St Catharine’s is a residential care home that provides accommodation and personal care for up to 24 older people, some of whom live with dementia. At the time of our inspection there were 20 people living at the home.

The inspection took place on 22 September 2016 and was unannounced.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

There were sufficient numbers of suitably trained and skilled staff employed at the service to meet people`s needs at all times. Staff had received training in how to safeguard people against the risks of abuse and they were able to tell us how they would report any concerns internally and externally to local safeguarding authorities. Safe and effective recruitment practices were followed to check that staff were of good character, physically and mentally fit for the role they performed and able to meet people’s needs. People received their medicines from staff who were trained to do so safely.

People were complimentary about the skills, experience and abilities of the staff who supported them. We found that staff had received training relevant to their roles and had regular supervisions to discuss and review their performance and professional development. Peoples consent was sought prior to care or support being given and where people had lacked capacity to make certain decisions staff ensured consent was sought in line with the principles of the Mental Capacity Act 2005. People told us that they enjoyed the food provided to them and were given ample food and fluid when requested. Where people were at risk of weight loss, staff were quick to refer them to appropriate health professionals.

People told us they were looked after in a kind, respectful and caring manner by staff who knew their individual needs well. Staff were knowledgeable about people`s likes and dislikes regarding their care and promoted people`s dignity and privacy when delivering care and support.

People told us they were involved in the planning, delivery and review of the care they received. People were able to pursue their individual interests as well as engage in meaningful activities within the home. Complaints had been recorded and investigated and where appropriate these were shared with staff to ensure lessons were learnt and improvements made where required.

People knew the registered manager and felt the leadership arrangements in the home promoted an open culture and delivered high quality care. There were regular audits done by the registered manager and the provider and where actions were needed to improve the service these were identified and completed. The provider sent regular surveys to people, relatives and staff to receive feedback to help them better understand how they could improve the care provided.

At our previous inspection of this service in December 2013 we had found that people were not consistently protected from the risks of unsafe or inappropriate care because accurate and appropriate records were not maintained. This specifically related to pressure area care.

At our inspection on 10 September 2014 we reviewed care records to ensure that people’s personal records, including medical records, were accurate and fit for purpose.

We reviewed the care records for three people who used the service. We found that records were clear and detailed and provided accurate information to support the staff team to provide care to meet people’s needs effectively.

We spoke with six people who used the service and three relatives. People told us they were satisfied with the care they or their relative received at the service. One person said, “The care is excellent here. My sons think that I have hit the jackpot”.

People told us they were able to make everyday choices and that these were respected. This included choosing what they wanted to eat or where and how to spend their time.

People’s individual dietary needs were considered and provided for. One person told us, “They do ask you what you would like to eat and drink. I have coffee in the mornings and prefer tea in the afternoon.” Another person told us, “I have bacon and eggs on Friday. It makes a nice change and I enjoy it.”

There were effective systems in place to reduce the risk and spread of infection. People told us the home was always kept clean and fresh.

Staff recruitment procedures were robust and all the required checks and references were in place before staff started working at the home.

We found that some records were not accurate and fit for purpose.

We spoke with three people living at the service, a relative and four staff during our visit on the 30 January 2013. We found that people's capacity to consent was recognised and where practicable they were able to exercise consent in their daily activities. Such as what to wear, what to eat, when to get up or go to bed. Where people lacked capacity this had been identified and appropriately recorded.

One person living at the service said "It's lovely here.They treat us very well." Another said "I made the right choice.There's nowhere better. The staff are lovely." We found that care plans were person centred, potential risks were assessed and action was taken to reduce these. We spoke with a relative who said "They really care and want it to be right for her. She's a person to them not just a resident."

There was a policy for management of medication which included the support for people self administering their medication each day. Staff received training before they administered medication.

The staff said they felt very supported at work, found the manager approachable and very caring about the people living and working in the home. They were supervised and supported with training and development to assist them in their role.

We saw a complaints policy on display. A relative said "The manager is very approachable and I would always speak with her first..." and the manager was "...very proactive..." and "...sought them out to check everything was ok."

People we spoke with were complimentary about the service and the care provided. A person commented, “Excellent service, excellent care. The staff are kind to me.” Another person said, “The service is good. Staff are very good.” This was echoed by another person who said, “Staff are charming and lovely. Food is very good.” A person’s relative added, “Staff are very friendly and helpful. If we have any problems they will always sort it out. Good care.”

When asked about choices and activities provided, a person said, “Very good service. Meals usually good. Can choose what I want.” A person said, “There are activities like music exercise, quiz and bingo.”

A relative added, “Staff help with activities. They have music exercise, quiz and bingo, and on Sunday there is a church service in the lounge with guitar and singing. I enjoyed it too.” A visitor commented, “There are always some activities every time I visit. There have been outside entertainers, a guitarist and a singer.”

A visitor commented that the person received “good care” and that the staff looked after the person “well”. The visitor also commented that the person is “neatly shaved” and “wears nice clean clothes.” and that the manager is “supportive and the staff are marvellous.”