Autumn Leaves Rest Home is a residential care home that can accommodate 20 older people. The home is a detached property that is close to the centre of Bispham Village. There is an accessible garden area, 2 communal lounges and a dining room. There are bedrooms on the ground and first floor of the home. The first floor is accessible via stairs or a passenger lift. At the time of the inspection visit there were 16 people who lived at the home.

There was a registered manager in place. Autumn Leaves Rest Home is a family run home, the registered manager is also the provider and currently provides oversight to her daughter who manages the day to day running of the home.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People and their relatives told us staff can not do enough for you, a relative stated, “I go home quite content, knowing the right level of care is provided.”

Risk assessments were updated to ensure people were supported in a safe manner and any identified risks were minimised. Where people had suffered an accident, action had been taken to ensure the on-going safety of the person.

Staff had received training appropriate to their role. Staff had received training around safeguarding and were confident to raise any concerns relating to potential abuse or neglect. The administration and management of medicines was safe. There were sufficient numbers of staff working at Autumn Leaves. There was a robust recruitment process to ensure suitable staff were recruited.

We found that the home had very little staff turnover and that the majority of staff had been employed for a number of years. Staff knew people they supported well and were able to describe what they like to do and how they liked to be supported. The service was responsive to people's needs. Care plans were person centred and provided a clear picture of the persons needs, likes and wishes. Life histories are currently being developed which helped staff to understand the person and communicate more effectively.

People were supported to access health professionals when required. Good relationships have developed between the local GP surgeries and other health professionals.

People could choose what they liked to eat and drink and were supported to be as independent as possible and to participate in meaningful activities.

People and their relatives were given information about the service in ways they wanted and could understand. The information provided at the point someone is admitted into the home makes it clear about the service provided and the level of care a person will receive.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

We looked around the home and found it was decorated to a good standard, clean and homely; however the kitchen requires some refurbishment.

The service demonstrated good management and leadership with clear lines of responsibility and accountability within the management team. Autumn Leaves has been owned and managed by the same family for 30 years.

Further information is in the detailed findings below.

This inspection took place on 16 October 2015 and was an unannounced inspection.

Autumn Leaves is situated on Devonshire Road in Bispham, Blackpool. The home is an extended detached property and provides accommodation for a maximum of 20 people. Accommodation is provided in 14 single and three double bedrooms. Double rooms are only used for single occupancy or couples. Communal facilities include two lounges and a dining room. There is a patio and garden at the rear of the home which overlooks a golf course.

The service was last inspected in February 2014. The service was meeting the requirements of the regulations that were inspected at that time.

There was a registered manager in place. However she was in the process of cancelling her registration and the care manager was applying to become the 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 2008 and associated Regulations about how the service is run.

Senior staff had procedures in place to protect people who lived at the home from abuse and unsafe care. Risk assessments were in place which provided guidance for staff. This minimised risks to people. People said they felt safe and well looked after at Autumn Leaves. One person said, “I feel safe in the home. I feel safe with the other service users and the building is very safe.” Another person told us, “I am safe and comfortable here.”

We looked at how the home was being staffed. We saw there were enough staff on shifts to provide safe care. One person said, “The staff come quickly if I have had to ring my call bell which is usually during the night, when I am unwell.” Another person told us, “Whenever I ask for help the staff are there with a cheerful smile.”

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working in the home. Staff had the skills, knowledge and experience needed to care for people.

Staff managed medicines safely. They were given as prescribed and stored and disposed of correctly. People were able to manage their own medicines if they were able to do so safely. People felt staff gave them their medicines correctly and when they needed them.

The environment was well maintained, clean and hygienic when we visited. There were no unpleasant odours. One person said, “It is nice here and the staff make sure it is clean every day.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). The registered manager discussed an application she had submitted. This showed us staff were working within the law to support people who may lack capacity to make their own decisions.

People were offered a choice of healthy and nutritious meals. Staff made sure people’s dietary and fluid intake was sufficient for good nutrition. One person said, “The food is very good and there are snacks and drinks available whenever you want them. Fresh fruit is also available in the dining room.”

People felt they could trust staff and had the freedom they wanted to make decisions and choices. One person said, “I can trust the staff to do the best for me.” They said staff made sure their privacy was respected when providing personal care. One person said, “The carers are very kind and caring they respect my privacy but also allow me to be independent.”

People said there were activities available. One person said, “Staff often just sit and talk to us. I do enjoy that.” A relative told us, “I came in one day to find [my family member] playing skittles with staff and laughing. It was good to see.”

People’s health needs had been met and any changes in health managed well. People said staff quickly arranged for them to see healthcare professionals when they needed them.

We asked people if they knew how to raise a concern or to make a complaint if they were unhappy with something. One person said, “I have a complaint form in my room should I wish to use it, but so far it is very good.” Another person told us, “I have not had to complain about anything in the home in all the time I have been here.”

There was a transparent and open culture that encouraged people to express any ideas or concerns. Senior staff sought people’s views and dealt with any issues of quality quickly and appropriately. One person told us, “I am very happy here. The staff are very good.”

We spoke individually with three staff at Autumn Leaves. We also discussed standards of care with three people living at the home and a relative. We observed staff interactions with people in their care. We checked the home’s practices in relation to staffing levels and working with other providers. We reviewed policies and procedures, care records and various audit processes.

We observed staff interacting with people in a compassionate, dignified and supportive manner. One relative told us, “The staff are very good and kind to my sister and I take her out occasionally because she then gets out of the home”. Care provided matched service user’s related care plans. Care records were person-centred and reviewed regularly. We found evidence that people’s continuing needs were maintained when Autumn Leaves worked with other providers.

People were cared for under appropriate staffing levels and skill mixes. Suitable systems were in place to monitor the quality of the service provided.

We spoke individually with two people living at Autumn Leaves UK Ltd, as well as relatives. More informal discussion also took place in communal areas of the home, at various times during our visit. We asked people to tell us about their experiences of living at the home. People told us they were very happy living there.

We were also told that the staff team were supportive and kind. People felt comfortable and relaxed as a result of the care they received. One person said, "It's very good here, you couldn’t find better care anywhere else". Another individual told us, “The staff really look after us and I never get bored."

We observed the interaction between the staff and the people who used the service. We observed that staff were respectful of people and treated them with dignity. For example, we saw staff knocking on people's bedroom doors before entering. We also saw staff engaging with people in a respectful and caring manner.

During the church service that took place during our inspection, people were seen to be happy and enjoying themselves.

Care records and staff files were of a good standard and policies and procedures were up-to-date. The home was clean and tidy when we were shown around.

We spoke with a relative who told us "I feel very reassured about mum being here. It’s a lovely home and I feel mum is safe here".

We spoke to people about their relatives experiences living in the home and were told the staff team provided sensitive and flexible personal care support. They told us routines were flexible and they could visit whenever they wished. They said the standard of food was very good and the activities organised kept people entertained.

People told us they can express their views and are involved in decision making about their relatives care. They told us the provider and her manager were very supportive towards them and they felt listened to when discussing the care needs of their relative. People visiting the home told us they had no concerns about the care being provided and felt the people living in the home were safe and protected from potential harm. They told us they were very happy with the standard of accommodation being provided and they were consulted about the service being provided and felt their views were listened to.

“I visit my mum most days and I am fully involved in her care. I am always updated about her care whenever I visit and they contact me immediately if they have any worries about her”.

“We looked at a number of homes for mum and this was the best. It was clean, smelt fresh and the atmosphere was very relaxed. I have never regretted choosing this home and I know mum is getting the best care available”.

“Very happy with mums care. I visit most days and find the staff are kind and friendly. We discuss mums care whenever I visit and I am always updated if any changes are to be made following their reviews. Mum tells me the food is very good and she is happy and settled”.

“I love it here, everything is excellent. The staff are ever so kind and I like the food. I enjoy all my meals and get plenty to eat”.

“I am very happy thank you. I always said if I needed care this was the home I wanted to move to. I was delighted when my family were able to get me a room. I am completely pampered and looking forward to my dinner”.