About the service: Stronvar rest home is a care home providing care and accommodation for up to 16 older adults who may or may not be living with Dementia. The service does not provide nursing care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. On the day of the inspection the registered manager informed us that 15 people were living at the service.

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

service.

People’s experience of using this service:

The environment that people lived in was homely, warm and clean and there was a constant program of improvements. Staff were committed to providing good care.

The registered manager ensured that appropriate safety checks on equipment and the environment were in place to keep people safe.

Medicines were managed safely and staff were trained to ensure they were competent to administer them. However, as required medications were not monitored to ensure they were affective. We have made a recommendation about this.

The service was not compliant with the Mental Capacity Act, 2005 and had breached this requirement. However, immediately following the inspection took the appropriate action to become compliant with the act, and demonstrated learning.

Care staffs understanding of dementia, and mental health conditions such as anxiety and depression needed improvement. However, staff knew people very well and were responsive in how they cared for people. We made a recommendation about staff training.

A dedicated cook and assistant were available to provide a choice of nutritious home cooked meals. They had an excellent understanding of people’s preferences and dietary needs.

People's health was well managed and there were strong links with professionals to ensure that peoples health and nutritional needs were met.

Staff were caring at all levels of the organisation. They knew people well and treated them with dignity and respect.

Whilst we observed that staff provided care that was responsive, care plans needed to improve to reflect people's care needs and preferences. We have made a recommendation about this.

The service had not explored peoples end of life preferences. Whilst no one was receiving end of life care people chose to stay at the service at the end of their life. However, the registered manager was not aware of the gold standard framework of end of life care so we made a recommendation about this.

The provider was very visible and role modelled a compassionate and caring approach to people living at the service. The registered manager was also very visible, working closely with staff and having high expectations of the quality of care provided.

The registered manager had good governance processes in place to monitor the safety of the environment. Improvements were needed to demonstrate that people living at the service were involved in their care planning.

Rating at last inspection: Rated Good with requires improvement in the Effective domain. (published 6 July 2016)

Why we inspected: This was a planned inspection based on the date and the rating of the last inspection.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

Stronvar Rest Home provides accommodation without nursing for up to 16 older people who may have dementia.

There were 15 people living in the service when we inspected on 24 May 2016. This was an unannounced inspection.

There was a registered manager in post. 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.

Procedures were in place which safeguarded people who used the service from the potential risk of abuse and staff understood the various types of abuse and knew who to report any concerns to.

There were sufficient numbers of trained staff to meet people’s needs and recruitment processes checked the suitability of staff to work in the service.

There were appropriate arrangements in place to ensure people’s medicines were obtained, administered and stored safely. However, guidance for staff on how and when to administer ‘as and when required’ medicines could contain more detail.

People were supported in accordance with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) however some staff had not had training and lacked awareness of what the Mental Capacity Act meant for people. The use of bed rails had not been recorded as being made in a person’s best interests.

People’s nutritional needs were met and people were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People were treated with kindness by the staff by staff who knew them well and had good relationships with people who used the service.

People were provided with personalised care which was planned to meet their individual needs although more information was needed in care records about how people communicated and the support that they required at meal times.

People were encouraged and involved in making decisions about their care and were encouraged to pursue their interests and to maintain links within the community.

A complaints procedure was in place and people’s comments, concerns and complaints were listened to and addressed in a timely manner.

There was an open and transparent culture in the service and staff understood their roles and responsibilities in providing good quality care to people who used the service.

Stronvar Rest Home provides support and accommodation to a maximum of 16 people. At the time of our inspection there were 14 people living at the home.

During our visit we spoke with two people who lived at the home. We also spoke with the providers, a relative of one person, the registered manager and two members of staff.

We used this inspection to answer our five key questions. Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

None of the people we spoke with had any concerns about the support they received. People were treated kindly and with dignity and respect by staff. People and their relatives told us about their satisfaction with the home and told us they felt safe.

We saw care and treatment was planned and delivered in a way that ensured people's safety and welfare. All of the care plans we looked at had assessment tools in place to assist staff in establishing the levels of risk for people.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager told us that staff had received training in relation to DoLS and the home was contacting the local DoLS team for advice on this subject.

Records showed regular checks of the fire alarm and emergency lighting systems were recorded. We also saw that regular fire exercises were conducted. Safety certificates were in date for gas safety, electrical wiring and for portable appliances. There were arrangements in place to deal with foreseeable emergencies. We also saw that the proprietor had a refurbishment plan in place regarding upgrading fire systems, improving bathrooms, kitchen, laundry facilities as well as bedrooms and communal areas of the home and gardens.

Is the service effective?

Each person had a plan of care and support. We saw that support plans explained what the person could do for themselves and what support they needed from staff. Staff told us the care and support plans gave them the information they needed to provide the level of support people required.

We observed staff supporting people and care staff we spoke with were aware of people's needs and the preferences of people they cared for in how people wanted care to be delivered. We saw staff offered advice and support and enabled people to make their own choices and decisions.

A relative told us, "I am very happy with the care provided for my relative, everyone is so good.”

Is the service caring?

We observed staff speaking to people appropriately and saw that they used people's preferred form of address. People we spoke with told us staff were kind and patient in their approach. We saw care workers taking time to chat with people. They responded promptly to people's requests for assistance and had a good understanding of people's needs. People described their satisfaction with the home. One person told us, "I am very happy here.” Another person told us, "They (the staff) are very good; they always have time for you.”

Is the service responsive?

We saw people had reviews of the care and support they received. We saw that care plans showed alterations had been made to people's plans of care as people's needs changed.

We saw people were able to participate in a range of activities. Staff told us that they encouraged and supported people to participate in activities to promote and maintain their well-being. A relative of one person told us, "The home has worked hard to ensure that their relative has been able to continue to be involved with the local community activities that she has been used to. This has helped her to remain in contact with her friends and settle in to the home."

People who used the service, their relatives and staff were asked for their views about how the home was meeting people's needs. Any concerns or ways to improve the service were considered by the management team and if appropriate were acted upon.

Is the service well led?

A relative we spoke with told us that they had regular contact with the home and said that they could speak to the manager or staff at any time. They told us they were kept informed about any issues which affected their relative. They told us the home's staff were "easy to approach.”

All of the staff and people we spoke with said they felt supported. We saw the home had systems to monitor and assess the quality of the service provided by the home. These including a number of audits including health and safety, medicines, cleaning and infection control.

Staff meetings took place regularly and minutes of these meetings were kept. Staff we spoke with confirmed this and said the staff meetings enabled them to discuss issues openly with the manager and the rest of the staff team. Staff had also recently been allocated a senior member of the staff team who acted as a coach/mentor to support them with their professional development.