About the service:

SS Philip and James Retirement Home is a residential care home that was providing personal and nursing care to 30 people aged 65 and over at the time of the inspection.

SS Philip and James Retirement Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and care provided, and both were looked at during this inspection.

SS Philip and James Retirement Home accommodates 32 people across three adapted houses which are interlinked as one building, each of which has separate adapted facilities.

People’s experience of using this service:

¿ People and relatives were full of praise for the excellent service they received. Relatives said, “We’re over the moon with it”, “It’s amazing” and, “We’re delighted.”

¿ Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were very kind and caring. People told us, “I’m so lucky to be here” and, “You just don’t get any better.”

¿ One healthcare professional told us the service was, “An incredible home…very responsive.”

¿ Relatives were highly complimentary about the support they and their loved ones received when their loved ones were at the end of their lives. They said the service was outstanding and the kindness and compassion were exceptional.

¿ Staff provided pamper sessions such as bubble baths, massages and alternative therapies for people.

¿ Although the registered manager ran a well organised service, the providers audits had not identified the manager had not notified CQC when one Deprivation of Liberty Safeguards (DoLS) application had been authorised. During the inspection we spoke with the manager to ensure CQC was notified in these cases.

¿ The provider sought the views of people’s relatives and took opportunities to improve the service. Staff were supervised, supported and clear about what was expected of them. Audits and checks were carried out, so any problem could be identified and rectified.

¿ 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.

¿ Staff were trained and supported to be skilled and efficient in their roles. They were very happy about the level of training and support they received and showed competence when supporting people.

¿ The provider had processes in place for recruitment, staffing levels, medicines management, infection control and upkeep of the premises which protected people from unsafe situations and harm.

¿ Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The manager worked with the local authority safeguarding adults team to protect people.

¿ The premises provided people with a variety of spaces for their use with relevant facilities to meet their needs. Bedrooms were very individual and age and gender appropriate.

¿ Support plans were detailed and reviewed with the person when possible, staff who supported the person and family members. Staff looked to identify best practise and used this to people’s benefit. Staff worked with and took advice from healthcare professionals. People’s health care needs were met.

¿ People had a variety of internal activities, such as games and entertainers which they enjoyed on a regular basis. Staff promoted people’s dignity and privacy.

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

Rating at last inspection:

At the last inspection the service was rated Good (26 September 2016). At this inspection, the overall rating remains Good.

Why we inspected:

This was a planned inspection to confirm that this service remained Good.

The inspection took place on 30 August 2016 and was unannounced. The care home was last inspected on 28 January 2014 and met the legal requirements at that time. SS Philip and James Retirement Home is registered to provide personal care for up to 32 people. There were 30 people living in the home on the day of our visit.

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.

People and their relatives all spoke positively about the care and support provided by the care home team. They told us that staff were, “Kind, caring and patient” and that, “Nothing is too much trouble.” People told us that staff were respectful and thoughtful.

People’s needs were assessed by the management team before they moved into the home. Care plans were devised with input from people and their relatives. Risks to people were assessed, and actions were taken to reduce the risks and keep people safe.

Staff understood how to safeguard people, and knew the actions to take if they suspected abuse. People who were supported by the service felt safe.

People received personalised care that was responsive to their needs. Care plans reflected that people’s individual needs, preferences and choices had been considered and then acted upon. Staff were knowledgeable about people’s individual needs.

People were supported to have their nutritional needs met. Where people required special or modified diets, external specialist support was obtained, and their advice, guidance and instructions were followed.

The provider was meeting their responsibilities with regard to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the mental capacity to consent to treatment or care and need protecting from harm. Where people were deprived of their liberty this was done lawfully.

The home was well-managed. The registered manager and senior managers monitored the quality of the service and sought and acted on people’s feedback. Quality assurance systems were in place to monitor and mitigate the risks relating to the health, safety and welfare of people.

The purpose of this inspection was to follow up a compliance action set at our last inspection on 22 August 2013 when we found that people were not protected against the risks associated with medicines. The provider told us the action they were taking to address the issues raised. During this inspection we found that suitable action had been taken. People were protected against the risks associated with medicines.

A relative told us; "My relative had no mental capacity when they lived here. I was involved in a mental capacity assessment and made all the decisions about their care. I went through all their care needs with the manager, all of which were implemented. I was so pleased with the place I would recommend it".

During our inspection we observed staff treated people in a respectful and dignified manner. One person who used the service said; "The staff are very caring and respectful, they never complain, they get me up in the morning and make sure I am clean and lovely. I'm very happy here. I never knew this type of place existed”. Another person said "the staff are excellent".

Two relatives of one person who used the service told us "staff have good skills and a lot of interaction with the residents as it should be. They are kind and usually respond to the bell quickly. They have also been so supportive to us whenever we come. The home feels homely, safe and comfortable. We go away knowing that our relative is in good hands. We are happy with the home".

We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the supply, recording, safe keeping and safe administration of some medicines.

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We found that that staff had been safely and effectively recruited and employed.

We found that effective systems were in place to monitor the quality of the service provided