About the service: St Matthews Care Home provides accommodation and personal care for up to 75 people including people with dementia. At this inspection 72 people were living at the service.

People’s experience of using this service:

People we spoke with at this inspection told us they were happy living in St Matthews Care Home because staff were kind and their needs were met.

People had risk assessments in place that supported positive risk taking and staff supported people’s independence daily.

Care and support was delivered in a personalised way by staff who knew people`s likes, dislikes and preferences. Staff promoted people`s privacy and dignity and their choices were respected.

Staff received training and had their competencies assessed to ensure they were skilled and knowledgeable to meet people`s needs effectively. Staff were supported to develop their skills and knowledge.

Staff used effective infection control measures to protect people from the risk of infections. Appropriate equipment was in place where needed for people to receive support in a safe way. The home looked and remained clean throughout the inspection.

People could purse their hobbies and interests. There were opportunities to take part in organised group activities. Staff encouraged and supported people to be involved. There were quiet areas for people if they preferred.

People and relatives told us there were enough staff to meet people`s needs. People felt listened to and knew who to talk with should they have any concerns.

People, relatives and staff told us the manager was visible around the home. They confirmed that managers and staff were approachable.

Complaints and feedback from people and relatives were used in a constructive way and lessons were learned to ensure improvements were made.

The registered manager used a range of effective audits and governance systems to check the quality and safety of the care people received.

Rating at last inspection: Good (report published 6 May 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection the service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 06 April 2016 and was unannounced. At our last inspection on 29 July 2014, the service was found to be meeting the required standards in the areas we looked at. St Matthews Care Home provides accommodation and personal care for up to 57 people. At the time of our inspection 52 people lived at the home. The home was divided into three units, named Meadows, Tree Tops, and Willows.

There was a registered 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 and associated Regulations about how the service is run.

The CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that where required DoLS authorities were in place.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. Trained staff helped people to take their medicines safely and at the right time. Identified and potential risks to people’s health and well-being were reviewed and managed effectively.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

People told us that they felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

People and relatives were positive about the skills, experience and abilities of staff who worked at the home. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people and their family’s access independent advice or guidance.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives and staff were complimentary about the regis

We previously inspected St Matthews Care Home and found that they were not meeting the regulations. The provider provided us with a plan of action to improve the service and we returned to the home on 29 July 2014 to check compliance. We found that the provider had made the changes required to meet the standards that we inspected against.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found.

Is the service safe?

We reviewed the staff training records and found that basic core training in areas such as dementia care, fire safety, safeguarding of vulnerable adults and moving and handling had been provided.

Is the service effective?

We saw that staff were available in appropriate numbers to assist people when needed.

We heard call bells sounding around the home where people summoned staff for assistance and we noted that the bells were answered in a timely manner.

Is the service caring?

People who used the service provided positive feedback about the staff team. One person said, “The staff are lovely. Nothing is too much trouble for them. They're all like friends really."

Is the service responsive?

We saw that management had acted on feedback received and was quick to make changes. For example we reviewed minutes of residents’ meetings and noted that concerns had been raised about the quality of the food provided. The manager was able to evidence that these matters had been escalated to the catering team manager and that all the issues had been addressed. The manager told us that a representative from the catering team would attend the next residents’ meeting to follow up on the concerns raised.

Is the service well led?

The provider had a quality assurance system in place that incorporated the views of people who used the service, their relatives, staff and external health professionals.

Staff and people who used the service were asked for their opinions and feedback was acted on.

We found the home to be visibly clean on the day of our inspection and people had had their personal care needs met.

People we spoke to were satisfied with the care they received and found the staff to be friendly and helpful. One person told us, “Staff here are exceptional” and another person said, “The staff here know what everyone wants” and that “they encourage independence”. Staff told us that they treat people how they would like to be treated.

Although people were satisfied with the care they received, they told us that there was not enough to do around the home. There was currently no activities co-ordinator in post, employed by the home at the time of our visit. This meant that minimal activities were arranged. The manager informed us that they were in the process of recruiting a new activities co-ordinator and that interim arrangements were being considered.

Overall, staffing levels were adequate but there had been occasions at night when they were short staffed, staff described the service as being ‘un-safe’ at night when they were short staffed. We were also told that there were not enough staffing during the early morning on the dementia unit and that staff were, ‘stretched’ during this time. This made it difficult to spend the amount of time needed to get people ready for the day.

We found that quality monitoring arrangements needed some improvement to ensure weaknesses identified by the home were improved.

People told us they were very happy living at St Matthews