Care service description

Upalong Residential Home is a care home that provides care, support and accommodation for a maximum of nine older people some of whom were living with dementia. At the time of the inspection eight people were living at the service. The service did not require a registered manager to be in place and was managed by the registered provider.

Rating at last inspection

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.

Why the service is rated good

People felt safe and staff were aware of the safeguarding procedure should there be a concern. Relatives also felt their family members were safe living at the service. There were sufficient levels of staff on duty to ensure that people’s needs were met and who had been recruited appropriately.

Risks to people’s care was managed well by staff and people received their medicines in a safe way. The registered provider had up-to date procedures to help ensure people remained safe in an emergency. Staff were effective in ensuring the service was clean and that they adhered to good infection control measures.

People's needs had been assessed before moving in to the service and care plans reflected those needs and preferences. Care plans were reviewed regularly and contained accurate information about people's current needs. People had access to health care professionals and staff followed the advice given by them. People were supported with their nutrition and hydration needs and told us the quality of the food was good.

People were treated in a kind and caring way by staff who respected their dignity. Staff spoke to people in a kind and considerate manner. People were supported with their independence and had choices around their delivery of care.

People chose how they spent their time and could take part in activities if they wanted to. Trips were arranged for people outside of the service. Staff worked well together and communicated changes to people’s needs to each other. Improvements in how of end of life care is discussed and recorded should be made. People told us that they would speak to staff if they had any concerns. There was a complaints procedure in place and complaints were investigated and responded to.

There was an experienced and well supported staff team employed at the service. The registered provider carried out quality assurance checks to ensure people received a good standard of care. Staff consulted with outside professionals to ensure the best delivery of care. People and staff had provided feedback when they were consulted about the service. Notification were sent to the CQC where appropriate.

Further information is in the detailed findings below

The inspection took place on the 27 June 2017 and was unannounced.

Upalong Residential Care home is a privately owned care home providing care, support and accommodation to up to 9 older people some of who are living with dementia. Accommodation is set over two floors, the first floor is accessed by stairs and a stair lift. At the time of the inspection there were 7 people living at the service.

We carried out an unannounced comprehensive inspection of this service on 7 June 2016. A breach of one legal requirement was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirement in relation to ensuring the principles of the Mental Capacity Act 2005 (MCA) were followed and people's legal rights were protected.

We undertook this focused inspection to check the provider had followed their action plan and to confirm that they now met this legal requirement. This report only covers our findings in relation to that requirement and the key area of effective. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Upalong Residential Home on our website at www.cqc.org.uk

Staff were able to demonstrate their understanding of the MCA and sought people’s consent before providing care. A policy was in place and the provider had begun the process of completing capacity assessments. We have made a recommendation that the provider ensures this work is completed and systems are embedded into practice.

Staff were provided with on-going support and development to support them in their role. Regular supervision was provided to staff to monitor their performance and development needs. Staff told us they felt supported by the provider and manager.

People told us they liked the food and were able to make choices about what they had to eat. Staff were aware of people’s preferences and were attentive to people’s needs. People’s nutrition needs were monitored and staff were aware of the action they should take if changes occurred. People had access to healthcare professionals. Guidance was provided to staff in meeting people’s healthcare needs.

Upalong Residential Care home is a privately owned care home providing care, support and accommodation to up to 9 older people some of who are living with dementia. Accommodation is set over two floors, the first floor is accessed by stairs and a stair lift. At the time of the inspection there were 7 people living at the service.

This was an unannounced inspection which took place on 7 June 2016.

The service is owned and operated by Mrs Mc Teggart. Mrs Mc Teggart is registered with the CQC as the Responsible Individual for the provision of accommodation for persons who require nursing or personal care. A Responsible Individual is a person who has the legal responsibility for meeting the requirements of the law. Mrs Mc Teggart manages the service on a day-to-day basis and is referred to in this report as ‘the provider’.

Staff did not have a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This meant people had restrictions in place without the proper procedures being followed and reviewed at regular intervals

People and staff spoke highly of the management of the home. Staff told us that they felt supported and knew that there was always someone available to help them when needed. We received positive feedback regarding the care staff from relatives and people living at Upalong.

Care plans and risk assessments had been completed to ensure people received appropriate care. These had been written using information from the people and their relatives. This meant information was personalised and reflected people's personal choices and preferences.

Medicine documentation and relevant policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out.

Systems were in place to assess the quality of the service people received and their relatives were regularly asked for feedback. Maintenance and servicing of equipment was completed regularly and fire evacuation plans and procedures were in place.

Staff received regular supervision and training which they felt was effective and supported them in providing safe care for people. Recruitment checks were completed before staff started work to ensure they were suitable to be employed in the service.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Staff demonstrated an understanding of how to recognise and report abuse and treated people with respect and dignity. People were given choices and involved in day to day decisions about how they spent their time. People were asked for their consent before care was provided and had their privacy and dignity respected.

People's nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people's likes and dislikes. People were positive about the food and relatives told us they had eaten with their family members and found the food to be good.

Referrals were made appropriately to outside agencies when required. For example GP visits, community nurses and speech and language therapists (SALT). Notifications had been completed to inform CQC and other outside organisations when significant events occurred.

During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People that we spoke with told us that they they were treated with dignity and respect, and that their independence was encouraged and that they were spoken to in a respectful way. Observations and records that we looked at during our inspection confirmed this.

People we spoke with said "Very happy here, staff are great" and "Staff help us to get out and about". A person's relative told us "Staff are absolutely lovely, I can't praise the home enough" and "I feel that mum is well cared for and safe".

People's bedrooms were spacious and personalised to meet the individual preferences of people that use the service. For example people had pictures of their relatives, art work and their own furniture from home in their bedrooms.

Staff training records that we looked at showed us that there were enough qualified and skilled staff to meet the needs of people that use the service. We saw that staff had attended all of the required mandatory training as well as additional training. Staff received regular and effective supervision.

We saw that the agency had received many compliments about the home. People that we spoke with and a relative were very complimentary about the home and staff.

Records that we looked at and discussions with the manager and a member of staff showed us that the home worked alongside professionals to ensure that the care and welfare needs of people that use the service were met.

People were invited to attend regular meetings on how the service was being run, and they had contributed to the decisions on how to improve the services provided. One person said, “I have negotiated my going to bed and waking times. I like to watch TV until about midnight and wake up later in the morning”.

Two people told us they did not know if they had a care plan. One said, “My family takes care of all the serious things. I don’t bother with them”. One person said, “I am self caring . I get on reasonably well with the staff, they accepts my humour. I find them very accommodating”

One person said, “The food is very good. It is exceptional. I am awkward with food, but the food here I cannot fault and the servings are just right”. Another person said, “They know what I like and do not like. I can have more of anything if I want it”.

We found people expressed their views and were involved in making decisions about their care, treatment and support. They experienced effective, safe and appropriate care and were supported to have adequate amounts of food and drink to maintain suitable nutrition. People had their medicines at the times they needed them from staff qualified and skilled to do so. People's comments or complaints were carefully considered and responded to.

People who used the service told us they were involved in the planning of their care; that their care worker discussed their support options and treatments with them and their family.

People said they were provided with the service user guide, and a contract of residency outlining costs and services which either they or their relatives signed.

Some people told us they could not remember if they had an assessment prior to being admitted into the service. Some people said someone from the service came to see them and asked a lot of questions, which they and their relatives answered.

People told us they had visits from their GP and they attended hospital appointments with a member of staff.

People told us they were asked to sign the care plan to show they agreed with the proposed care documented.

People said they felt safe in the service and they knew whom to speak to if they felt uncomfortable with a situation. They told us they would speak with the manager who would act on their behalf. Some people said they would speak with their relatives. They told us they had been provided with the service user's guide which contained information on keeping people safe, but they have never had to use it.