Shockerwick House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is an 18th Century listed detached building that stands in twelve acres of landscaped gardens. It is registered to provide accommodation and personal care for up to 38 older people. At the time of the inspection 23 people were living at the service.

The inspection took place on 30 November 2018 and was unannounced.

There was 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.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff had been trained to keep people safe. People using the service and their relatives told us they felt safe. Care plans contained risk assessments and when risks were identified the plans provided clear guidance for staff on how to reduce the risk of harm to people. Incidents and accidents were reported and analysed to identify trends. There was evidence that lessons were learned when incidents happened.

Safe recruitment procedures were in place and there was enough staff on duty to meet people’s needs.

Medicines were managed safely. The environment was exceptionally clean.

Staff were trained to undertake their roles. Staff had regular supervisions with a supervisor. People’s nutritional needs were met and people told us the food was “excellent.”

Staff remained knowledgeable about the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We observed many positive interactions between people and staff. People spoke highly of the staff and staff spoke positively about their roles. Regular feedback was sought from people.

Some aspects of care plans were person centred and contained details of people’s choices and preferences for how they wanted to be supported; however, this was not seen consistently. Although staff told us people were involved in care plan reviews, this was not documented.

There was a complaints procedure in place. Complaints were recorded and investigated appropriately.

There were robust quality assurance processes in place; however, these had not identified some of the issues we noted.

People and staff unanimously, spoke highly of the registered manager who they described as a strong leader with high standards. Staff told us morale at the service was good and that they felt valued by the provider.

Further information is in the detailed findings below.

This inspection took place on 19 and 20 May 2016 and was unannounced. When Shockerwick House was last inspected in November 2013 there were no breaches of the legal requirements identified.

Shockerwick House is a nursing home and provides care and support for up to 38 older people. On the day of our inspection there were 20 people living in the home. The home had restricted admissions whilst it was being refurbished.

The service has 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.

People had a very positive experience living at the home. They were supported by staff that enjoyed their job; who ensured that people lived in a safe home; which gave effective care; by caring and passionate staff; who responded to people's needs and really involved them in their care and support. The registered manager gave an outstanding level of leadership to make people's lives happy and fulfilled.

The provider had quality monitoring systems in place which were used to improve the service and embed a culture of continuous improvement throughout the service. People were involved in how the home was managed. Regular meetings took place to give people a chance to have their say; the feedback was used to improve the home and the people's experience of living there.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff and people we spoke with felt the staffing level was appropriate. Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their care needs. Staff also understood their safeguarding responsibilities and whistle-blowing policy and procedures. Staff supervision was undertaken regularly and staff felt well supported by the registered manager.

There were positive and caring relationships between staff and people at the service. People praised the staff that provided their care and we received positive feedback from people’s relatives and visitors. Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way when responding to their needs.

Care provided to people met their needs. Care records provided personalised information about how to support people. We saw that the service took time to work with and understand people’s individual preferences in order that the staff could respond appropriately to the person. People were also supported to undertake person centred activities and be involved in the local community.

The staff had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Meetings had been arranged in order to enable people’s best interest to be assessed when it had been identified that they lacked the capacity to consent to their care and treatment.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support individuals to meet their needs.

People had their physical and mental health needs monitored. The service maintained daily records of how people’s needs were meet and this included information about medical appointments with GP’s and dentists.

There was a complaints procedure for people, families and friends to use and compliments were also recorded.

People were very happy with the service they received. They were able to make choices about their daily routines. There was an emphasis on lifestyle and people were able to participate within the range of social activity provision.

People looked well care for and were relaxed within their surroundings. Staff spoke to people in a caring and considerate manner. Interactions were attentive and respectful.

All areas of the home were clean. Clear housekeeping and laundry systems were in place. Staff had received training in infection control and regular audits had been undertaken.

Staff managed and administered people’s medicines in a safe manner. Systems to receive, store and dispose of medicines were ordered and well managed. Staff undertook a comprehensive training and assessment process before administering people’s medicines.

There were sufficient staff on duty to meet people’s needs. Staff told us they had time, particularly in the afternoons, to spend with people. The home was relaxed and routines were unhurried.

Staff were well supported and had access to a range of training opportunities. There were various in house sessions as well as courses facilitated by external training providers. Staff meetings, one-to-one supervision and appraisals were established systems which worked well.

The residents that spoke to us were positive about how they felt supported by the staff team. For example one resident said "We're very well taken care of" whilst another said "The carers are real carers."

We saw staff supporting residents with a range of nursing and personal care needs. We heard staff speaking with residents in a caring and respectful way. We saw that care plans were sufficiently detailed to support and guide staff. This helped ensure residents received the care they needed.

Residents said they felt safe in Shockerwick House. A relative said " carers were nice kind and friendly" whilst a resident said " Staff are good and those that aren't don't last long." when we asked the resident if any of the staff who had left had concerned him he replied " definitely not."

We saw that residents were asked for their views on the care and support they received. This information was used to change, reevaluate and improve the quality of service and the care that residents received.

The people that spoke to us were positive about how they are supported by the staff team. Examples of comments people made included, “on the whole they are really good”, “this is now my home and I won’t be going anywhere else”, “they are all lovely”, and “I couldn’t manage without them, they are so helpful”.

We saw people being effectively supported by the staff team with their range of nursing and personal care needs. We saw that care plans properly support and guide staff, to ensure people receive the care they need.

We found that people are provided with a varied and nutritious diet. One person did say to us that they did not like the food choices. However we found that where people are unhappy about the food their concerns are addressed.

We found that there are enough competent staff employed to support and care for people properly so that their needs are met.

We found that people benefit from the systems in place to help them make comments or complaints. When complaints are made these are resolved, where possible, to the satisfaction of the person making the complaint.

We found that people are cared for by staff with a good knowledge of their needs. The staff have done a variety of training to help them understand what care and support people need.

We saw that people are asked their views of the care and support they receive. This information is used to monitor and improve the quality of service and the care that people receive.