Taptonholme is a small charity run care home registered to provide accommodation and personal care for up to 19 older people, some of whom may be living with dementia. The home is located in a residential area of west Sheffield, close to local amenities and transport links. The accommodation is provided over four floors, accessed by a passenger lift. The home has a garden and a car park.

There was a manager at the service who was 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.

Our last inspection at Taptonholme took place on 22 August 2016. We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 9: Person centred care and Regulation 17: Good governance. The registered provider sent an action plan detailing how they were going to make improvements. At this inspection, we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of Regulation 9: Person centred care, as care plans and risk assessments were found to be accurate and up to date. We also found sufficient improvements had been made to meet the requirements of Regulation 17: Good governance, as systems were in place to effectively monitor the quality and safety of the service.

This inspection took place on 16 October 2017 and was unannounced. This meant the people who lived at Taptonholme and the staff who worked there did not know we were coming. On the day of our inspection there were 15 people living at Taptonholme.

People we were able to speak with spoke positively about their experience of living at Taptonholme. They told us they felt safe and they liked the staff.

Staff were aware of safeguarding procedures and knew what to do if an allegation was made or they suspected abuse.

We found systems were in place to make sure people received their medicines safely so their health was looked after.

Staff recruitment procedures were robust and ensured people’s safety was promoted.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

Whilst the home was well maintained, there was no dedicated maintenance person working at the home. This meant that small repairs and maintenance work could take longer to address.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected. Pictures and information about the meal choices on offer were not displayed to improve access to information.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

Taptonholme is a small charity run care home located in a residential area of West Sheffield. The home is arranged over four floors and can accommodate up to 19 people. At the time of our inspection there were 16 people living at the home. A small number of people were quite independent and only needed minimal assistance. Others needed assistance with most daily living requirements including support with managing their personal care, medication and mobility needs. Some of the people being cared in the home were living with dementia.

There was a registered manager in post. 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 on leave during the inspection and the deputy manager supported the visit.

We found not everyone had a full and up to date care plan and risk assessment to guide staff in how to meet the person’s needs in a person-centred way. You can see what action we have asked the registered provider to take at the back of the full version of the report.

The quality and safety of the service had not been monitored effectively and shortfalls had not been dealt with consistently or had not been identified. You can see what action we have asked the registered provider to take at the back of the full version of the report.

We found there was an inconsistency regarding the application of the Mental Capacity Act 2005. The registered provider and registered manager had not always followed best practice regarding assessing people’s capacity and discussing and recording decisions made in their best interests. We have made a recommendation about this.

There were policies and procedures to guide staff in how to keep people safe from abuse and harm. Staff had completed safeguarding training. Records showed concerns were generally reported to the local safeguarding team and CQC; however we found one incident had not been reported appropriately which we discussed with the deputy and registered managers and received assurance that any similar concerns would always be reported to the appropriate agency.

We found the service was generally clean and tidy in communal areas and bedrooms. There were some areas of the environment and practice that could be improved in regards to good infection prevention and control. These were mentioned to the deputy manager during the inspection to address.

We found people’s health care needs were met. Health professionals were contacted to ensure people received treatment and advice when required. People received their medicines as prescribed. Staff knew what to do in cases of emergencies and each person who used the service had a personal evacuation plan.

We observed kind and caring approaches from the staff team. People’s privacy and dignity were respected and staff provided people with explanations and information so they could make choices about aspects of their lives. There were positive comments from relatives about the staff team.

People enjoyed the meals provided to them. The menus enabled people to have choice and special diets when required. We saw people’s weight, their nutritional intake and their ability to eat and drink safely was monitored and referrals to dieticians and speech and language therapists took place when required for treatment and advice. During the day, we observed people were served drinks and snacks between meals.

We saw people were encouraged to participate in a range of activities within the service and local community. They were supported to maintain their independence where possible. Relatives told us they could visit at any time and we saw staff supported people who used the service to maintain relationships with their family.

We found staff were r

We spoke to four people who use the service and two relatives. The people who use the were very happy at the way that they were being cared for and the two relatives were happy at the care given. Comments included "The staff are marvellous and the food is good".

"Absolutely superb" and "Excellent care". A relative commented " The consistency of care is commendable". We found that the staff were supported and well trained to provide care to people who use the service.

We observed that the home had a happy and relaxed atmosphere and it was clean and tidy. We found that individual preferences were catered for and that people using the service were treated with respect and dignity.

We were told by the people using the service and their relatives that they would feel comfortable in approaching staff with any concerns they had. People using the service and their relative's felt that they were involved in their care and were kept informed of any changes.

We were able to speak with five people who use the service and a visiting relative. The people we spoke with told us they were very happy at the home and we received comments such as “We are looked after very well”, “I can’t think of anything that could be improved”, “We only have to ask to do something like go shopping into town and they (the staff) organise it” and “The food is really good”.

People told us they felt safe at the home and we received comments such as “Yes, I feel safe here” and “They (the staff) make sure we are safe”.

A relative we spoke with told us they came frequently to visit their relative who was currently residing at the home. This person had previously lived at home and their relative described examples of how the staff had helped integrate them into living at the home by ensuring some of the habits and routines they had when living at home continued.

They told us that their relative was happy at the home and that the staff were knowledgeable and approachable. They felt they were involved in the care of their relative and staff kept them informed of any changes. They had no complaints or concerns about the care provided.