The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one inspector.

Service and service type:

Redwoods is a care home. People in care homes receive accommodation and personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service us run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and other professionals who work with the service. We assessed the Provider Information Return (PIR) had submitted. Providers are required to send us a PIR at least once annually to give some key information about their service, what they do well and improvements they plan to make. This information helps support our inspections.

During the inspection we met all six-people living there and spoke with three people to ask about their experience of the care provided. We also spoke with two relatives, two members of care staff, and the registered manager.

We reviewed a range of records. This included three people's care records and medicine records. We also looked at one staff file around staff recruitment. We also reviewed records relating to the management of the home including checks and audits.

We inspected this home on 12 April 2016 and returned on 21 April to meet with the registered manager and talk to additional care staff. This was an unannounced Inspection. The home was registered to provide residential care and accommodation for up to seven people who have mental health needs. At the time of our inspection five people were living at the home. People had all lived there for many years.

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 using this service told us they felt safe and staff understood their roles and responsibilities to protect people from the risk of potential harm. Staff were aware of the provider’s processes for reporting any concerns. Recruitment checks were in place to ensure staff who were employed were safe to work in adult social care.

Difficulties in recruiting to a vacant post had resulted in some instances of agency staff working on their own at night time. The provider had ensured that robust induction arrangements were in place for agency staff. Action was being taken to address the recruitment issue by the registered provider.

We found that staff were trained to support people effectively and received opportunities to further develop their skills. Staff told us that they received regular supervision and that senior staff were always available for them to seek advice and guidance.

People had access to a variety of food and drink which they enjoyed. People were supported when necessary to access a range of health care professionals.

We observed staff seeking people’s consent before providing any care and support. Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions.

People spoke to us about how genuinely caring and kind staff were towards them. We saw and people told us they felt involved in decisions about how they were communicated with and cared for. People told us they were encouraged to remain as independent as possible by staff. We observed staff ensuring people’s privacy and dignity was maintained.

We found some parts of the home were in need of general refurbishment. This was being addressed by the registered provider and a full refurbishment of the home was planned

Processes were in place which supported people to express their opinions in developing their care plans. People knew how to raise complaints. Where complaints had been raised the registered manager had taken prompt and appropriate action.

Staff working in this home understood the needs of the people who lived there. We saw that staff communicated well with each other and spoke highly of the management and leadership they received. There were systems in place to monitor the quality and safety of the home and improvements had been identified to increase the quality of life for people at the home.

The inspection was carried out by one inspector. At the time of our inspection there were six people who were using the service. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with three people who used the service, three staff who were supporting them and from looking at records. This evidence helped us answer the five questions detailed below.

Is the service safe?

People were treated with dignity and respect by staff. People told us they felt safe. We observed a relaxed atmosphere and positive relationships between the people who used the service and staff.

CQC monitors the operation of Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

There were risk management plans in place for people and health and safety. We noted that the premises were appropriate, well maintained and safe for the people who were using the service. Safe systems for the recruitment of staff were in place and a person who used the service assisted with the selection process.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. There was evidence of people and or their relatives being involved with the development and regular reviews of care plans. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they knew them well. Staff encouraged and supported people in leading interesting and enriched lifestyles. The people we spoke with all said they received the standard of care that matched their needs. Staff had received training to meet the needs of the people living in the home.

Is the service caring?

The people we spoke with were positive about the way they were cared for and supported. A person told us: "Staff look after me very well." People were cared for by kind and attentive staff. We observed people asking staff to do things for them. Staff responded to the requests promptly and efficiently. We observed staff making arrangements to assist people with their preferred activities when they had made a decision about what they wanted to do. The home was supported by a team of health and social care professionals who worked closely with staff in providing people's care needs.

Is the service responsive?

Staff respected people’s confidentiality and asked for permission before sharing personal information with other organisations. When people who lived in the home made suggestions for changes these were actioned as far as practically possible. We found evidence that people were able to make choices about their room, day trips and holidays. Records confirmed people’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes. We found evidence that staff sought professional advice when they had identified concerns about people’s health and safety. Staff followed the guidance provided by healthcare professionals to ensure that people received appropriate care and support.

Is the service well led?

The service had a quality assurance system in place. Records showed us that improvements had been made when they were identified through monitoring processes. There were clear processes in place for dealing with complaints. When complaints did arise the person was offered an advocacy service to speak on their behalf. Regular audits had been carried out that enabled staff to make changes that could be of benefit for the people who used the service. Staff told us they were clear about their roles and responsibilities, the ethos of the service and the quality assurance processes.

There were six people using the service at the time of our inspection. We spoke with all of these people, the staff that were supporting them and one relative. Mostly positive feedback was received about the service provided at the home. A relative told us “I am very happy with the care provided here.” Staff are friendly and always helpful. Food is good and it’s always nice and warm within the home.”

People told us that they were happy with how their care and support needs were being met. Staff turnover was low and we obtained mostly positive feedback in relation to how support was provided by staff. Most people told us that staff supported them in a respectful manner and offered them choices of how and where they wanted to spend their time. During our inspection we saw that staff supported people in a caring and sensitive manner and in a way that encouraged them to be as independent as possible.

People told us that they felt safe living at the home and that they would speak to the staff if they had any concerns. A person using the service told us “I find the staff easy to talk to.”

People told us that they were satisfied with the choice and quality of meals available to them. A person using the service told us “Staff have supported me so I have meals that I choose.”

Arrangements were in place so that people received their medicines in a safe and timely manner. Some people were encouraged to self- administer their own medication, with support from staff.

Improvements were needed in relation to the systems in place to assess, manage and monitor the quality and safety of service that people received.

There were six people using the service at the time of our visit. We spoke with four of these people and the staff that were supporting them.

People told us that that they were happy with the quality of service they received and how their care and support needs were being met. Comments included: “I am very happy here thank you” and, “I get on well with the staff.”

People told us that staff supported them in a respectful manner and offered them choices of how and where they wanted to spend their time.

People told us that they were happy with the staff team that were supporting them. During our inspection we saw that staff supported people in a caring and sensitive manner and in a way that encouraged them to be as independent as possible.

People told us that they felt safe and that they would speak to the staff if they had any concerns. A person using the service told us “I have no problems. I would speak to the manager if I had any worries.”

People who use the service told us that they were involved in making decisions about the service provided to them. They told us that actions are taken following any suggestions that they put forward about this. One person who uses the service told us “I go to meetings with other people that live here and the staff ask us questions. We talk about if we have any problems and new things”

People told us that they could choose how they spend their time, so that they could make decisions about their daily lives.

People told us that they had the opportunity to view the service prior to staying there. One person who uses the service told us “I came and saw Redwoods and I liked it”.

People told us that they were happy with how the home was meeting their care and support needs.

People told us that they are encouraged to do things for themselves. This is so that they develop the skills needed to lead more independent lives in the future. One person who uses the service told us “I tidy my room myself.”

People told us that they were offered a variety of meals and that they had a choice about what they had to eat. One person who uses the service told us “We had a Chinese takeaway to see if we liked it. The staff ask us what we would like to eat the next day”.

People told us that Redwoods was always clean and tidy.

People that use the service told us that they are encouraged and supported to administer their own medication. One person told us “I do the medication myself and then someone comes in and checks that I have done it ok. I have got a key for where I keep my medication in my bedroom”.

People told us that they were comfortable in their bedrooms and that they had been involved in decorating their rooms with personal items.

People told us that there were enough staff on duty to meet their needs.

People told us that they were supported by staff who were familiar with their individual needs.

People told us that they were confident to raise any complaints they had with the staff team in order for the service to improve. People told us that they were confident that any concerns raised were taken seriously and that their views were acted upon.