About the service: York House is a residential care home that provides personal and nursing care to up to 43 people aged 65 and over. At the time of the inspection 31 people were receiving care at the home.

People’s experience of using this service:

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• People received care that met their individual needs from a team of caring and dedicated staff.

• Staff took time to get to know people and responded well to their care needs. Where possible, people’s preferences were met and they were encouraged to maintain their independence.

• Staff assessed and reduced potential risks to people’s safety.

• Staff were recruited and trained effectively to ensure people’s health and wellbeing was promoted.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• There were effective systems in place to monitor and improve the service. If issues of concern were raised, management responded promptly and appropriately.

• The registered manager had very recently been promoted from the position of deputy manager. As this was their first appointment as a registered manager, they were receiving support from senior management at the time of inspection. The registered manager demonstrated a good understanding of the service and of the requirements of their role.

Rating at last inspection: At the last inspection, the service was rated Good. (Published 31 August 2016)

Why we inspected: We inspected this service in line with our inspection schedule for services rated Good.

Follow up: We will continue to monitor this service according to our inspection schedule.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was an unannounced inspection that took place on 02 August 2016.

York house is a residential care home that can provide up to 43 people with accommodation and personal care. At the time of the inspection, 34 people were living in the home.

There was a registered manager at the service. 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 were happy living at York House. They received care and support that was based on their individual needs and choices. This was provided to them by kind, compassionate, caring and polite staff who knew them well and who treated them with dignity and respect.

There was an open and transparent culture within the home. People and staff could openly voice their opinion if they wished to without hesitation. They could be confident that they would be listened to and that any concerns would be acted upon. People were supported to make their own decisions about the care and support they received.

People were safe living in York House and there were enough staff to help them when they needed support. People received their medicines when they needed them and risks to people’s safety had been assessed and actions taken to reduce the risk of them experiencing harm.

People received enough to eat and drink and were supported by the staff to maintain their health. They were encouraged to participate in activities that were of interest and meaningful to them to enhance their quality of life.

Good leadership was in place that provided staff with the necessary support and training to make sure people received good quality care. The provider had effective systems in place to monitor and improve the quality of care that people received. People could be confident that where any shortfalls were identified that action would be taken to address these.

Throughout our inspection visit to York House we received comments such as, "I like living here. The staff are supportive and caring and the meals are great." "I speak my mind and will say if I am not happy. The staff will always sort me out." We found that people were offered choices and treated with dignity and respect.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We read personalised details in the care plan but noted that improvements could be made on the day to day records written by the staff on each shift. Risks had been identified and acted upon to ensure people were cared for as safely as possible.

Meals and meal supplements were provided with choice and appeared nutritionally balanced. We were told how much they were enjoyed. We received comments such as, "....The food is lovely, ....I am never hungry as we can have as much as we want,.....We have a great cook who looks after our food needs well,....I can never complain about the food and I really like my food.”

The medication was administered to people safely. People were supported by competent staff correctly with their medication needs. All storage of medication and controlled drugs was secure. People were assured their medication was appropriately managed.

During our inspection on 6 September 2012 we found that there were not enough staff employed by the provider to meet the needs of the people living at York House. At that inspection we received negative feedback from the people using this service demonstrating that they were not being cared for how they wished. For example, when talking with one person about time pressures on staff they told us that they did not get to choose when they went to bed they commented “I got told I had to go to bed now – it was like now or never”

The purpose of this inspection, carried out on 01 February 2013, was to ensure that the necessary improvements had been made. We found that they had.

Since our last inspection, the provider had recruited additional staff. Staff confirmed that improvements had been made and our feedback from the people using this service was generally more positive.

To help us understand people's experiences we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

We found that although during the period of our observation there were limited staff interactions we saw that when staff did approach and speak to people they did so in a friendly and respectful manner. On one occasion we saw a member staff bend down and speak with a person to enable more effective communication and that on another occasion a member of staff responded promptly when a person asked them for their assistance.

We spoke with four people and a relative of one of the people using the service. We were told that "the staff are all good and kind" and another person told us "I am quite happy here - I get on well with the staff"

However, all people we spoke with raised concerns about the numbers staff available to help them with their needs. One person told us "The girls [staff] don't have five minutes to talk to you, I feel the place is falling apart from what it was". When we asked them if they had to wait long periods of time to receive care they responded "Yes sometimes". Another person told us that due to time pressures on staff they sometimes did not get to choose when they went to bed, they commented "I got told I had to go bed now - it was like now or never".

On our arrival at the home people confirmed they enjoyed being in the home and that they were well cared for. One person told us that staff were ‘very, very good’ and if they could not be in their own home then York House ‘would do fine.’

Everyone told us that they enjoyed their meals and when we discussed their needs, we were told that staff did know what to do and how they preferred to be helped. People told us they could speak with staff and have a laugh.

People living in the home and visitors did say that there was sometimes a bit of a wait if they needed to use the call bell. However, they did say that staff were usually available to help when needed and were always caring.