This inspection took place on 2 September 2016 and was unannounced.

The provider of Woofferton Residential Home is registered to provide accommodation and personal care for up to 15 people. At the time of this inspection 14 people were living at the home.

The registered provider was also the registered manager and was present for our inspection. 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 service was last inspected on 15 April 2014 and was meeting the requirements of the law in all areas inspected at the time.

People were kept safe by staff who understood how to identify and report potential harm and abuse. Staff were aware of the risks to people and what they needed to do to help reduce those risks, such as helping people to move safely around the home. People were supported by sufficient numbers of staff who had the skills and knowledge to meet their needs. People were supported to take their medicine when they needed it.

Staff respected and supported people's right to make their own decisions and choices about their care and treatment. People's permission was sought by staff before they helped them with care tasks. Staff had received training relevant to their roles and felt supported by the registered manager. People were supported to eat and drink enough to maintain good health. People had access to other healthcare professionals as required to make sure their health needs were met.

People felt staff treated them with kindness and compassion and they felt involved in their own care. Staff respected people's dignity and privacy and supported them to keep their independence. People received care that was personal to them because staff knew them well. People received their care when they needed it and were not kept waiting by staff when they asked for assistance. People knew how to make a complaint and felt able to discuss any concerns with the registered manager.

The registered manager and staff had created an environment that was homely and welcoming. The provider encouraged staff to value people and support them in a dignified and compassionate way. Staff were clear on their roles and spoke about the people they supported with fondness and respect.

We saw that systems were in place to monitor and check the quality of care and to make sure people were safe. The provider used the information to drive continuous improvement of the service they provided.

We conducted a visit to the home and during this time we spoke with two staff and six people who used the service.

This is a summary of what we found-

Is the service safe?

The people we spoke with told us they felt that their dignity was respected and they were assisted to live their life as they wished. They considered they were kept safe and listened to. We observed that people were free to go about their daily routine as they wished. One person told us, “I feel happy here. The staff are always on hand to help me and I can do as I please”.

We saw records that informed us that a person living with dementia was cared for effectively by staff who responded to their dignity and protected them from harm. The staff had worked with external healthcare professionals to improve the safety and quality of life for the individual.

Staff understood generally about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how they would be put into practice in the service. No applications had been submitted.

Recruitment practice was thorough and safe for new starters. The checks required by legislation had been carried out before the applicant cared for people who used the service. This meant that suitable staff were employed to care for people who used the service.

Is the service caring?

The people we spoke with told us that staff treated them kindly and that their individual needs were met. We saw in records that people’s care was regularly reviewed with them and that they were encouraged to be as independent as they wanted to be. The registered manager had made changes to the staffing structure and compliment of the home. There had been an emphasis on respectful behaviour and positive attitudes towards people who used the service. People told us that their relative was encouraged to make their views of the care known to staff. This showed that staff listened to people and cared about them if they were unhappy with anything. Staff told us they tried to look after people in the way they wanted.

Is the service responsive?

The people’s views were sought through an annual survey. This meant that people could express their views anonymously if they wished. We were told that the registered manager was regularly in contact with people so any issues were discussed on an informal basis as and when they occurred and action immediately taken. We saw records that told us a person’s ability to make decisions had been considered. Contact with other health professionals ensured that the person received the external professional support they required. This meant people were supported to express their views and staff were responsive to their needs to enhance their well-being.

Is the service effective?

People’s on going needs were regularly re assessed and care planned with them. The registered manager had received information from the funding authority where it had not been possible to visit the individual in person before admission. Records for pre admission assessments were in place. People told us they had been satisfied with how they were admitted to the service. They said they had been asked about their preferences, choice and wishes before they moved in. Staff we spoke with showed that they knew people’s needs well. This meant people were supported to maintain optimum health and well-being and that planned care was effective.

Is the service well led?

Since our inspection December 2013 the registered manager had reviewed the documentation of the service and made improvements to the records that the service kept.

Staffing had been reviewed so that more care staff hours were on the rota at weekends. Staff stated that “This has made care better for people all the time”. The provider may wish to note that although the rotas were better they did not display the full name, qualification and role within the home and nor were the registered manager shifts clearly recorded. This meant it could not be clear to people who actually worked on any day.

The system to assess and monitor that there were sufficient numbers of staff, with the right competencies, skills and knowledge to meet people’s needs was improved upon and in place. We saw that staff practice was monitored and questioned and concerns dealt with through the appropriate channels. This meant the service had implemented a more inward looking practice and had recognised the need to improve their management systems to lead the home better.

People shared positive experiences of the care and support they received. Comments included, "I have no complaints and I am very well looked after here. The staff are very helpful" and, "There is a good atmosphere here and the staff are kind". People who were self-caring or immobile had their needs met. Other people with more challenging behaviour had their ability to express choice and control over their lives compromised.

Staffing levels at Woofferton were not sufficient to meet all of the preferences and choices of the people that lived in the home, particularly at night. Some people considered there were enough staff on duty to meet their current needs. They said, "I have no complaints and if I needed more help I expect that would be given". Staff told us they were rushed to get work done, particularly at weekends when less staff were on duty. We were told caring and domestic roles and responsibilities were not entirely clear. There was no deputy manager in place when the registered manager was not on duty. This meant staff were sometimes engaged in non-care duties and the provider could not ensure that staff could respond to people’s changing needs.

The provider acknowledged at our last inspection in January 2013 the need to produce and monitor the service’s records more robustly. The care records in place did not enable staff to be aware of problems swiftly and act upon them to keep people safe at all times. This meant staff may not understand how people preferred their care to be delivered. Other records required to be maintained were not easily accessible as the manager was not on duty.

People we spoke with told us that they received the care and support they needed. Comments included, “Everything is well catered for”. “I am being very well looked after”.

We viewed records that showed people had been involved in and consulted about their care and support. People received a care needs assessment prior to being admitted to the home. We saw that staff supported people sensitively and politely. We spoke to people who said staff promoted their privacy and dignity whilst delivering their care.

The service had systems in place to manage and monitor the prevention and control of infection within the home. The provider had carried out some refurbishment to the décor of the home.

People told us that the staff asked them if they were alright and if they were happy with everything. They said that they were able to express their wishes and share their views about how they were feeling. People said that if they had any concerns or worries that they would speak with a member of staff or the manager.

People told us that they enjoyed living at this home and that they very much considered it ‘their home’. They told us that they were involved in planning their care, that their views were always taken into account in the way the service was provided and delivered. Peoples’ comments were:

“Absolutely very good in every respect.”

“The food is superb.”

“Everyone seems happy, looked after well, staff explained things very well”.

People said their privacy and dignity was always respected and their independence promoted. They said that staff made a difference to their lives.

People told us that the home was very well run and that staff were kind and considerate. “The care is superb, it’s a happy home and I’m very well looked after here”.

People told us they were happy with their bedrooms and that they can either remain in the privacy of their own room or join other people in the lounge. They said their rooms were kept clean and when they moved in they were encouraged to bring in some of their personal belongings to make it their ‘own’.