Aliwal Care Centre provides accommodation, support and care, for up to 32 adults and older people, some of whom live with dementia. 32 people were living at the service on the day of our inspection.

This inspection was undertaken by one inspector and an expert by experience of people who are living with dementia. At the last inspection on 10 October 2014 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Systems were in place to manage risks to people using the service and to keep them safe. This included fire safety.

There was sufficient staff on duty to keep people safe. A thorough recruitment and selection process was in place, which ensured staff recruited were suitable to work with people who used the service.

People received their medicines as prescribed and received care and support when they needed it from staff who had the skills and knowledge to provide safe and appropriate support.

The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were assessed so that their care was planned and delivered in a consistent way. The registered manager and staff talked passionately about the people they supported and knew their care needs well. Staff offered people choices, for example, how they spent their day and what they wanted to eat. These choices were respected.

People were supported to maintain their nutrition and staff had the information they needed to monitor and respond to people’s health conditions.

People lived in a service where staff treated them as an individual and encouraged them to maintain relationships. People were supported to take part in activities of their choice..

The provider had a range of systems in place to assess, monitor and improve the service. Significant improvements had been made to the interior décor since our last inspection. People had been consulted on the improvements made to the premises and their choices had been respected. People, their relatives and staff were regularly asked for their feedback about the quality of the service provided. Feedback was used to recognise good practice and to drive improvements where shortfalls were identified.

Further information is in the detailed findings below.

This inspection was carried out on 14 October 2014. It was an unannounced inspection and was undertaken by two inspectors.

Aliwal Manor is a registered care home which provides accommodation, support and non-nursing care for up to 32 older people including those living with dementia. The home is divided into four units over two floors. There were 30 people living at the home when we visited.

At the time of our inspection the home had 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 our previous inspection on 12 July 2013 we found the provider to be meeting all the regulations that we looked at.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation on Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected and DOLs applications were in progress. Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that they were working within the law when they cared for people who lacked the capacity to make their own decisions. We saw that there were policies and procedures in relation to the MCA and DoLS to ensure that people, who could not make decisions for themselves were protected.

There was process was in place to ensure that people’s health care needs were assessed, so that care was planned and delivered in a consistent way. Staff were seen to support each person according to their needs. This included people at risk of malnutrition or dehydration who were being supported to have sufficient quantities to eat and drink.

We saw that staff respected people’s privacy and dignity. They knocked on people’s bedroom doors and waited for a response before entering. People told us that staff ensured doors were shut when they were assisting them with their personal care.

People confirmed they were offered a variety of chosen hobbies and interests to take part in and people were able to change their minds if they did not wish to take part in these.

There was a complaints process in place which was available in the entrance hall to people, relatives and others who used and visited the service. People confirmed that they would not hesitate in making a complaint if they needed to.

The provider had clear recruitment process in place. Records we looked at and staff we spoke with confirmed that staff were only employed after all essential checks had been satisfactorily completed.

The provider had an effective quality assurance system in place to monitor and improve the quality of care it provided. There was a programme of audits that involved people who used the service, families, health care professionals and others on a regular basis. When improvements had been identified these had been undertaken.

All of the six people with whom we spoke gave us positive feedback about the service. One of them said, “The staff are good to us and help us a lot”.

We saw that people had been given accurate information about the fees they would have to pay. Records showed that people had been correctly charged for the facilities and services they had received.

People said or showed us that they received all of the health and personal care they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

We saw that there were enough staff on duty to enable people to promptly receive the assistance they needed.

Documents and records were accurate and easy to find so they supported staff to run the service in a safe and reliable way.

During our inspection on 21 February 2013, we spoke with the people using the service, manager and staff on duty.

People we spoke with told us they were happy living at Aliwal Manor, and they liked the staff. One person said, “Its like home, I’m well looked after. The food is good. I can choose what I want. Nothing is too much trouble”. Staff treated people with respect and supported people to maintain as much independence as possible.

The care plans that we looked at gave staff suitable guidance for staff to follow to ensure that they were able to provide the care and support that each person needed. Risks to people had been assessed.

All staff had undergone training in safeguarding vulnerable adults. When we spoke with staff they were clear about their responsibilities to report concerns or allegations of abuse.

Staff had undergone sufficient training relevant to their role, so they were able to offer people the support they needed. Staff had received regular supervision and an annual appraisal of their development. They told us they felt supported by the manager and the staff team.

Some areas of the home had recently been redecorated and further decorating had been planned to ensure the home would be well maintained.

The provider had a complaints procedure in place. People we spoke with said they would be comfortable talking with staff should they have a complaint although they told us they had never had any reason to complain.

People we spoke with during our visit on 11 November 2011 were satisfied and positive about the care they received and said they felt safe living at the home. People's comments included, "I've lived here for some years and would not want to live anywhere else" and "The staff are always here for me, its very good" and "I think they (the staff) are very respectful". People also informed us they were satisfied with their accommodation.