This inspection was unannounced and took place on 28 September 2016. Wellfield House provides care and accommodation to up to 21 people. The home specialises in the care of older people. The home is situated in the centre of a small village and had close links with the local community.

The home does not provide nursing care and people who require nursing assistance were supported regularly by the community nursing team.

There is 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.

The registered manager was open and approachable and supported people and staff well. At this inspection we found the registered provider had improved their support for the home by providing regular contact and supervision for the manager. The provider arranged for their in-house trainer to provide training to staff in the home.

The manager had robust systems in the home to monitor the quality of the service offered to

people.

The quantity and range of social activities available in the home had been developed since the last inspection. An activities co-ordinator had been appointed and people were offered a range of in-house activities. Some people were also able to enjoy trips to local places of interest. The registered manager told us they continued to encourage people to give ideas for the

activities they would like to have arranged.

People told us staff were kind and caring and always respected their privacy and dignity. Several people commented on how helpful staff were. One person said “Staff are more than kind. They wait on me hand, foot and finger.” Another person said “Staff are very kind and polite. Everyone.” “With some you do not even have to ask. They know us and what we need.”

A relative wrote “I was so pleased to see where (relatives name) lived and how well they were taken care of.”

People felt well looked after and said the home arranged for them to see healthcare professionals according to their individual needs. A visiting nurse practitioner s informed us the

staff monitored people’s health and always asked for advice if they had any concerns. They said “I have no concerns about the home. They are responsive. They take action and listen to any advice given”

Care was responsive to people’s needs and personalised to their wishes and preferences. People were able to make choices about all aspects of their day to day lives. Staff knew the importance of learning about people’s preferred ways of daily living and supporting them to continue to be independent when possible. One person said” “I do what I like. I go where I like. Tomorrow I am going out for the day. All day. But the next day I will be a bit tired. So I will take it easy. Please myself. Everyday.”

Staff were aware of how to assist people to make decisions if they lacked the mental capacity to make decisions for themselves.People were involved in discussions about the care and support they received and were made aware of any risks. The staff responded to changes in people’s needs and adjusted care accordingly.

People enjoyed the food in the home. They had a choice of food and staff catered for people with specific dietary needs and preferences when required. Food was plentiful and the size of people’s meals varied according to their appetite and preferences.

Staff had access to on-going training in health and safety and the specific needs of the people who lived at the home. This made sure staff had the skills and knowledge to safely and effectively support people.

There was a robust recruitment procedure which minimised the risks of abuse to people. Staff had received training in recognising and reporting abuse and were confident that any conce

This inspection was unannounced and took place on 26 February 2015

Wellfield House provides care and accommodation to up to 21 people. The home specialises in the care of older people. The home does not provide nursing care and people who require nursing assistance are supported by the local district nursing team.

There is 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.

The registered manager was open and approachable and supported people and staff well. However the registered provider did not take an active role in supporting the home or monitoring the quality of the service offered to people. This meant they had no system to assure themselves the manager was managing the home appropriately.

There were limited social activities available in the home but many people said they preferred to occupy themselves. The registered manager told us they continued to encourage people to give ideas for the activities they would like to have arranged.

People told us staff were kind and caring and always respected their privacy and dignity. Several people commented on how helpful staff were. One person said “If you wanted anything they would try their best to get it for you.”

People felt well looked after and said the home arranged for them to see healthcare professionals according to their individual needs. Visiting nurses informed us the staff monitored people’s health and always asked for advice if they had any concerns.

Care was responsive to people’s needs and personalised to their wishes and preferences. People were able to make choices about all aspects of their day to day lives. Staff were aware of how to assist people to make decisions if they lacked the mental capacity to make decisions for themselves.

People were involved in discussions about the care and support they received and were made aware of any risks. The staff responded to changes in people’s needs and adjusted care accordingly.

People had a choice of food and staff catered for people with specific dietary needs and preferences. People were happy with the quality of food served in the home and all said portion sizes were ample. People told us “Food is excellent,” “Food is always good and there’s plenty of it” and “Food is very nice, I’ve put on weight since I moved here.”

Staff had access to on-going training in health and safety and the specific needs of the people who lived at the home. This made sure staff had the skills and knowledge to safely and effectively support people.

There was a robust recruitment procedure which minimised the risks of abuse to people. Staff had received training in recognising and reporting abuse and were confident that any concerns would be fully investigated to make sure people were protected.

People knew how to make a complaint and everyone told us they would be comfortable to do so. All were confident they would be listened to and action would be taken to address any shortfalls. One person said “The manager is a super lady. She said right at the beginning if there is anything that bothers you please tell me. I won’t know unless you tell me and then we can put it right.”

A single inspector carried out this inspection. We spoke with 14 residents, two family members and six members of staff. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at.

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?

People had been cared for in an environment that was clean, safe and hygienic. Equipment was well maintained and regularly checked. We observed people being well cared for and treated with respect and dignity. Staff personnel records contained appropriate documentation detailing applications, references, disclosure and barring service reports and on going training that had been completed.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

People told us 'I can say they look after me 100%, hand, foot and finger and they are so respectful' and 'Things are fine here we are treated with respect and kindness'. A visiting relative told us 'The care here is absolutely super, I cannot fault it and it's totally reassuring' 'You can come and go as you please and I think that's telling, it always smells so wonderful, like a home'

Is the service effective?

People told us they were very happy with the care they received and felt their needs had been met. We observed people being treated in a respectful, kind and supportive way. There was an unhurried atmosphere and we observed people being supported to maintain maximum independence.

All the staff we spoke with told us they had received appropriate training to do their job and felt well supported by the manager and colleagues. One member of staff told us 'I absolutely love it here, everyone is so nice and friendly' and 'People are looked after well, staff are very polite and kind to residents'

Records confirmed that care plans were updated with new information and action taken following incidents to prevent recurrence.

Person centred care plans identified individual preferences and dislikes.

Is the service caring?

We observed people being supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. We observed people doing things at their own pace and were not rushed or hurried.

We saw that staff and people interacted in a positive way and heard lots of laughter from people during the day when talking and interacting with staff. One person told us 'It's so nice when you get up and feel low to have some company who cheer you up'

Is the service responsive?

People's needs had been assessed before they moved into the home. Some people were able to tell us the name of their key worker and told us that they signed their care plans on a monthly basis and had been involved in developing them.

Some people we spoke to felt there could be more in the way of activities especially in the afternoons. One person told us 'The care is alright but there could be more stimulus, it can get boring' The manager had recently started placing the planned activity schedule in people's rooms on a monthly basis so they were aware of the activities available.

Is the service well-led?

Wellfield House has a registered manager who is registered with the Care Quality Commission.

Staff had a good understanding of the ethos of the home, one member of staff told us 'We try to make it as homely as we can'

The manager aims to hold residents meetings on a three monthly basis and we saw evidence of how residents suggestions had been acted upon.

Resident and family member surveys are conducted annually. All staff received supervision with the manager on a three monthly basis. Staff meetings are held three monthly. The registered manager is in the process of developing staff appraisals and surveys for staff and visiting professionals.

Staff told us they were clear about their roles and responsibilities and received good support from the manager. Staff also told us that they felt they worked well as a team and that communication was very good.

People we spoke with said that they were happy with the care that they received at the home. One person told us “I am looked after very well and am pleased with everything.”

Some people who lived at the home were unable to fully express their views verbally. We saw that people were well dressed and well presented which demonstrated that staff took time to assist people with personal care. We saw staff assisting people in a kind and caring way.

There were some organised activities in the home to provide social and mental stimulation for people. A fortnightly activity programme was displayed in the entrance hall. It was not clearly visible and therefore most people we spoke with were unaware of any planned activities. People we spoke with said that the activities in the home were poor.

There were policies and procedures in place for the safe handling and administration of medicines. There was appropriate storage available for medication.

All areas of the building we viewed were clean, well decorated and maintained. This meant that people lived in a pleasant and safe environment.

The recruitment procedure minimised the risks of abuse to people who lived at the home by making sure that all staff were thoroughly checked before beginning work.

The manager had basic systems in place to monitor the quality of the service offered to people and to ensure that practices within the home were safe.

People told us that there were no strict routines in the home and they were able to make choices about their day to day lives. One person said “I’m very individual in my routine and they just seem to go along with it.” Another person commented “I’m quite free to do what I want but I always tell someone when I’m going out.”

Many people spoken with were unsure about the contents of their care plans. However everyone agreed that they were always asked about how they would like to be supported. Several people said that their key worker spent time with them talking about the care that they needed. This demonstrated that people were involved in planning their care and deciding how they wished to be assisted by staff.

People we asked were very happy with the care that they received. Comments included; “The care is beautiful, the girls are all top notch,” “They take great care to look after you; it’s a wonderful place” and “I feel very well looked after.”

One person made a specific comment about the way they were supported with personal care. They said “They are so sensitive and gentle when they help you.”

Everyone felt that the care that they received was personalised to their individual needs and they were able to maintain their independence where possible. One person told us “I like to do as much as I can for myself but am confident that I could ask for help at anytime and it would be given.”

People said that they were able to have visitors at anytime. They said that they could see social or professional visitors in their personal rooms or in the communal areas. One visitor told us “I can pop in at anytime and I’m always made welcome. I never have to tell anyone in advance that I’m going to be visiting.”

People told us that they felt safe at the home with one person commenting “I feel safe with all the staff, they are so kind and polite.”

Everyone said that if they had any worries or concerns they would be comfortable to speak with a member of staff. One person said “I would always talk with someone and I know they would take action to make sure that we were all OK.”

Without exception everyone spoken with praised the staff. People said that staff were “kind and polite,” “very patient” and “excellent.” One person said “I think the staff get a lot of extra training because they all appear really well trained.”

People living at the home told us that they were happy with the care that they received and felt that they were able to make choices about their care and their day to day lives.

Everyone asked was very complimentary about the staff who supported them, people said that they were kind, polite and cheerful. One person said “The staff are very lovely and always polite.” Generally people felt that the home was adequately staffed and all said that staff came quickly if they rang for assistance. One person said that they thought there should be more staff at meal times.

People felt that there were ways to share their views about the home and everyone said that they would be comfortable to speak with a member of staff if they had any worries or concerns.

There are organised activities in the home but some people said that these could be erratic and often depended on which staff were on duty. One person said that they would like to see more “physical and mental activity.”

Everyone asked was happy with the food served in the home and said that there was always a choice of meal. People said that they received enough to eat and drink and could ask for more at any time.

One person said “If you need to live in a rest home I don’t think you could choose a better one.” Another person said that they thought the home was “Value for money as you get everything you want.”