This inspection took place on 15 and 16 June 2017 and was unannounced. The previous inspection was carried out on 15 February 2015. We had no previous concerns prior to this inspection.

The Turrets Residential Care Home provides accommodation and personal care for up to 17 people. At the time of our visit there were 17 people living at the home. The home is also registered to provide personal care to people who lived nearby in a supported living service. At the time of our inspection no persons received the regulated activity of personal care at the supported living service.

There was a not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the home is run. At the time of our inspection the manager had applied to the Care Quality Commission to become the homes registered manager.

People told us they felt safe living at the home. Staff were aware of what constituted abuse and the actions they should take if they suspected abuse.

People were provided with safe care by adequate numbers of appropriately skilled staff being made available. Staff recruitment procedures were safe and the employment files contained all the relevant information to help ensure only the appropriate people were employed to work at the home

The manager and staff understood their role and responsibilities to protect people from harm. Risks had been assessed and appropriate assessments were in place to reduce or eliminate the risk.

Medicines were handled appropriately and stored securely. Medicine Administration Records (MAR) were signed to indicate people's prescribed medicine had been given.

The manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). These safeguards aimed to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. Staff had an understanding of the Mental Capacity Act 2005 (MCA) and how it applied to their work. Records showed appropriate mental capacity assessments had been carried out.

Staff had the right skills and training to support people appropriately. People told us they felt there were enough staff available on each shift to care for them well. Staff felt well supported by the manager and received regular supervision sessions and appraisals.

Staff ensured people's privacy and dignity was protected. People received personalised care from staff who were responsive to their needs and knew them well. Staff created a relaxed atmosphere which resulted in a calm and friendly culture in the home.

People had access to a range of healthcare professionals when they required specialist help. Care records showed advice had been sought from a range of health and social care professionals.

People had their nutritional needs assessed and monitored and were supported to enjoy a range of food and drink of their choice throughout the day.

People were actively encouraged to provide feedback. Any complaints were investigated and action taken to address concerns when needed. People and their relatives told us they had no complaints.

The home was well led and the management promoted a positive culture that was open and transparent. The manager demonstrated good visible leadership and understood their responsibilities. Quality assurance practices were robust and used to make improvements.

The inspection took place on 17 February 2015 and was unannounced. At our last inspection in April 2014 the service was meeting the regulations inspected.

There was a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered nominated people, 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.

People told us they felt very safe at the home and were very comfortable with the staff who supported them. There were systems in place to ensure that staff and other people knew how to repost any concerns about safety and wellbeing if they had them.

People felt well cared for and supported in the home and in the community when they went out. There was enough staff who were able to meet their needs and provide people with a caring and supportive service.

Staff knew the people they were supporting well and provided them with a personalised service that effectively met their needs. Care plans clearly explained how people wanted to be supported. People were fully involved if they wanted to be in making decisions about their care. People told us they liked the staff and the registered manager a great deal and felt extremely well supported by them.

People were involved in deciding what choice of meals, snacks and drinks they had. People spoke highly of the meals provided and told us they always enjoyed the choices available.

The registered manager and staff knew about the Mental Capacity Act 2005 code of practice and the Deprivation of Liberty Safeguards. They ensured they were followed when decisions were made on people’s behalf where people lacked capacity to make these decisions.

If people had a complaint or a concern there was an effective system in place to ensure these were properly addressed.

The home was well run and the registered manager worked closely with the provider’s representative who was involved in the way the home was run. Every person we spoke with had very positive views of the attitudes and approach of the registered manager and provider’s representative who they also knew well.

There were systems used to assess the quality of the service. When improvements where needed, the quality checking systems were able to identify them and changes were made. This showed quality monitoring processes were effective and helped ensure people received safe care that met their needs.

The aim of the inspection was to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. We spoke with eight people who used the service and with three people’s relatives as part of our inspection.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people were treated with respect and dignity by the staff at The Turrets. People told us they felt safe and well cared for. Some of the people we spoke with told us, “it is very nice, the staff are very good to me”, “the staff are all very kind to us they are all so caring”.

The environment looked satisfactorily maintained throughout. Equipment was properly maintained and we saw that it was serviced regularly. This was to ensure that people were not put at unnecessary risk from unsafe equipment in the home. For example we saw that the hoist that was used to assist one person with their mobility was serviced regularly.

There were effective systems in place to ensure that the provider, manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This keeps people safe because risks are identified and actions taken to minimise them.

The provider had a recruitment procedure in place that was robust .This meant people were protected because the risk of unsuitable staff being recruited were minimised

Is the service effective?

Peoples nutritional needs were properly met. Care records included suitable plans of care in place for people who were assessed as being at nutritional risk.

Staff understood that one of the aims of the home was to promote and encourage people to live as independently as possible. Each person we spoke with told us how much they enjoyed living at The Turrets. People told us they were able to do what they wanted to do at the home. People also went out into the community on a daily basis. We observed people who were going into town independently on the day of our inspection.

Is the service caring?

People had very positive comments to share with us about the staff and life at the home. One person told us, “they are all lovely, they actually care about people”. Another person said, “the staff are very good to me I would give them a 100 out of 10”.

We saw that the staff had a caring and attentive manner when they assisted people with their needs. We saw people being effectively supported with their range of needs. These included their mobility needs, nutritional, needs and prompting with personal care needs.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. The results from the survey were analysed by the provider. If there were shortfalls or concerns raised these were addressed by them.

People’s preferences, interests and diverse needs had been set out in their care records. We saw that people received support from the staff in accordance with their wishes in their care records.

Is the service responsive?

People took part in a range of activities in and outside the home on a regular basis. People told us they were supported by the staff to be involved with their local community.

People knew how to express their views if they were unhappy. Everyone we spoke with said that the manager was always available and they could see them at any time if they had any concerns or complaints.

A representative of the provider visited the service regularly and consulted people to find out their views. They also worked shifts there to monitor the standards in the home.

Is the service well-led?

All of the eight people who used the service who we spoke with praised the kindness of the manager and the way the service was run. Examples of comments people made included “the home is very well run”, and “the manager is lovely and very kind”.

The service has an effective quality assurance system in place. We saw information that showed that action was taken to address shortfall in the service promptly. This meant that the quality of the service was improving and developing.

Staff told us they had a good understanding of their roles and responsibilities. Staff also demonstrated that they had a good understanding of the philosophy of the home. This meant people who supported by staff who knew how to help them meet their needs.

We met seven of the ten people who were living at the Turrets on the day of our inspection.

Every person we spoke with told us how happy they were living at the Turrets. Examples of the comments people told us about what life was like for at the home included, “the staff are very nice, they help us to go on holiday, the food is very nice and it’s a very nice home ”, and “it’s lovely here , the staff are lovely and I’ve got quite a few friends here”.

People who used the service were supported and encouraged to live an active fulfilling life at the Turrets and in the community.

People were able to eat a varied and nutritious choice of meals at the home. Menus were planned based on the choices and preferences of people who used the service.

People were assisted with their needs by staff who were who were effectively supervised to make sure ensure they were providing suitable care and assistance.

The provider had a suitable system to quality check the service people were receiving. People who used the service were actively involved in the quality checking process.

People told us that they got on well with staff and were being treated with respect. They said that they were able to do a lot of things for themselves but were given help when they needed it. One person told us that they appreciated the support they received with going to the doctors and with following up their health needs.

People said they felt safe in the home and had been given information about what to do if they had a concern. One person told us they would have “no qualms about talking to staff”. We were told about a change in the occupancy of the home and how people’s relationships had improved as a result. One person commented “people are more relaxed now”.

Meetings were taking place when people could pass on their views and talk about new activities they would like to do. People said that they felt more involved in the home and were being given more choices and opportunities. One person told us “we now have a choice of food; it used to be whatever they gave us”.

We were told about improvements that had been made in the home and one person commented “the quality of care is up”. Policies and procedures were being reviewed and further improvements identified. Overall there had been some good developments although there were shortcomings in the arrangements being made for staff training.

We carried out an unannounced visit on 27 January 2012.

We spoke with two people living at the home who told us they did not want to move.

They told us they had cooked a meal for everyone and that they really enjoyed cooking. They said they liked the staff and that they helped them with cooking and other household tasks.

People told us that they had been upset by another person living at the home because their behaviour had caused a change in the home with people shouting at each other.

This was a review of a new service registered with the Care Quality Commission in August 2011.

We spoke with two people. We were told some people went shopping, and to church regularly.

One person told us they had retired from employment and went to a luncheon club and a craft club during the week and organised other activities independently.

They told us they had their own bedroom and front door key which they used.

Another person chose not to go to planned day services. We were told by staff that they encouraged them to be involved in other routines and activities such as shopping and trips out of the home. They said they were happy living at the home.

We were told that there was "different food now". When we asked what this meant we were told there was more choice.