We carried a comprehensive inspection of Shalom on 20 November 2016. This was the first inspection the service had been inspected under the current regulations.

Shalom provides residential care for up to 18 people. On the day of the inspection there were 14 people using the service. Shalom is situated in a residential area of Eastbourne. The service has three floors which are split level and served by stair lifts. People could move around freely without restriction.

The service had a registered manager 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.

On the day of the inspection visit there was a calm and relaxed atmosphere in the service. We observed staff had a good relationship with people and supported them in a caring and respectful way. People were being cared for by competent and experienced staff. A family member told us, “We visit regularly and find the staff are very caring. They always make us feel welcome.”

People were protected from the risk of abuse because staff had received training to help them identify possible signs of abuse and knew what action they should take. Staff told us they supported people in a way that kept people safe.

People received their medicines when they needed them and staff knew how to administer and record medicines safely.

Staff received a thorough induction when they started working at the service. Training was regularly refreshed and staff told us it was effective. Recruitment processes were satisfactory; for example pre-employment checks had been completed to help ensure staff were suitable to work in the care sector.

Systems were in place to support staff. Staff were receiving regular supervision meetings with the deputy manager and annual appraisals to look at personal development and training. A staff member told us, “The manager is always there for us. It’s good to know that we are encouraged to do training and that the manager checks that we are doing things right.”

Systems were in place to monitor the quality of the service people received. This included meetings with staff. Informal meetings with people using the service and their families. A relative told us, “I never leave without having a chat with the girls or the manager. I think we are kept up to date with what’s going on.” Regular surveys took place to gain the views of people using the service and their relatives. A relative told us, “I fill in the forms they give us to say what I think about the home. I think they use the information to make things better. It’s usually about what people like to eat, the choice of meals and if they get the care they need.”

Checks had been made and were in date for the maintenance and servicing of gas, electric and fire systems. All other equipment used by the service to support people were well maintained and regularly serviced as per equipment guidance.

Staff understood the needs of people they supported, so they could respond to them effectively. They told us they felt supported and had the resources they needed to carry out their role. Comments included, “The manager is very supportive to us (staff). They help us out if we need that extra support” and, “We get all the information we need especially when things change.”

Staff supported people to be involved in and make decisions about their daily lives. There were systems in place to help ensure staff acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This was to protect people and uphold people’s rights where they faced restrictions due to lack of mental capacity.

Most people chose to stay in their rooms. However there were a range of activities availabl

We looked at the personal care or treatment records of people who use the service, carried out a visit on 3 September 2014, and checked how people were cared for at each stage of their treatment and care.

We considered all the information we had gathered under the outcomes we inspected. We spoke with eight people using the service, three relatives and a visiting health professional. We also spoke with four staff, the deputy manager and the registered manager. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is it safe?

People's needs had been assessed and care was delivered to them in line with their needs. Care plans were comprehensive, clear and informative and staff were aware of people's needs and how to meet them. People had the equipment they required to move around the home safely. Emergency arrangements were in place to ensure people could be evacuated safely and continue to be cared for if they could not return to the building.

The manager was aware of their responsibilities under the Mental Capacity Act (MCA). No applications had been made under the Deprivation of Liberty Safeguards (DoLS) however, the manager was aware of the procedures to follow should this be necessary. People were cared for by staff who understood their human rights.

Systems were in place to ensure medication was administered safely and according to people's needs. Policies and procedures were in place to make sure that unsafe practices were identified and people were protected. People told us they felt safe.

Is it effective?

People, and their relatives, told us they were satisfied with the care they received and felt their needs had been met. One person said, “I struck lucky here, you couldn't get better care, I’m very happy here". Daily records of care showed people received the care they required which was in line with their care plan. Risks to people's health, safety and welfare were assessed and measures were put in place to mitigate these. Staff had designated duties to carry out on each shift and the staff we spoke with understood people’s care and support needs. Staff training needs were identified and staff had completed training appropriate to their role. Where people had specific dietary or moving and handling needs, we observed these were met. The people we spoke with said they were cared for by a consistent team of staff who were skilled, caring and experienced.

Is it caring?

The staff provided support with a caring, and friendly attitude. Staff were attentive to people's needs and fostered a friendly atmosphere in the home. People’s preferences, interests and diverse needs had been recorded in the care plans we viewed. A relative we spoke with said, "Everyone's very kind, especially when [my relative] has been poorly, they were on to it like a shot". Another relative told us, "It's such a relief to walk away and know [my relative] is well looked after".

Is it responsive?

People’s needs had been assessed before they moved into the home. People told us they regularly discuss their needs with their carer. An hour by hour communication daily log book was in use to ensure staff were kept up to date with people’s changing health and welfare needs. This enabled staff to take appropriate action when necessary because they were aware of people's needs. People knew how to complain, although people said they had no complaints. They told us they would talk with the manager if they had any concerns. People said they felt confident that their comments and concerns would be received positively and action would be taken

Is it well-led?

The service worked with other agencies and services to make sure people received care in a joined up way. People living in the home, their relatives and health professionals had opportunity to give feedback about the service. Survey responses showed people were satisfied with the service. Arrangements were in place to audit records and check the quality of the care provided in the home. Improvements had been made as a result. This helped to ensure people received a good quality service at all times. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home.

People we spoke with told us, "I am very happy here. The food is good, you get a choice," and "The staff are all very obliging and very respectful."

We looked at four care plans, and spoke with people and staff. We found that care plans were regularly reviewed to ensure they were relevant and addressed people's needs. There was clear evidence that people were involved in developing their care plans.

We looked at the home's safeguarding training and policy and spoke with staff. People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The home was cleaned to a high standard and had no unpleasant odours. We spoke to staff and examined cleaning schedules and the laundry. We found that there were effective systems in place to protect people from the risk of infection because appropriate guidance had been followed.

We examined four staff files and found evidence that robust recruiting and vetting systems were in place to ensure that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

One person we spoke with told us “I like the home very much, the food is very good.” Others told us “the staff are very friendly” and “I’m very comfortable here and well looked after.”