St Rita's Care 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 home is a registered location of The Order of St Augustine of the Mercy of Jesus, a registered charity. The home is a purpose built property which provides residential and nursing care for a maximum of 60 people. The home specialises in providing care to older people who may have physical or sensory impairments and people who have dementia related illnesses. There were 55 people at the home at the time of the inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe at the service and staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe. Risks were assessed and managed to keep people safe. Checks such as identity and criminal records checks were carried out on new staff as part of the recruitment process. Staffing was suitable to meet the needs of people who used the service. Medicines were managed safely using an electronic system and staff were assessed to ensure they were competent to administer medicines to people.

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.

People had their needs assessed and care was planned using best practice guidance. People said they were involved in reviewing their care and relatives were invited to attend reviews. Staff received training and support which allowed them to provide care to people in a safe way and developed their skills in areas relevant to the needs of people at the service such as in dementia and end of life care.

Staff were observed being kind to people and respecting their dignity and independence. Feedback received from people and their relatives was positive and they spoke highly of the service. Staff communicated with people in a way that they understood and were patient with people. People told us they liked the staff and there was a nice atmosphere within the home.

People’s preferences and choices were reflected in their care plans. The service took account of people’s individuality and supported them to maintain their individual interests. People knew how to raise concerns and were provided with information in a way they understood. The service had received an accreditation in the Gold Standards Framework for end of life care and people and their relatives were encouraged to express their wishes about how they would like to be cared for when they reached the end of their life.

People told us they liked the registered manager and staff and there was an open and inclusive culture. Staff felt supported and their views were sought to drive improvements. There were governance structures in place for information to be shared and lessons learned to be fed back to services by the provider. People and their relatives were asked for their views and action plans were put in place to address any shortfalls in the quality of the service.

Further information is in the detailed findings below.

St Rita's Care Home is registered to provide care with nursing for up to sixty older people. All bedrooms were single and en-suite. The home was full at the time of the inspection.

People required a range of support in relation to living with dementia, nursing and personal care needs.

The home is purpose built with a range of communal rooms. The home has a passenger lift to assist people to access all areas of the building.

This was an unannounced inspection which took place on 1 December 2015.

St Rita's Care Home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

The registered manager was in day to day charge of the home, supported by the provider. People and staff spoke highly of the registered manager. People told us that they felt supported by staff and knew that there was always someone available to support them when needed. One person said, “I didn’t know that such kindness existed really.”

We received positive feedback from people, staff, relatives and visiting professionals. Everyone told us that the manager was committed to ensuring people received the best care possible. This was supported by clear up to date care documentation which was personalised and regularly reviewed.

Staff felt that training provided was effective and ensured they were able to provide the best care for people. Staff were encouraged to attend further training in a range of areas. New care staff were supported to achieve the Care Certificate and staff held the National Vocational Qualifications (NVQ) or similar.

Medicine administration, documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure high standards were maintained.

There were robust systems in place to assess the quality of the service. Maintenance, including all equipment and services to the building, had been checked regularly. Fire evacuation plans and personal evacuation procedure information was in place in event of an emergency evacuation.

There a programme of supervision and appraisals for staff. One member of staff said, “We get feedback about the job that we are doing. I come to work with a smile and I leave with a smile.” Staffing levels were reviewed regularly. Robust recruitment checks were completed before staff began work.

Care plans and risk assessments had been completed to ensure people received appropriate care. Care plans identified all health care needs and were reviewed regularly to ensure information was up to date and relevant. One member of staff said, “We are the first point of contact for residents. We see when things are changing and can suggest to the registered nurses if we think a reassessment is needed. They then talk to the manager if it’s necessary. It’s all part of the teamwork approach.”

People’s mental health and capacity were assessed and reviewed with information in care files to inform staff of people’s individual needs. People were asked for their consent before care was provided and had their privacy and dignity respected.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Staff treated people with respect and dignity and involved people in decisions about how they spent their time.

Staff demonstrated a clear understanding on how to recognise and report abuse.

Feedback was gained from people and their relatives. It included questionnaires that sought people’s views of the home. Regular residents and staff meetings were held with minutes available for people to access.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food and visitors told us they had eaten with their relative and found the food to be of a very high standard. One relative said, “It’s the little things like the menu on the dining table. [My relative] always reads it. It means so much that assumptions aren’t made just because some people probably can’t read it.”

Referrals were made appropriately to outside agencies when required, for example to community nurses and speech and language therapists (SALT). And notifications had been completed to inform CQC and other outside organisations when events occurred.

On the day of our visit there were 60 people living at St Rita's. The manager was on annual leave so we met with the deputy manager who was able to provide all the information we required and was knowledgeable about systems, policies and care provided in the home.

We looked at the records relating to people's care and support and saw that people's wishes had been taken into account in planning their care and treatment. Risks to people's health had been assessed and managed and we saw that care was delivered in a way that helped to promote people's independence.

We spoke with six people living in the home, three relatives and six members of staff. One person told us "I'm in control of my life again and another said "I'm confident that the manager would do everything possible to resolve any issues. They [the staff] are professional, approachable and genuinely care about us all". One relative told us "I think this is one of the best care homes around" and a member of staff said "the care is very good here".

We used a number of different methods to help us understand the experiences of people using the service. We did this because due to their complex needs many of the people living at the home were not able to tell us about their experiences themselves.

The people who were able to speak with us told us that they liked living at the home and that they were “happy” to be there. People described staff as “very kind” and “respectful”. People said that they “would recommend the food” and that they “enjoyed” the meals at St Rita’s.

We also spoke with relatives of four of the people who lived at the home. They told us that their relatives were “exceptionally well looked after” and that “they couldn’t improve it at all”. All the relatives who spoke with us said that they were “kept totally informed” and that staff were “always there to support them” and were “very professional”, “warm and caring”.

We also used a Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

Due to dementia type illnesses not all of the people using the service were able to tell us about their experiences in the home. However, some told us that they were happy. Other people told us that staff were caring and compassionate and that any concerns raised were dealt with immediately.