The Depperhaugh is a residential care home with nursing for up to 30 older people some may be living with dementia and, or a physical disability. On the day of our inspection there were 27 people living in the service.

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 ongoing 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.

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Why the service is rated Good.

People’s safety was promoted. There were procedures in place to recognise and respond to abuse. Staff knew how to follow these procedures. Risk assessments were carried out and risk management plans were in place which enabled people to receive care with minimum risk to themselves and others.

Where accidents and incidents occurred these were monitored in order to identify and react to any trends.

The staff recruitment process ensured that only those suitable to work in this type of environment were recruited. Appropriate recruitment checks were carried out before staff were employed. There were sufficient numbers of staff to meet people's needs. Staff received regular, relevant training as well as supervision and appraisal. This helped to ensure they had the skills and knowledge to support people effectively. Staff were caring and treated people with respect. They knew people well and understood how to meet their needs.

People knew how to make a complaint. Complaints were investigated and where deficiencies were found actions were put in place to address these.

Staff supported people to maintain their independence. People were supported to maintain relationships with their family and friends. This included the use of modern technology to both support communication and provide activities. People had the opportunity to participate in

organised activities and to go out on trips.

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.

There were appropriate arrangements in place to ensure that people received their medicines safely. People were supported with their nutrition and hydration needs and people who required support at mealtimes had the support they required. People were supported to maintain their health and had access to a variety of healthcare professionals.

The service was well-managed. The registered manager communicated effectively with staff and relatives. There were effective systems in place to regularly assess and monitor the quality of the service provided to people.

Further information is in the detailed findings below

This inspection took place on 30 July 2016 and was unannounced. On the day of this inspection there were 30 people living in the service. Our inspection of July 2015 had found that the service required improvement as infection control measures were not adequate, people were not involved in their care planning with some care plans containing content which was generic and not relevant to the person. This inspection found that the service had improved in all of these areas. The infection control problems had been fully addressed and good progress had been made in care planning.

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.

Risks to people had been identified, assessed and managed safely. There was guidance for staff on how to manage people’s care needs. Staff understood the signs of potential abuse and what action they needed to take if it was suspected.

There were sufficient numbers of staff employed to meet people’s needs and the service followed safe recruitment practices. The service actively managed the number of staff on duty to ensure there were staff available to meet people’s needs. Medicines were managed safely.

Staff were trained in all the essential areas and undertook an induction programme. Staff were supported by the management team and received regular supervision and appraisal.

The service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Appropriate referrals had been made to the relevant authorities. This ensured decisions were taken in accordance with the MCA and associated Code of Practice.

People had access to healthcare professionals and the GP visited the service weekly. A choice of food and drink was available which took account of personal preferences and health needs.

People and staff had developed positive caring relationships. People felt they were well looked after by kind, friendly staff who understood and knew them well. People’s preferences and choices were known and respected by staff and they were encouraged to express their views and be involved in all aspects of their care. People’s privacy and dignity was respected.

Care plans covered people’s needs and personal preferences. We noted some contained generic statements and some contradictory information. The registered manager was aware of this and was able to explain the reasons and what action they were taking to address the issue.

People, their relatives and staff spoken with had confidence in the registered manager and provider and felt the service had clear leadership in the service. There were effective systems to assess and monitor the quality of the service.

This inspection took place on 15 July 2015 and was unannounced.

There was a registered manager in place who had registered with the Care Quality Commission in May 2015. 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.

Some areas of the service were not cleaned effectively. The manager had identified some of the issues and explained to us the measures they had taken to improve. However, on the day of our inspection the general cleanliness of the service was not of a good standard.

People told us they felt safe living in the service. Staff understood how to keep people safe and had received training in safeguarding procedures.

There were sufficient staff who had received appropriate training. The recruitment procedures ensured that staff who were employed were suitable to work in the service. Staff received effective support, induction, supervision and training.

People were supported to have sufficient to eat and drink. Meals provided offered people choice and mealtimes were a sociable and relaxed experience and people were helped to maintain as much independence as possible.

Care plans contained sufficient information to help staff and guide them to deliver care and support that met people’s individual assessed health and care needs. However, people or their relatives were not always actively involved in making decisions about their care. Care plans were not always individualised.

Care files seen indicated that people using the service had access to health care professionals such as doctors, dieticians and opticians. Discussion with care staff demonstrated that they knew and understood the needs of the people they were supporting.

Systems were in place to monitor and evaluate the quality of service being provided and staff spoke highly about the management of the service.

During the inspection we spoke with four people who used the service. They told us that they felt well cared for. One person told us, “Staff are really nice, they treat me well.” Another person said, “The carers are so helpful, the food is beautiful.” A further person told us, “I like living here, I feel well cared for and I cannot find a fault.” We observed staff talking to people in a kind and respectful way and saw that they were attentive to people’s needs. Staff understood the principle of consent.

There were a variety of activities in place for people and care was given in a safe and dignified way. Assessments of people’s care had taken place to ensure that it was delivered in a safe manner. On the day of our inspection, the service was clean and tidy and free from unpleasant odours. Staff were able to explain their roles in relation to infection control and we saw that steps were taken to minimise the risk of cross infection.

The staff were knowledgeable and well trained and had the opportunity to develop further in their role if they wished to do so. Any complaints made had been dealt with effectively and policies and procedures were in place to assist people to make a complaint if they wanted to.

We spoke with five people who used the service. They told us that it was a comfortable place to live and that they had everything they needed.

One person told that the service was "Very relaxed", and that they didn't feel "Pressed." Another told us that staff "Helped me when needed."

The premises were clean and well decorated, and people using the service had safe access to the gardens.

The provider gathered the views of people using the service and used this information to ensure the care and support was appropriate to people's needs and wishes.

People who used the service varied in the ways that they communicated their views about the service that they were provided with. During our visit to the service we observed the care and support that people were provided with and we spoke with seven people who used the service.

People who used the service told us that the staff treated them with respect. One person said 'the only fair word to use is excellent'. Another person said that the staff were 'very good'. People told us that the staff listened to them and provided assistance when they needed it. We saw the staff interact with the people who used the service in a caring, friendly and respectful manner. They were attentive to people's needs and they assisted people when they asked for help. Where people were unable to vocalise their needs for assistance we saw that the staff were observant to their non verbal communication.

People who used the service told us that the quality of the food was good and that they were always offered choices. This was confirmed in our observations during the day of our visit.

We saw people participating in group and individual activities during our visit. Two people told us that there was sufficient opportunities to participate in activities that interested them.