This inspection was carried out on 2 and 3 May 2018 and was unannounced.

Wyndham House is a residential care home registered for up to 50 people. 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. At the time of the inspection there were 44 people living at the home.

The home specialises in the care of older people.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Good

Why the service is rated Good

People felt safe at the home and with the staff who supported them. One person told us, “I feel very safe here. All the staff are lovely to you.” There were sufficient numbers of well trained and competent staff to meet people’s needs and maintain their safety.

People had their needs assessed and staff provided care in a way that met their needs and respected their preferences and wishes. Staff supported people with kindness and compassion. One person said, “Everyone is very kind and I couldn’t be more comfortable.” Another person told us, “I just can’t speak highly enough of the staff. All the carers know us and all about us.”

The staff worked in partnership with other professionals and community groups to meet people’s health and social needs. People said staff supported them to see healthcare professionals according to their individual needs.

People were 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 supported this practice.

People had opportunities to take part in a wide range of activities. One person said, “The activities here are the icing on the cake. We do all sorts, things I never thought I would. I don’t think you could find a better place than Wyndham for the entertainment and activities.” People were also supported to follow their own interests and hobbies and maintain their independence.

The home was well led by a registered manager who had a clear vision and ensured people’s individuality was respected. 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.

Further information is in the detailed findings below

This inspection was unannounced and took place on 18th January 2016.

Wyndham House provides care and accommodation to up to 50 people. The home specialises in the care of older people. At the time of this inspection there were 35 people living at the home.

The last inspection was carried out on 17th June 2014. No concerns were identified with the care being provided to people at that inspection.

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 in the process of changing. A new manager was registering and the process was almost complete. The new manager had been the deputy manager in the home and knew people living there and the staff well.

People felt safe at the home and praised the staff who supported them. One person said “Really and truly you could not ask for better, you tell them what you need and they respond. I feel safe here, I have privacy and they are very careful with dignity. They always knock on the door, even if it’s open.”

There were sufficient numbers of staff available at all times to keep people safe and to meet their needs. People we asked said there were always staff available to assist them when they needed help. One person said “Overall it suits me well. I can’t find fault with it. ”

Risks of abuse to people were minimised because the service recruitment procedures included checks to ensure new staff were suitable. Staff received training to enable them to recognise and report any possible abuse. Staff felt confident that any concerns reported would be dealt with to make sure people were protected. People received medicines safely and at the prescribed times.

People told us they felt well cared for. One person said ““I am going home today. I couldn’t have asked for nicer, kinder people. They have been lovely. They have all come to say good-bye.” Another person said “This is my home now. It is the staff that make it feel like home.”

People received care and support that met their needs and took account of their individual wishes. People were involved in decisions about any care and treatment and were able to make choices about their day to day routines. Care plans contained risks assessments which outlined measures in place to enable people to take part in activities with minimum risk to themselves and others. Risk assessments were updated when people’s needs or abilities changed.

People had access to the healthcare professionals they needed. Staff were prompt in seeking advice from appropriate professionals if they had concerns about a person’s health.

People we spoke with praised the food and told us “The food is good, I am diabetic and I can always find something” “The care here is very good and food and drink no problem” “They are very good at getting me food I can eat and I like” and “They are very good, if you don’t like the food they will find you something else.”

People knew how to make a complaint if they were unhappy with any aspect of their care. People were confident that any complaints made would be taken seriously and action would be taken to address any issues.

The home was well led because there were effective systems in place and a strong management team. People knew who the registered manager was and said there were lots of opportunities to discuss their care or make suggestions about the running of the home.

An adult social care inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five 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?

People felt safe at the home and with the staff who supported them. People we spoke with told us that there were enough staff to meet their needs. One person said: “I certainly feel safe here. I feel very safe. I haven’t found anything to worry about. The staff shut up at night and lock up. Staff come when you ring the buzzer. If you don’t feel well the supervisor is straight up.”

There were systems in place to ensure the safety of the building and any equipment used. There were regular health and safety checks including checking the fire alarm system and hot water temperatures. Equipment was regularly checked by staff at the home and serviced by outside contractors.

Staff we spoke with were aware of the Mental Capacity Act 2005 and how to support people who were unable to make decisions for themselves. Staff were able to tell us about how they had involved other people in making decisions when someone lacked the capacity to make a decision for themselves.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. While no applications have been submitted relevant staff have been trained to understand when an application should be made, and in how to submit one. People’s rights were therefore properly recognised, respected and promoted.

Is the service effective?

People said they received effective care and support. We saw the care plan for one person who had developed pressure damage. The records showed the wound had healed. Staff continued to provide preventative care because the person remained at risk of further skin breakdown.

People told us they continued to make choices about all aspects of their day to day lives and to enjoy daily living as much as possible. One person preferred to do as much for themselves as they could. They told us "I feel free here. I came here from hospital four years ago and I make the most of it. I have a frame and walk round the garden. Sometimes I get into town. The staff encourage us. "

People told us they were able to make choices about what time they got up, when they went to bed and how they spent their day.

Is the service caring?

People told us staff were kind and caring. They commented on the patience and kindness of the staff who supported them. One person told us: “They are excellent. They could not be kinder.” Another person said: “They ask me if I am happy. They are so very good. They really do seem to care about us.”

People we spoke with felt their privacy and dignity was respected. Throughout the inspection we heard and saw staff treating people with respect, asking their views and responding politely to all requests for assistance. One person said: “All the girls are gentle and kind.”

A member of staff told us this was “a good place to work” and felt people’s best interests, care and welfare were considered to be the main focus of the home.

Is the service responsive?

People received care that was responsive to their individual needs. People we asked were very satisfied with the care and support they received.

The home had systems in place to plan and monitor people’s individual care and support. Each person had their needs assessed before a placement was offered to ensure the home was able to meet their needs. From the initial assessment a care plan was written to identify how the person’s needs would be met.

Staff had a very good knowledge of people’s healthcare needs and were able to tell us about how they monitored and treated individual needs.

Is the service well led?

There was a registered manager in place who had many years’ experience of caring for older people. They were very knowledgeable about the needs of people in the home and led the staff in providing good standards of care.

There was a staffing structure in the home which gave clear lines of accountability and responsibility. There was always a senior member of staff on duty to offer advice and support to less experienced staff.

There was a complaints policy in place. We saw that any complaints made were fully investigated and responded to. People we spoke with told us they would be comfortable to make a complaint if they were not happy with any aspect of their care. One person said: “I am satisfied with everything but if I wasn’t I’d complain. I know they would listen.”

People’s views were listened to and action was taken to make sure suggestions were put in place where appropriate.

This was a planned unannounced inspection visit. We reviewed six care records and other records for the management and administration of the service. We spoke with 12 people who used the service, two visitors to the service and the staff on duty. We observed how care and support was provided to people. We looked at the homes environment and whether it met the needs of the people who lived there.

People told us they were very happy about how care and support was provided to them. We were told that they had the help and assistance they needed. One person told us, “I have no worries they look after me well.” One visitor told us, “I come in very often and I see X always looks cared for.”

People told us about their experiences with the staff. Comments included, “Staff are lovely,” and “The staff are excellent I wouldn’t run them down. You wouldn’t get better anywhere.” We observed that people had good relationships with the staff, people and staff interacted well and there was a friendly and sociable atmosphere.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. However, we found that some of the aspects of control of infection practices and facilities put people at risk from the spread of infection.

This inspection was part of the schedule of inspections. We reviewed six care records and other records for the management and administration of the service. We spoke with eight people who used the service, two people visiting the service and the staff on duty. Following the inspection visit we obtained feedback about the service from a GP practice who visited the home on a regular basis.

People expressed their views and were involved in making decisions about their care and treatment. When we spoke with people they told us the staff were respectful to the choices of how they wished to live. We were told that they thought they received the care and support they needed. Comments from people included, “Staff give me the help I need,” and “I can truly say I feel I am looked after.”

The people we spoke with told us they felt safe living in the home. One person told us, “I feel safe here, not on my own, and I am not worried in the same way.” All of the people we spoke with were clearly very confident that staff listened to their concerns and responded quickly if they had worries.

People told us their experiences with the staff. One person said, “Staff are lovely, some I can talk to more than others.” Another person said, “Staff are friendly and approachable, always willing to talk.” A visitor said, “Staff always speak to me when I visit, tell me what is happening, keep me informed.”