This was an unannounced inspection carried out on the 8 and 9 May 2017.

Whitby House is a care home providing nursing care for up to 40 older people who require nursing support and/or have a physical disability. The home is a purpose built, two-storey building set in its own grounds in the Whitby area of Ellesmere Port.

Our last visit on 23 and 24 March 2016 identified that improvement was needed in relation to care planning. Because of this, we rated the responsive domain as 'requires improvement'. Despite this, the rating for the service had been assessed as good overall. This inspection identified that the required improvements had been made. The service met the all the relevant fundamental standards and the rating remains Good.

Care plans had been improved and provided a good overview of the person’s health and care needs. Risks to people's health and safety had been identified and care plans contained appropriate risk assessments and risk management plans to guide staff. Plans were person centred and regularly reviewed.

People continued to be supported in a safe way and where risks to people were identified they were managed effectively. Staff knew what abuse was and how to recognise and report it.

There were enough staff available to offer individual support to people and recruitment processes ensured they were suitable to work at Whitby house.

Medicines were managed safely. People received their medicines as prescribed.

Staff knew the people they cared for and had received an induction and training and supervision to help in their role.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us that staff were kind and caring. Observations showed staff approached and spoke with people kindly and with respect. There was an activities organiser employed at the service and staff assisted in organising activities for people which reduced the risk of social isolation.

There was a complaints policy and procedure and people knew how to make complaints.

The quality assurance system in place used audits in each area of the service so that there was a consistent approach to improvement. Accidents and incidents were recorded, analysed and trends identified. The registered provider understood the importance of gaining feedback from people using the service. Regular residents meeting were held and surveys used to gain feedback to help improve the service provided.

Further information is in the detailed findings below.

This was an unannounced inspection carried out on 23 and 24 March 2016.

Whitby House is a care home providing nursing care for up to 40 older people with dementia and/or physical disabilities. The home is a purpose built, two-storey building set in its own grounds in the Whitby area of Ellesmere Port. At the time of our inspection there were 34 people living at the service.

The service has a registered manager. 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.

We last inspected this location in May 2014 and we found that the registered provider met all the regulations we reviewed.

During this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see the action we have told the provider to take at the end of the report.

People’s needs were assessed and planned for and information was available for staff. Risk assessments were in place for people which identified potential areas of risk. However we found that care plans did not always record people’s needs accurately. Records were not always personalised to reflect people’s individual preferences about how they would like their care and support to be provided. Food and fluid charts were not always completed in detail to reflect what people had consumed on a daily basis.

People said they were happy with the service that they received and that they felt safe. Staff had a good understanding of how to protect people from the risk of harm or abuse. The registered provider had clear policies and procedures in place for reporting any concerns they had about the safety and well being of people they supported.

There were sufficient levels of suitably trained staff to support people and ensure they received their medicines in a safe and timely way. When new staff were appointed robust recruitment checks were carried out to make sure they were suitable to work with vulnerable people.

People were supported to access health care professionals to make sure they received appropriate care and treatment for their needs.

The registered manager and staff had a good knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Records were in place to show how best interest decision making had been completed when people were unable to make decisions themselves.

Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a well-developed programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.

People told us that staff always treated them with kindness and respect. They told us that staff were mindful of their privacy and dignity and encouraged them to maintain their independence. Relatives and visitors told us that they always felt welcome when they visited the service.

People and family members we spoke with said they knew how to complain but they hadn't needed to. Staff said the registered manager was supportive and approachable. People were consulted and asked their views about aspects of service provision.

The provider had quality assurance systems in place to audit the service provided. Records we saw were regularly completed in line with the registered provider’s own timescales.

We considered our inspection findings to answer questions we always ask; Is the service Safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of what we found.

Is the service safe?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) and the Mental Capacity Act 2005. While no DOLs applications have needed to be submitted, proper policies and procedures were in place. We discussed this with the manager who understood when an application should be made, and how to submit one.

All of the people we spoke with said they felt safe living at Whitby House. Comments from them included; "I feel safe I have never been afraid of anything here" and "I have never had anything to be concerned about here. I'm quite safe".

Is the service effective?

We spoke with five people who used the service. They all told us they were happy at Whitby House and had no concerns with the care provided. Comments from them included; "I get plenty to eat and drink here. I've got no complaints" and "When I press the call bell they come very quickly".

We spoke with five members of the staff team. They demonstrated a clear understanding of people's care needs and their role and responsibility to maintain people's safety.

Is the service caring?

We observed how people were cared for at Whitby House. Staff were always present in the communal areas throughout our visit and promptly answered calls for assistance. We saw that staff spoke to people in a caring and compassionate manner. People were seen to be comfortable with the staff that supported them. A person who lived at the home told us; "They always come in to check on me in the night".

Is the service responsive?

We saw that before a person started to use the service, an assessment of their needs and abilities was undertaken. The care plans showed how the needs of the people who used the service were to be met, including any risks to their well-being.

Records and discussions with staff showed that where there was a concern about a person's health needs the advice and support of health professionals such as GP's, specialist nurses had been sought. Records suggested that any instruction given had been followed.

Is the service well led?

The management team had been in place for a long period of time at the home. Staff and people who used the service spoke highly of them and said they were listened to when concerns or suggestions were made.

We saw the service carried out monthly audits of various aspects of the service's operations such as medication management, care planning, people's finances and the homes environment. Where concerns were identified, processes were in place to enable appropriate changes to be made.

We spoke with seven people who used the service and two of their relatives. They told us they felt staff at the home respected them and they felt involved in the planning of their care and treatment. They also told us they thought there was enough staff to meet the needs of the people living at Whitby House. Comments from them included: “I am well looked after. I would recommend this place to others” and “I’ve just got new carpets and curtains in my room. I’m very pleased.”

We saw that staff were very respectful towards people who used the service. For example, we observed staff bend down to the person's level to speak to them. They explained what they were going to do and ask permission.

We saw that the home had been recently refurbished and was clean and tidy throughout.

We saw that the provider had effective recruitment policies and procedures in place. This also ensured that people were not discriminated against during the recruitment process.

We found that people who used the service and their representatives were asked for their views about the care and treatment that was received. We examined the provider’s statement of purpose which was given to a person who used the service and/or their advocates. It was clear that people were given the right information of who to complain to if they were not happy or had any concerns about the service.

We contacted the Local Authority prior to our inspection. They had no concerns about Whitby House.

We spoke with four people who live at Whitby House as well as one relative. They made the following comments about their experiences at Whitby House:

“Staff are very nice”

“They are good at caring and the home is very relaxing”

“Staff are responsive”

“A complaint was made but it was sorted out quickly”

“I feel as though my relation is safe living here”

“They always let the family know if something happens”

‘If I am ill they always get a doctor out’

“‘I definitely feel involved”

“They always let me help myself as far as I can”

“They are very good; I do not have a wrong word to say about them”

“They respect me and look after me completely”

“I feel perfectly safe here”

“I know who to talk to if I was not happy with something and they would sort it out”

“It is a very nice place”