Trafalgar house was last inspected on 18 November 2013. The home was found to be meeting all requirements in the areas inspected.

Trafalgar Care Home is a detached home on a main road in the seaside town of Weymouth. The care home provides personal care for up to 29 people, many of whom have dementia type illnesses. Accommodation is provided over two floors which can be accessed by a lift. It is not registered for nursing.

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.

People had detailed personalised support plans which enabled staff to provide the right care and support to ensure people’s needs were met. People had opportunities to be involved in activities on both a group and individual level. Staff understood the importance of supporting people to maintain their preferred routines. They were respectful of their diverse needs. Staff knew the best way of communicating with individuals which varied according to the person.

Relatives and staff told us the care was person centred and people’s needs were reviewed regularly. There was an annual review of people’s needs, which relatives and healthcare professionals were invited to. This was an opportunity to ensure that support plans were working for people. There were additional reviews throughout the year if people’s needs changed.

People were cared for by staff who were kind and considerate. The staff were flexible to the needs of people and were able to safely support them. Staff had a flexible approach to their work to ensure they had enough time to sit and talk with people.

Relatives, staff and healthcare professionals told us the registered manager had an open approach where they could speak with them at any time. They told us the registered manager had created a positive culture which encouraged continual improvement. There were systems in place to monitor the quality of the service and to ensure any actions were followed up.

The provider was meeting the requirements of the Mental Capacity Act 2005 and assessments of people’s capacity had consistently been made. The staff at the home understood some of the concepts of the Act, such as allowing people to make decisions for themselves.

The provider had developed a culture of learning and staff told us there were opportunities to attend various in training opportunities and work towards qualifications in health and social care. Staff told us they felt supported. Staff received regular supervision and an annual appraisal.

The registered manager and provider were supportive of new staff and told us they introduced them gently into the work. They were respectful of staffs’ individual needs and were flexible in their approach to accommodate them.

We saw that people and their relatives or representatives were involved in the planning and delivery of care.

People’s care needs and risks were assessed and care was delivered to meet their needs. One person we spoke with said, “I’m happy here”. One person’s relative told us, “It’s a fantastic home. They (the staff) bend over backwards for people.”

The home was clean and there were procedures to prevent and control the risk of healthcare associated infections.

The provider had effective systems to monitor pre-employment checks and recruitment procedures for staff.

The home had suitable systems to monitor the quality of service provided.

During our visit we used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. One method we used was the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

During our visit we observed staff offering people choice and independence. An activities co-ordinator was talking to people and offering a range of books and magazines then discussing them with them.

We saw people were kept clean and comfortable. One staff member was observed asking 'do you want a blanket for your legs' to one person and caring for her needs in a gentle manner.

Staff had good knowledge of safeguarding polices and knew the local and national guidance about reporting. There was numerous opportunities to train and develop in the caring role. Some of the staff we talked were doing an aspects of mental illness course, one noted 'I really didn't appreciate the amount of mental illness in the people I care for, I feel more able to help and understand their needs now'.

Records pertaining to people and staff were kept safe in the managers office which ensured confidentiality.