Waterside provides care and accommodation for up to 48 people. On the day we visited 26 older people were living at the home, some of whom had dementia. The home is split into three units, at the time of our visit two of these were in use and one was closed.

The last inspection of the home took place on 30 September 2014 and all of the regulations were met.

The home had a registered manager who was on maternity leave when we visited. The care manager had been covering management duties in her absence. 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’s diverse needs were considered and met. This included their cultural, social and religious needs. There was a focus on people’s individual needs which were recognised and care was targeted on meeting them. People enjoyed taking part in activities which were creative and imaginative. People and staff spoke proudly of their achievements in creating a herb garden and a memory tree. These projects formed part of the home’s recognition in the provider’s scheme called ‘Anchor Inspires’, which aimed to promote best practice in dementia care.

People had opportunities to give their views about the home at meetings, in surveys and informally in discussions. Their views were taken into account. People knew how to complain and felt confident to do so if necessary.

Staff provided support which was considerate, respectful and protected people’s dignity and privacy. There were kindly relationships between them and the atmosphere was relaxed and warm. Relatives expressed their satisfaction with the care people received and health and social care professionals said people’s health had improved as a result.

People received kind and compassionate care at the end of their lives from staff who had specialist training.

We found the home was providing safe care for people. Staff were knowledgeable about abuse, how to recognise if people were at risk and what to do to protect them. Risk management systems were managed well and they kept people safe, as did health and safety procedures. Staff gave people their medicines when they needed them and made accurate records to confirm they had done so.

The provider had safe procedures for recruiting staff so people could be assured they were looked after by suitable workers. Staff were supported and trained well for their roles and people were confident in their abilities. People had a choice of meals available that met their nutritional and cultural needs. People saw a range of health care professionals to make sure their needs were met and staff had specialist advice to deliver good care.

People’s care was in line with the requirements of the Mental Capacity Act 2005. They were not deprived of their liberty unless this was properly authorised under the Deprivation of Liberty Safeguards.

The home had clear management arrangements and audits were carried out to ensure the systems contributed to providing good quality care.

One inspector carried out this inspection. This inspection focussed on the safe management of medicines at the home.

Below is a summary of what we found. During this inspection we reviewed records relating to medicines management. We spoke with the recently appointed manager of the service, two team leaders who were responsible for administering medicines and the GP.

If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:

Is the service safe?

At our last inspection on 4 June 2014 we found that people were not adequately protected from risks associated with medicines. Staff had not always checked that people were only prescribed medicines they were not allergic to. We asked the provider to make improvements.

At this visit we found arrangements for managing people's medicines had improved. Changes had been made which ensured staff acted on information about people's allergies and people received their medicines safely.

Is the service effective?

Not reviewed during this inspection

Is the service caring?

Not reviewed during this inspection

Is the service responsive to people's needs?

Not reviewed during this inspection

Is the service well-led?

Not reviewed during this inspection

One inspector visited the service, our visit was unannounced. During our visit we gathered evidence 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 describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us about the service. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that one person had been prescribed an item of medicine which, it was stated in their care plan, they were allergic to. This did not adequately protect the person from harm.

Staff had been trained in safeguarding vulnerable adults from abuse and were aware of how to report concerns about people's safety. Reminders were given in meetings for people who lived at the service and their relatives that they could make complaints and raise concerns.

Is the service effective?

People expressed their views about their care and these were taken into account in the assessment of their needs and the planning of the service. Staff were supported and trained to understand and meet people's needs. The service involved specialists to ensure they were fully informed about how to meet people's particular needs. For example referrals were made to District Nurses, dieticians and podiatrists if people required assistance that was outside the expertise of the service.

Is the service caring?

People said they felt the staff were caring. One person told us, "the carers are wonderful....they are so kind."

We observed that staff interaction with people living at the service was kind, patient and warm. We saw that people's dignity was protected, caring tasks were carried out in privacy and people's independence was promoted.

Is the service responsive?

People felt staff were responsive and attentive. One person told us they were assisted by staff when they felt unwell. They said the staff quickly realised they needed urgent attention and contacted the emergency services.

People were able to follow activities they enjoy, including knitting, painting, singing and taking part in religious services.

People, their relatives and friends were encouraged to give their views about the service at regular meetings. In addition surveys are distributed so they can give their views confidentially.

Is the service well-led?

There were systems to ensure that the service provided good quality care which took into account health and safety and people's views. People told us they had no complaints but knew who to talk to if they did and felt confident that they would be listened to. The provider carried out checks on the quality of the service.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. Alternative management arrangements were in place and an application has been made for the new manager of the service to be registered under the Health and Social Care Act.

When we visited there were 38 people living at Waterside. We spoke with people on all floors of the service and with their visitors. We used 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. We spoke with staff members and with two visiting professionals.

People’s privacy, dignity and independence were respected. We observed that people were treated with respect and warmth.

People told us they received the care and support they needed. They described staff as “very good” and “helpful”. Another person said “staff are very good .... if they say they will come back to do something for you they keep their promise”.

People enjoyed the meals and were protected from the risks of inadequate nutrition and dehydration.

People were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were enough skilled and experienced staff to meet the needs of people who lived at Waterside.

There were arrangements to make sure that the quality of the service was assessed regularly and action taken to make improvements when necessary.

On the day of our visit there were thirty five people living at the service. We spent time in each of the three units. We spoke with nine people who lived at the service, with three visitors and with eight staff and managers. After our visit we spoke with three professionals involved with the service.

We found that people were satisfied with the service they received and most people found the activities suited their interests. A person who lived at the service said "it couldn't be better, I am very happy".

A visitor whose relative lived at Waterside told us "we are very happy, they tell us about everything. She likes the food,".

A professional involved with Waterside said "I’d be happy for any of my clients to go there and I have recommended the service to colleagues”. Another professional told us they were concerned they had not been informed about an accident that a person living at the service had.

We found that the quality of record keeping was not consistent throughout the building and needed improvement to ensure people were protected from the risk of inappropriate care.

Staff members said they enjoyed their work and found there was "good team work" and support working at Waterside.

People and relatives we spoke to told us that they were happy with the care they received at the home.

People felt that generally there was sufficient staff on duty to meet their needs.

Some people told us that the food was very good and that the home was clean and well maintained.