Wilhelmina is a care home that can accommodate and provide personal care and support for up to 26 older people. There were 19 people living in the home at the time of our inspection.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

When we last inspected the service on 30 June and 1 July 2015 they were meeting the regulations we looked at and we rated the service Good overall and in all five key questions.

At this inspection we found the service continued to be Good.

The provider had systems in place to safeguard people from abuse including systems to respond to allegations of abuse. The provider shared learning from incidents and investigations across the organisation to improve practice.

Risks relating to people’s care were reduced as the provider assessed and managed risks. Risks relating to the premises and infection control were also controlled and the premises were clean and well maintained. Systems to ensure water temperatures remained safe to reduce the risk of scalding for some people could be improved. The premises met the support needs of older people and people had sufficient space to entertain visitors.

There were enough staff deployed to support people and the provider checked staff were suitable to work with people by carrying out recruitment checks.

The provider managed people’s medicines safely although systems to monitor the temperature some medicines were stored at required improvement. Medicines were administered, recorded and disposed of in line with best practice. Staff received training in medicines management and the provider checked staff were competent to administer medicines to people.

People were supported by staff who were well supported to carry out their role with a programme of induction, training, supervision and appraisal. A trainer closely monitored staff training requirements and provided training and workshops to staff in small groups.

The registered manager understood their responsibilities to provide care in line with MCA, although there was no reason to suspect people lacked capacity. Staff received training in MCA to understand expectations of them in relation to this Act.

The provider assessed people’s needs through consulting people, their relatives and any professional reports. People were supported to maintain their health as staff monitored their day to day health needs and helped them access healthcare services.

People received choice of food and drink and were positive about the food they received. Systems to ensure chefs had access to information about people’s dietary needs and preferences could be strengthened.

People liked the staff who cared for them. Staff understood the people they supported and had developed good relationships with them. Staff supported people to communicate as they understood people’s communication needs. People were involved in decisions relating to their care and staff supported people to maintain their independence. Staff treated people with dignity and respect. Relatives could visit people at any time and staff made them feel welcome.

People were supported to access activities they were interested in as the service provided a popular activity programme.

People’s care plans contained sufficient detail to be reliable guide staff in understanding people’s needs and how best to support them. Care was provided responsively to people and staff responded promptly to call bells.

The provider had a suitable complaints process in place which people were made aware of, although the provider had not received any complaints in the past year.

The registered manager was experienced and competent and there was a clear management structure. Leadership was visible across the service. Staff understood their roles and responsibilities well.

The provider developed strong li

We spoke to four residents and one relative as a part of this inspection and they told us that they had been given enough information about the home and the services that were provided.

When we asked about the quality of the care they received, one person said, “The staff can’t do enough for me, they are fantastic”. Another resident said, “It’s the best decision I made – the quality of care here is excellent”. A relative told us, “The care that my relative receives here is excellent, I have always found staff here to be helpful and friendly, I have no complaints at all”.

In feedback received from people via the quality assurance audit carried out in July 2013, one person said, “The staff always show a great deal of respect and patience towards mum. As a family we appreciate all that is done for her, thank you”. Another person said, “Respite care – a thoroughly pleasant and enjoyable experience”. Staff feedback was equally positive with several comments reflecting on Wilhelmina House being a good place to work in.

The people who use this service told us that they like to be called residents. They told us that they had sufficient information to make choices about their care and support. They told us that staff worked hard to maintain their dignity and privacy and that they felt safe and well looked after at Wilhelmina House. People said that they were asked for their views on a variety of aspects of living at Wilhelmina House and that their views were taken into account in the running of the home.

Please see main report for this information.

We visited Wilhelmina House on 30 June and 1 July 2015.

The inspection was unannounced.

The service provides residential care and support to up to 21 people over the age of 65. At the time of our inspection 14 people were using the service but one was in hospital.

The service had 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.

People at the service felt safe. Staff had completed safeguarding of vulnerable adults training and knew how to recognise and report to abuse. They knew how to escalate concerns. People’s needs were assessed and appropriate risk assessments developed. There were sufficient numbers of staff to meet people’s needs and safe recruitment procedures were followed. People received their medicines safely and as prescribed.

Staff had the skills, knowledge and experience to deliver safe and effective care and support. People had capacity to make decisions and consent to care and treatment. That capacity was monitored for signs of deterioration. Staff had completed mental capacity and deprivation of liberty safeguards training. People were supported to have a healthy diet and to maintain good health.

People and visitors commented positively about relationships with staff and we observed numerous examples of positive interactions. People and their representatives were supported to express their views and were involved in making decisions about their care and treatment. There were meetings for people and relatives where they could express their views and opinions about the day to day running of the home. Staff respected people’s privacy and dignity.

People received personalised care. Care plans were person centred and addressed a wide range of social and healthcare needs. People were involved in the development of their care and treatment. Care plans and associated risk assessments reflected their needs and preferences. People were encouraged to take part in activities that reduced the risks of social isolation. People were confident that they could raise concerns with staff.

Staff spoke positively about the management team and were confident they could raise any concerns or issues. Staff meetings were held on a regular basis. The service had a system of audits and performance monitoring to assess the quality of service they provided.