This inspection took place on 25 & 27 May 2016 and was unannounced.

The service met all legal requirements we checked at the last inspection in January 2014 and the previous year.

St. Anthony’s Care Home is registered to provide personal care and accommodation. The home provides accommodation for up to five people. Each person has their own bedroom and some have en-suite facilities.

The home had a registered manager in place. 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 receiving care were safe. Their risks had been assessed and well managed. There were procedures in place for monitoring and managing risks to people. When there were changes in the level of risk, the risk management strategies changed to reflect this.

There were appropriate procedures in place to help ensure people were protected from all forms of abuse. Staff had received training on how to identify abuse and understood procedures for safeguarding people.

Risk assessments for the environment had been drawn up and were regularly reviewed with the changing needs of the people who lived at the home in mind.

People were protected from the risks associated with the recruitment of new staff. The service followed safe recruitment practices.

People were safe because staffing levels were assessed and monitored to ensure they were sufficient to meet people’s identified needs at all times.

There were appropriate arrangements for obtaining medicines. The registered manager and senior staff regularly reviewed and audited medicines to ensure they met people’s current needs.

People were supported by staff who had the necessary skills and knowledge to meet their assessed needs, preferences and choices. The registered manager, his deputy and staff team knew people well and understood their specific care needs.

The service had had a good working partnership with primary care services. People had access to healthcare services when they needed them.

Staff sought people’s consent to care and treatment. Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.

The staff team were passionate about providing good care and routinely treated people with kindness and respect. People receiving care, relatives and professionals described the home in complimentary terms. They told us the home provided excellent care.

Staff took time to understand people's life stories and encouraged people to celebrate important life events and significant people. People were supported maintain their personal interests and hobbies.

The service looked at ways of including people in planning their care. People were encouraged to input in their care through a range of avenues, including participation in their assessments, ‘service-user meetings’, life stories, surveys and staff’s own observations.

People received care that was flexible and responsive to their individual needs and preferences. People confirmed they were involved in their care and felt listened to. Staff ensured people’s care plans matched their individual needs, abilities and preferences. People and their relatives told us they were listened to and knew how to make a complaint.

There was an effective quality assurance system in place. The registered manager and staff team were proactive in seeking out ways to improve.

At the time of the visit there were four people living in the home. We spent time observing staff supporting two people. The other three were either at work or taking part in social activities outside of the home. We spoke to two staff. One person indicated that they were happy living in the home and the staff; the food and their room were nice.

Staff appeared motivated and one said they felt well supported.

We saw the home was clean and the decor was in a reasonable state. There was equipment available to ensure people's physical needs were met.

People were encouraged to make choices and to maintain their independence and staff supported them in that. We saw that people were treated as individuals and there were opportunities to take part in leisure and social activities.

Staff demonstrated a good understanding of safeguarding and the action they would take if they suspected a person was at risk of abuse.

Staff were observed to interact with people in a friendly and respectful way.

There were five people using the service at the time of our inspection visit. We spoke with the three members of staff that were on duty but we were unable to speak with all of the people using the service as they were unable to hold a verbal conversation due to there medical conditions. Therefore we made observations throughout the visit and we reviewed all the care plans related to individual people using the service.

We saw that staff were communicating with people respectfully and in a way that they understood. We observed staff giving encouragement at all times throughout the day and were always talking to the people and involving them as much as possible. For example, people using the service were involved in meal and drinks preparation.

One staff member said "The people we look after are very dependant on us but we try to give them as much independence as possible."

We saw that medication was stored correctly and that all staff had received appropriate training in the dispensing of medication. We reviewed six staff files and saw that the employment process was very robust and that all relevant checks had been completed. We spoke to staff in relation to the complaints procedure. All staff were able to verbalise the procedure for taking, reporting and dealing with a complaint. However, we were not able to see evidence of this in practice as the service had never received any complaints. Relatives all told us they had never had to make a complaint.

People told us that they were happy with the care and support that they received and that their needs were being met. They said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. People told us that the service responded to their needs and that staff talked to them regularly about their plan of care and any changes that may be needed.

People that use the service told us there was a consistent staff team that created a pleasant atmosphere in the home and that the staff were competent and knew how to care for them safely. One person said the staff were very approachable, staff work to provide good support and they had no concerns