This inspection took place on 14 December 2018 and was unannounced.

Wolfe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Wolfe House can accommodate up to 16 people in one adapted building. At the time of our inspection there were 11 older people living at the home, some of whom were living with dementia.

There was 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 assisted us in our inspection.

We found at times staff were not always deployed across the service in a way which meant people received their meals promptly. We also found that at times the registered manager did not display a person-centred approach towards people. We have issued a recommendation in relation these to the registered providers.

People’s medicines were managed safely. Staff had identified risks to people and when people had accidents or incidents these were recorded and analysed. People were cared for by staff who understood their responsibility in relation to recognising and reporting abuse. Fire safety equipment and fire drills were carried out so staff would know what to do in an emergency.

People were cared for by staff who underwent a recruitment process to ensure they were suitable to work at the service. People lived in an environment that was clean and well maintained.

People’s consent was sought before providing care, in line with the Mental Capacity Act 2005. People were provided with support to access healthcare professionals and their dietary needs were monitored to ensure they remained healthy.

People’s needs were assessed before moving into the service and they were cared for by staff who had access to the training and support they needed to carry out their roles.

People could make their own decisions and retain some independence. People were cared for by staff who demonstrated a kind, caring, respectful and attentive attitude towards people. People were supported to maintain relationships that meant something to them.

People had access to activities and the recruitment of an activities lead had enhanced the choices available to them. People’s care plans were detailed and contained a range of information about them to assist staff in providing responsive care. This included some end of life information.

People were aware of how to make a complaint, however no one we spoke with said they had felt the need to do so. Regular auditing of the service was carried out and in order to help make improvements, people, relatives and staff were asked for their feedback through annual questionnaires. The staff worked with external agencies to help improve the experience people had of living at Wolfe House.

The inspection took place on 1 November 2017 and was unannounced.

Wolfe House Care Home is a home that provides accommodation and personal care for up to 13 people. The majority of people at the home were living with dementia. At the time of our inspection there were 10 people living at the home.

There was 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.

At this inspection, we did identify areas in which the provider was not meeting their legal requirements.

Although people received responsive care, people’s care records were not contemporaneous. Quality assurance audits were carried out, but some evidence of audits were not recorded. Staff did not always follow the requirements of the Mental Capacity Act 2005 although staff were able to demonstrate to us their understanding of it.

People were not always shown respect by staff or encouraged to be independent. However, we did find staff caring and kind. People were happy living in the home and we found the environment was clean, hygienic and homely. The registered provider was carrying out works on the home to help improve the environment for people with poor mobility or living with dementia.

People’s medicines were managed safely. Important information about people’s healthcare needs and medicines were recorded in their care plans. Staff worked alongside healthcare professionals to meet people’s health needs. Where any accidents, incidents or infections occurred, staff took appropriate action in response to them; however we found that this was not always recorded.

People were cared for by sufficient numbers of staff. We did not see people having to wait to receive care or support. Appropriate checks were carried out when recruiting staff to ensure that they were suitable for their roles. Staff were aware of their responsibilities in relation to keeping people safe. Both in respect of keeping people safe from harm because individual risks had been identified and also in respect of signs of abuse. People were comfortable with speaking with staff if they had any concerns.

There was a procedure in place to help ensure that people were kept safe in the event of an emergency. People lived in a safe environment. Even though there was a large amount of building work going on staff had undertaken a risk assessment to ensure people were kept free from harm. Regular checks were made on equipment and services within the home to check they were well maintained.

People were provided with food that matched their preferences. People had access to activities that suited their needs and to help ensure they did not feel isolated. People’s individuality was recognised by staff and as such staff supported people in relation to their personal needs. People’s needs were assessed before they moved into the home to help ensure they received appropriate care.

The registered manager created a positive culture and staff felt supported by her. Although there was a clear management structure in place it was evident that all staff worked together as a team. The registered manager was very hands on throughout the day. Staff received training appropriate to their roles and the provider’s values. Staff benefitted from regular supervision and appraisals.

During our inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made one recommendation to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

Wolfe House Care Home provides personal care and support for a maximum of 13 older people, some of whom may be living with dementia. On the day of our inspection 11 people were living in the home.

This was an unannounced inspection that took place on 6 November 2015.

The home 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.

Staff did not always follow correct and appropriate procedures in dispensing medicines and we have made a recommendation to the provider in relation to this.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff followed the correct procedures for people who did not have capacity to make decisions for themselves.

Care was provided to people by staff who were trained and received relevant support from their manager. This included regular supervisions and undertaking training specific to their role.

Care plans were individualised and contained information to guide staff on how someone wished to be cared for. Information included detail around people’s mobility, food, personal care needs and activities. Care plans were reviewed regularly and we read that where people had risks identified guidance was in place for staff to help reduce these risks.

We saw evidence of quality assurance checks carried out by staff to help ensure the environment was a safe place for people to live and they received a good quality of care. Staff were involved in the running of the home as regular staff meetings were held. People were asked for their views about all aspects of their care and could make their own decisions.

There was a relaxed atmosphere in the home where people and staff interacted in an easy-going manner. It was evident staff knew people well. People and relatives were happy with the care provided and they were made to feel welcome when they visited.

There were a sufficient number of staff to care for people. Staff supported people to take part in various activities and arranged activities that were individualised. People were treated with respect and dignity by staff.

The provider had ensured safe recruitment practices were followed, which meant they endeavoured to employ staff who were suitable to work in the home. Staff were able to evidence to us they knew the procedures to follow should they have any concerns about abuse or someone being harmed.

People had care responsive to their needs. For example, one person preferred to spend time in their room and another required a lot of rest in bed and we saw staff provided this. People were provided with a home cooked meal each day and drinks and squash were available for people. Those who had dietary requirements received appropriate food to ensure they were not at risk of choking.

Staff maintained people’s health and ensured good access to healthcare professionals when needed. For example, the doctor, optician or district nurse.

Complaint procedures were available to people. There was a contingency plan in place should the home have to be evacuated. Regular fire drills were carried out by staff to ensure they would know what to do in the event of a fire.

There was an open positive culture within the home and it was evident the registered manager had good management oversight and was respected by staff. This was reiterated by relatives we spoke with who told us the registered manager had, “Got it just right.”

We carried out an inspection at Wolfe House Care Home to look at the care and treatment that people who used the service received.

At the time of our inspection the service provided care and support to 12 people. As part of our inspection we spoke with three people who used the service and four relatives. We also spoke to five staff which included the registered manager and the provider.

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?

Is the service safe?

We found that people were being cared for in a clean, well maintained environment. We saw that, where appropriate, extra security had been installed to ensure the safety of the residents. For example we saw a fence had been erected in the front garden to minimise the risk of people wandering out onto the road.

When we looked at a sample of care plans we found that risk assessments were in place to provide information to staff to help minimise any identified risks. One relative that we spoke with told us, “I have no concerns whatsoever that my relative isn’t safe.” Another relative we spoke with said, “I don’t have to worry about my relative’s welfare.”

We saw that the recruitment practice was safe and thorough to ensure that only staff suitable to work with vulnerable people were employed by the service. Staff we spoke with confirmed that they had provided referee contact details from their previous employer.

Is the service effective?

We saw that people's care plans had been regularly reviewed which ensured they remained up to date in order to reflect a person’s needs. Both the people who used the service and their relatives told us that staff had a good understanding of their needs. One relative said, “They (staff) are responsive to my relative’s needs.”

Is the service caring?

We saw that people were supported by kind and attentive staff. Staff were seen to interact with people well. We saw that staff spent time sitting talking with people.

One person who used the service told us, “The staff are very caring.”

Is the service responsive?

We saw that where people’s needs had changed, or their health deteriorated, staff responded by involving an appropriate health care professional.

Is the service well-led?

The provider had systems in place for regularly monitoring the quality of the service. We saw that the provider had recently carried out a residents and relatives satisfaction survey in order to gain the views from people with regards to the quality of the care and support they received.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plans.

We were told that people had the opportunity to visit the home to help them make a choice. Some relatives visited the home on behalf of their relatives.

People told us that they liked living in Wolf House because it was small and friendly.

People told us that they were happy with the care and support provided and that the staff were kind and caring. One person said

"The staff will go out of their way to help us". One person tolds us that their room was cleaned daily.

We found the home and garden clean and well maintained.

Staff told us that they liked working in the home. They said that they had the training and supervision necessary to undertake their roles.

We looked at the provider's quality assurance systems and found a range of monitoring processes in place to monitor the quality of the service provided.

There were twelve people living in the home on the day of our visit.

We spoke to several people who used the service and five members of staff during our visit.

We also spoke with four relatives who visited at various times.

People told us that they liked living in the home. We were told that the staff were kind and caring and that made it easier to leave their home.

We were told that the home was comfortable and that they enjoyed spending time in the front garden.

Relatives told us that they were always made welcome and kept up to date with all the events in the home.

We were told that the food was good and that there was a good variety.

People told us that the food was very good and that they had had fresh runner beans from the neighbour’s garden today. They said they the staff were nice, and looked after them very well.

People told us that they felt safe at the home, they were treated well, that they had no complaints but knew how to make one if they did.

People who use the service, their relatives and a district nurse, said the home is always clean, spotless and smelt fresh. People who use the service and their relatives said the food was always very good and said they could have an alternative if they didn’t like what was on the menu. People told us they like their room, that they were happy at the home, that they had no complaints, and knew how to make one if they needed to.

A GP wrote in the compliments book saying they were very happy with the care provided, and the staff always had a good understanding of the patients’ or problem (health needs).

Staff told us how they had an induction to the home, which included infection control, manual handling, food hygiene and safeguarding, and that they had regular supervision and appraisal, and additional ongoing training.