About the service: Stocks Hall Care Home provides accommodation for up to 54 adults who need assistance with personal or nursing care. Both younger and older people were accommodated at the service whose needs included physical, psychological, communication and emotional support. In addition a number of people using the service were living with dementia. At the time of our inspection 52 people were receiving support.

People’s experience of using this service:

The general atmosphere at Stocks Hall was calm and friendly. Staff were continuously seen to be kind and compassionate towards people and it was obvious they had built strong familiar relationships with people that made them feel relaxed. Positive comments were received regarding the caring approach of the staff team and how well they knew people’s needs.

Staff were motivated to deliver care that was person-centred and based on people’s needs and preferences. People were treated with kindness, compassion and respect and staff interacted well with people. Techniques were used to staff to help relax people with positive outcomes. People told us they were supported to be as independent as possible.

People told us they felt safe living at the home and were comforted by the knowledge that staff would respond to any concerns they had. Family members also felt positive that their loved ones were safe and had peace of mind knowing they did not need to worry about them. Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely and people told us they received their medication at the right times. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. The environment was safe and people had access to appropriate equipment where needed.

Enough suitably qualified and skilled staff were deployed to meet people’s needs. Staff received a range of training appropriate to their role and people’s needs. Most staff told us they felt supported by the new manager, however as they had only been in post a short time, some staff told us they would approach other senior staff or nurses for support. We discussed with the manager the importance of all staff feeling supported by them and they assured us they were in the process of getting to know staff and reassure them of their support.

People’s needs and choices had been assessed and planned for and care plans provided guidance for staff to support people in the way they preferred. People were encouraged and supported to eat and drink well and supported to access healthcare when needed. People were offered choice and control and where able consented to their care and support. Where people lacked capacity to make their own decisions they were made in their best interests in line with the Mental Capacity Act.

The leadership of the service promoted a positive culture that was person-centred and inclusive. People and family members, along with most staff, described the manager as approachable, supportive and visible around the home. The manager showed a desire to improve on the service provided and was able to show ways in which they planned to do this. Effective systems were in place to check the quality and safety of the service.

Rating at last inspection: Good (report published September 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating from the previous inspection.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We undertook a focused inspection of Stocks Hall Care Home in St. Helens. This inspection was unannounced and took place on the 15 June 2017.

We carried out this inspection as a result of an incident involving an individual. We therefore focused our inspection around whether people’s care was safe and the service well-led.

We last inspected the service in April 2016. At that inspection we found the service was meeting all the legal requirements which were assessed at the time and was rated as good.

Stocks Hall Care Home St Helens provides accommodation for up to 54 adults who need assistance with personal or nursing care. Both younger and older people were accommodated at the service whose needs included physical, psychological, communication and emotional support. In addition a number of people using the service were living with dementia. Accommodation comprises of four separate units. Jade and Opal are nursing units and are situated on the ground floor. Coral is a dementia unit situated on the first floor together with Amethyst which is a residential unit. The service is situated in a residential area of St Helens with a range of amenities close by. St Helen's town centre is within easy reach and there are local bus and train links to nearby cities. The service has its own mini bus with wheelchair access. All bedrooms have en-suite facilities. Lounge and dining areas are located on each of the four units.

There were 53 people living in the home at the time of our visit.

At the time of the inspection there was a registered manager at Stocks Hall. 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.

The registered manager was present during our inspection and was supported by two quality monitoring managers who held responsibility for quality monitoring, training and support. They were open and transparent throughout the inspection process, supportive towards the inspector and were seen to interact well with people using the service, their representatives and staff in a caring and helpful manner.

We saw that people living at Stocks Hall presented as clean, appropriately dressed and happy in their appearance. Staff demonstrated an understanding of the need to safeguard people’s dignity, individuality and human rights and the importance of providing person centred and compassionate care. We saw lots of positive interactions, banter and humour being exchanged between staff and people living in the home and people presented as being comfortable and relaxed.

Holistic assessments of need had been undertaken and care plans and risk assessments produced to ensure staff understood how to meet the needs of people living in Stocks Hall and keep them safe.

Recruitment practices were robust and relevant checks had been completed before staff commenced work which helped to safeguard the welfare of vulnerable people. Staff also received training, supervision and support to enable them to understand their role and how to deliver person centred care.

Policies and procedures relating to the Mental Capacity Act and Deprivation of Liberty Safeguards had been developed. This provided guidance to staff on how to protect the rights of people who may lack capacity. Likewise, systems were in place to safeguard people from abuse and to ensure complaints were listened to and acted upon in a timely manner.

There was a quality monitoring system in place which involved seeking feedback from stakeholders and people who used the service and their relatives. This consisted of surveys and a range of audits.

Medicines were ordered, stored, administered and disposed of safely.

Maintenance records were clear and well managed and identified that checks were in place for

This inspection took place on 7 April 2016 and was unannounced.

We last inspected the service in December 2013. At that inspection we found the service was meeting all the legal requirements which were assessed at the time.

Stocks Hall Care Home St Helens provides accommodation for up to 54 adults who need assistance with personal or nursing care. Both younger and older people were accommodated at the service whose needs included physical, psychological, communication and emotional support . In addition a number of people using the service were living with dementia. The service is situated in a residential area of St Helens with a range of amenities close by. St Helen's town centre is within easy reach and there are local bus and train links to nearby cities. The service has its own mini bus with wheelchair access. All bedrooms have en-suite facilities. Lounge and dining areas are located on each of the four units.

The service had a registered manager. 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.

The registered manager provided excellent leadership and promoted a person centred approach within the service.

People described the care they received as excellent. Family members told us that they felt their relatives were looked after extremely well and that they felt very included in their relative’s life. We found outstanding aspects in relation to how the service promotes and supports the inclusion of people’s family into their lives.

Interactions between people, their family members and the staff team were excellent. It was very evident that positive relationships had been formed and staff had got to know the likes, dislikes and lifestyle preferences of people.

People were able to engage in a number of varied activities both within the service and in the local community which promoted both physical and mental stimulation.

Good systems were in place to minimise people from harm. Appropriate policies and procedures were in place to safeguard people from abuse and staff were knowledgeable on how to manage any safeguarding concerns they became aware of.

Sufficient suitably qualified and experienced staff were on duty to meet people’s needs. Staff received the required training and support to carry out their role safely.

Care plans were in place that detailed people’s needs and wishes which enabled staff to deliver good care and support in a manner that people wished. People were supported in a very positive manner by the staff team who promoted peoples’ individual rights and lifestyle choices. When required, people rights were maintained and respected under the Mental Health Act 2005.

People had access to community health care professionals when needed to manage their physical and mental health needs.

People’s nutritional needs were assessed and planned for. People were very happy with the quality and quantity of food available to them and they had a choice of where they ate their meals.

Extensive Information was available to people and their family members as to what facilities and services were available within the service and the registered provider had a clear philosophy of care and set values which were recognised and followed by the registered manager and staff team.

People’s views on the service were sought on a regular basis and when an improvement was identified it was acted upon quickly.

Staff worked hard to ensure that people who used the service were involved in the decision making whenever possible.

The majority of people at Stocks Hall Care Home had complex needs and we were unable to communicate with them. However, those we did speak to confirmed they understood the care, treatment and support choices that were available to them. Care was provided in a person-centred manner which ensured the needs of all people using services were being met and, as a result of regular meetings, was developed with them or with people who acted on their behalf. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines which kept all people safe.

Staff records showed that all the necessary checks were made before any staff were allowed to start work at Stocks Hall which ensured the safety and welfare of all people using services. Records also showed that staff had received appropriate training that helped them meet the needs of all people at the home. There was a comprehensive complaints procedure in place which allowed people’s complaints to be fully investigated and resolved, where possible, to their satisfaction and within an acceptable time-frame.

We spoke with relatives who informed us they were always consulted about care and treatment provided. One relative who we spoke with said: “My X lacks mental capacity so I make the decisions for him. They always consult me about things and I have a good relationship with them”.

During the inspection, staff were seen engaging with people in a positive and friendly manner. There was a relaxed atmosphere where people looked well cared for and were seen to be comfortable and at home in the environment.

During the inspection we were able to examine people's responses to a recent satisfaction survey. Comments included: “Words can’t say how much my X and I, and all my family have been impressed”. “The care my X receives is of an exceptional standard, I could not wish for my X to be in a better place”.

We examined the maintenance and log book which contained details of fire alarm testing which was undertaken on a weekly basis. Audit checks had been regularly undertaken in respect of emergency lighting, fire doors and fire extinguishers.

We saw that staff had appropriate skills, qualifications and training to undertake their roles and responsibilities.

Care files were detailed and comprehensive and maintained in a neat and chronological order. We found that people's care files and daily records were securely stored and information remained confidential, though readily available to staff in each unit.

During our visit to this service we spoke with a good percentage of people living at the home and their relatives. We also had discussions with an external professional and a number of staff members. In general, we received positive feedback from everyone. We were told that a good quality of service was provided at Stocks Hall, with high standards being maintained. People spoken with were evidently happy to be there.

Comments from the residents and their relatives included:

"Obviously there is no place like home, but Stocks comes a close second. Everyone is so friendly and helpful. I have no concerns about living here and they (the staff) let me do what I want."

"I like it here. Everything is nice and comfortable. If I want something doing in my room I just ask and it is sorted out quickly."

"I think my relative is receiving good care and attention. He is safe and happy."