This inspection took place on 15 November 2017 and was unannounced. At our last inspection in May 2015, we found the provider was meeting the regulations we inspected and the service was rated “Good”. At this inspection, we found that the service continued to be rated “Good”.

St Josephs Rest home 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 service is registered for 26 people. At the time of our visit, 23 people were using the service.

There was 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 felt safe using the service. Staff were aware of safeguarding policies and procedures and their role in keeping them safe. Risks to people were assessed and managed effectively.

There were enough staff to meet people's needs. The provider had a robust recruitment process in place before staff commenced employment.

Staff received an induction and on-going training to support them in their roles. They understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People had access to healthcare professionals as needed and their nutritional needs were met. They received their medicines as prescribed.

People and their relatives felt staff were kind and caring. Staff supported people to maintain their independence and respected their privacy and dignity. People were supported to take part in activities based on their own interests.

People, relatives and staff felt the service was well run and the management team was open and approachable.

The management team worked well with other organisations to ensure people received all the care and support they needed.

The provider had systems in place to monitor the quality of the service provided to people. People and their representatives were able to raise concerns or complaints if they needed to.

This inspection took place on 20 May 2015 and was unannounced. At the last inspection on 11 February 2015 we found the service to be breaching regulations as staff were not adhering to fire regulations. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Josephs Rest Home on our website at www.cqc.org.uk.

St Josephs Rest home is registered to provide accommodation and support for twenty six people who require nursing or personal care, some of whom have dementia.

There is 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.

At this inspection we found the service had taken sufficient action to keep people, visitors and staff safe. We saw that fire doors were either closed or held by a device that would release and the door would close by itself in the event of a fire.

This inspection took place on 11 February 2015 and was unannounced. At our last inspection in August 2014 we found the provider was meeting the regulations in relation to outcomes we inspected.

St Josephs Rest home is registered to provide accommodation and support for twenty six people who require nursing or personal care, some of whom have dementia.

There is 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.

Staff were not adhering to fire regulations and this was a breach of regulation 15 in relation to safety and suitability of premises. You can see the action we have told the provider to take at the back of this report.

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening.

People told us that they were happy with the care they received. We observed the way staff interacted with the people using the service and saw they treated people with respect and dignity.

Staff regularly assessed potential risks to people’s health and welfare, both within the service and in the community. The equipment at the service had been maintained and serviced regularly.

People were supported to eat and drink sufficient amounts of nutritionally well-balanced food and drink that met their needs. People were able to express their views and were involved in making decisions about their care and treatment. Appropriate arrangements were in place in relation to the obtaining, recording and administration of medicines.

The staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). They were aware of how to support people who could not make decisions for themselves when required. People’s preferences and likes and dislikes were clearly identified in their care records so staff had the necessary information to care for and support them appropriately.

Staff records showed that the staff had received appropriate training to meet the needs of people using the service and appropriate checks were carried out before staff began work.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The provider took account of complaints and comments to improve the service.

A single inspector carried out this inspection. During the inspection we spoke with three people who used the service. We spoke with the deputy manager, a senior care worker, two other care workers and relatives/visitors. We also spoke with a visiting health professional. We reviewed the care records for four people and reviewed a selection of other records, including audits, staff files, policies and procedures.

Is the service safe?

Risk assessments of people had been documented in their care records together with guidance on action to take to protect people. There was documented evidence that staff had been provided with essential training such as first aid and health and safety to enable them to care for people safely.

Staff received training and guidance regarding the requirements of the Mental Capacity Act (MCA) 2005. The deputy manager demonstrated to us their knowledge of the Deprivation of Liberty Safeguards (DoLS) and the MCA requirements.

Is the service effective?

Feedback from people who used the service was limited due to the nature of their dementia. We spoke with relatives and visitors who indicated the service was effective and responsive to the needs of people. One person said, "I like it here." One visitor said, "My friend is looked after very well." People's care needs had been assessed with the help of their relatives, representatives and other providers involved in their care. Their choices and preferences were documented and staff we spoke with were aware of these. This enabled staff to respond effectively when caring for people. Care plans had been clearly prepared. These were up to date and were regularly reviewed.

Is the service caring?

We saw feedback from people who used the service, which indicated people found the staff caring and kind. We observed the staff treating people with respect and dignity. A relative wrote regarding the care provided, "This is a welcoming and caring place."

Is the service responsive?

The deputy manager informed us the provision of services and care was regularly reviewed and if there were problems or suggestions made, they would respond. This included providing special meals for those that required a certain diet or preferred a certain type of food. On the day of the inspection, there was fresh Asian food cooked as one of the meal choices. When we needed information regarding the care provided and the management of the service, this was promptly provided. We spoke with an external health professional who told us that they staff were very responsive to the changing needs of the people who used the service and were good at making appropriate referrals to other care providers.

Is the service well-led?

The staff who were present during the inspection were knowledgeable regarding their roles and responsibilities. There were arrangements for monitoring the quality of care provided. The senior care worker said they had been given good support and plenty of training to do the job. Staff were aware of the policies and procedures in place.

People told us that they were treated with respect by the staff. They said the care they received was "good". One person said, "I like it here.The best thing is my room I can do whatever I like there." Another person said “it is good living here, the staff are excellent, whatever we ask for we get."

People who use the service and their relatives were satisfied with the care and support provided at the service. A relative told us "they are really good,very alert to people's needs, no issues, they talk to us and phone us if there is anything going on." People were supported to access health and social care professionals when required with their consent. People who used the service and their families told us they were involved in making decisions around their care and support planning. Staff told us they received appropriate training and support from the management team to carry out their roles. Medicines were safely administered by staff who were trained to carry out this task. People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative or friend.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink that was provided. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes were treated with dignity and respect and whether their nutritional needs were met.

The inspection team was led by a CQC inspector joined by an Expert by Experience.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. Through the use of SOFI we observed people’s experience of the service was a positive one. Staff support was provided in a way that protected people’s dignity and met their nutritional needs.

People told us their dignity and privacy was respected. They told us that they get enough to eat and drink, and that the food was of a good quality. People told us that they felt safe, and that the staff were able to meet their needs. One person said, “nothing is too much trouble for them (staff).” A relative told us that their father, “has a good relationship with the carers and staff have a good knowledge of his needs.”