to him. When we spoke with the provider, it was clear he knew people and their relatives, with the depth of conversational knowledge.

The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. Care staff understood their roles and responsibilities and knew how to access support. Staff had access to people’s care plans and received regular updates about people’s care needs.

Staff were aware of the reporting procedure for faults and repairs and had access to external contractors for maintenance and to manage any emergency repairs.

There were systems in place for monitoring of the building and equipment which meant people lived in an environment which was regularly maintained.

The provider had quality assurance systems, which included internal audits and monitoring of person centred planning. However, those were not used consistently and any shortfalls identified were not always recorded to help the provider monitor the improvements needed.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We did not speak with people as part of our visit. We looked at the storage arrangements for controlled drugs that had been prescribed to people who used the service. We also looked at the records of recording the medication for two people who had been prescribed a controlled drug.

We spoke with two visitors who were visiting relatives of people who used the service. Visitors told us they were happy with the care and support their relative received and told us they were kept informed about their health and welfare. Visitors comments included: “This home stood out for our needs. It was small and intimate and the residents here seemed happy. We’re very happy with the care." “A really good group of staff they’re fab.” We asked visitors if their relatives had made any comments to them about the service. One visitor told us their relative had made the following comment: I love my room and I have a window that I can look out of and look at the birds in the trees.

In the morning we observed a number of people taking part in a ‘sing-a-long’ with staff. People were seen to be enjoying themselves with some people getting up and having a dance. In the afternoon we noted that a musical dvd was showing on the television and a number or people sang along to the songs.

We looked at records which included the care plans for three people who used the service, along with staff recruitment and training records and records detailing the maintenance of systems and equipment within the service. We found all records were up to date and accurate and were kept securely.

We found by observing and speaking with people who use the service that people were given the opportunity to influence the care and support they receive. People told us they had the opportunity to take part in ‘resident meetings’. We saw people being asked by care staff how they wished to spend their day. We saw people, supported by care staff to take part in a range of activities, which they told us they enjoyed.

We spoke with people who use the service who told us they were happy with the care they received and that they found staff to be kind and helpful. One person we spoke with confirmed that the information written about them within their care plan was accurate and that it reflected the care and support they received. Staff we spoke with had a clear understanding as to the care and support people required.

We asked two people if they felt safe at the service. One person said “oh yes, if I had any worries I’d speak with the manager.” A second person told us “definitely, everyone is so kind and helpful.”

We looked at training and supervision records of staff and spoke with staff about their training and the support they received. Staff told us they were supervised and felt that they were felt generally supported by the provider and registered manager. They told us they had the opportunity to attend staff meetings and express their views and ideas.

The provider had developed a quality assurance system, which included the sending out of surveys to people who use the service, their relatives along with health and social care professionals. The quality assurance system also included the holding of regular resident and staff meetings, as well as auditing health and safety within the service.

People in residence at Pendene House told us that they were happy living at the home and that the staff looked after them well. People throughout our visit spoke with the provider and manager and were confident in their company. In the afternoon the manager and a member of staff encouraged people to take part in activities which people enjoyed, and which stimulated conversation and laughter.

People told us that there was not a menu to choose from; however in the main they were happy with the food provided. People had the opportunity to talk about the service they received however their views had not been recorded.

Visitors told us that they were happy with the care their relative received and had been involved in the development of the persons care plan.