This inspection visit took place on 09 January 2018 and was unannounced.

Avonbloom retirement home is a care home for up to fifteen older people situated in the south of Blackpool close to Blackpool airport. There are 14 single bedrooms and one double bedroom. The building has two floors with stair and lift access to the first floor. There are two communal lounges and a dining area. Car parking is available at the front of the home on a small forecourt. There are secure accessible gardens at the rear for the use of residents. At the time of the inspection visit there were 11 people who lived at the home.

The registered provider is an individual who has been assessed by CQC as fit to manage the day-to-day running of the service. 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 provider had owned and managed Avonbloom for many years.

At the last inspection, the service was rated overall as Good. The safe domain required improvement in relation to infection control. At this inspection we found infection control had improved and good infection control practices were in place. All domains were good and the service remained overall good on this inspection.

People we spoke with told us they felt safe at Avonbloom. There were procedures in place to minimise the risk of unsafe care or abuse. Staff knew the actions they needed to take and had received training on safeguarding vulnerable people.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been reviewed and monitored and were relevant to the care provided.

People told us there were enough staff on duty and they didn’t have to wait long for assistance. There was a stable staff team who had all worked at Avonbloom for a number of years.

Staff were appropriately trained and supported. They had skills, knowledge and experience required to support people with their care needs.

Medicines were managed safely. People received their medicines as prescribed and when needed and staff were trained and competent to administer them.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required. The design of the building and facilities provided were appropriate for the care and support provided.

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. Staff involved people in planning their care and sought their consent to provide this.

Staff supported people and met their nutrition and hydration needs. People told us they had frequent drinks and snacks and enjoyed their meals. One person told us, “We get plenty here and you can always ask for more if you want it. Another person said, “The food is good we get choices.”

Staff were knowledgeable about the needs of the people they supported and treated them with respect. People told us staff treated them as individuals and respected their diverse needs.

We saw staff interacted frequently with people and engaged them in activities. People told us staff often sat with them just to chat which they said they thoroughly enjoyed. A relative said, “The staff are wonderful. It’s like a home from home.”

People knew how to raise a concern or to make a complaint and told us they were encouraged to raise any concerns. People told us they were happy with care and support they received and had no complaints.

People who lived at the home and relatives told us the home was well led. The registered provider monitored the home, sought people’s views and were receptive to feedback.

Further information is in the detailed findings below

This inspection took place on 25 March 2015 and was an unannounced inspection.

Avonbloom retirement home is situated in the south of Blackpool close to Blackpool airport. The home is registered for 15 older people with 14 single rooms and one double room. Some were en-suite. At the time of our visit 15 people lived at the home. Communal bathing facilities and toilets were available throughout the home. The building had two floors with lift access to the first floor. Car parking was available at the front of the home on a private forecourt. There were gardens to the rear.

The service was last inspected in June 2013. The service was meeting the requirements of the regulations that were inspected at that time.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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.

Risks to people were minimised because the registered provider had procedures in place to protect people from abuse and unsafe care. Risk assessments were in place to reduce risks to people’s safety. People told us they felt safe living at Avonbloom and were very happy there. One person said, “I do feel safe here and the staff are very good to me. They make sure I am safe and happy.” Another person told us, “I know the staff are very good to me.”

Staff had all received training to assist them in infection control. When we looked around the home most areas were clean, and fresh smelling, with good infection control practices. However we saw poor infection control during the inspection in two bedrooms. The registered provider had an infection control policy, cleaning checklists and carried out regular checks for cleanliness, but these areas had been missed on the day we inspected. They were quickly cleaned when we highlighted them.

Although there were plenty of hand gels around the home, the communal toilets had shared towelling hand towels. There was a risk assessment in place regarding the use of these. However shared towels increased the risk of cross infection.  The registered provider informed us after the inspection that disposable paper towels had been purchased and were in use.

We looked at how the home was being staffed. We saw there were enough staff on shifts to provide safe care. People we spoke with were satisfied with staffing levels. One person said, “There are always enough staff to look after us.” The staff team told us the registered provider worked with them daily and made sure people had enough staff to care for and support them.

When we undertook this inspection visit, the service had not recently appointed any new staff members, but had appropriate procedures in place.

Medicines were managed appropriately. They were given as prescribed and stored and disposed of correctly. People told us they felt staff supported them with medicines well.

People’s health needs were met and any changes in health managed in a timely manner. One person said, “The staff act quickly if anyone is ill and always contact the doctor for me if needed.” A relative commented, “[My family member] looks much healthier now and has settled well. The care and attention given is to a very high standard.”

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. One person said of the staff team, “They all seem to know what they are doing and they are kind.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) which meant they 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. The staff team made sure that people’s dietary and fluid intake was sufficient for good nutrition. People were very complimentary about the food. They said that the choices were good, the meals were excellent and that they had no problems getting snacks or drinks outside of meal times. One person said, “I enjoyed my lunch today but then the food is always very good.” Another person told us, “I only have to ask for a particular food and the owners get it in. They are marvellous.” Relatives spoken with were in agreement with these comments.

People we spoke with told us that staff were kind and caring. One person told us “The staff couldn’t be more caring if they tried. They always make you feel that you really matter to them.” A relative told us, “The staff are doing an excellent job in caring for my [family member] the way they do. You can feel the family atmosphere and we see at first hand the way the staff are kind and compassionate to the people they are caring for.”

Staff knew and understood people’s history, likes, dislikes, needs and wishes. They knew and responded to each person’s diverse cultural, gender and spiritual needs and treated people with respect and patience. Staff frequently interacted with people. We saw that any questions or requests by people were handled appropriately and in a kindly way. Staff offered choices and encouraged people to retain their independence wherever possible. People felt they could trust staff and they were friendly and respected their privacy. ”One person said, “They know all our little ways and are always so kind.” “A relative told us, “We have been visiting for a while now so I have seen a lot of what the staff do for the residents in that time. I must say I have been impressed with their enthusiasm and general approach.”

Staff recognised the importance of social contact, companionship and activities. There was a broad and varied activities programme. People said they went on regular trips out, walking or in the home’s minibus to local shops, pubs, garden centres and other places of interest. Staff were very welcoming to people’s friends and relatives. One relative said, “As visitors we are not restricted in any way and are always made to feel welcome.”

There was a transparent and open culture that encouraged people to express any ideas or concerns. People and their relatives felt that their needs and wishes were listened to and acted on. They said the staff team were easy to talk to, were open to discussion and encouraged people to raise questions at any time.

The registered provider routinely worked in the home and dealt with any issues of quality quickly and appropriately. People told us they had not needed to complain but knew how to if they ever needed to. One person said, “I’ve no complaints but I would have no trouble making a complaint to the owner if I needed to. I have not had anything serious to complain about but what points I have raised have been dealt with satisfactorily.” A relative told us, “We have no complaints at all, we are totally delighted.”

We spoke individually with the provider, staff and people living at Avonbloom Retirement Home. We also discussed care with relatives. We additionally observed care being undertaken throughout our inspection. We reviewed care records, policies and procedures, audits and risk assessment documentation.

The service demonstrated good practice that ensured people were cared for in a supportive and respectful manner. One person told us, “I feel safe and comfortable here”. A relative said, “My mum’s safe here, they care for her well”. This was underpinned by the service’s in-depth understanding of consent and safeguarding people from potential abuse.

Care practice and record-keeping was underpinned by clear, regular auditing procedures. There appeared to be sufficient staffing levels for the number of people living at the home.

We observed that staff were able to provide treatment in a respectful, timely and unhurried way. This was because staff were supported to carry out their duties effectively.

We spoke with a range of people about the home. They included, the acting manager, staff and people who lived at the home individually and in a group setting. We also had responses from external agencies such as social services in order to gain a balanced overview of what people experienced. This home cares for people with a range of dementia conditions, therefore there were limited comments made from people who lived there.

Conversation with most residents was limited due to their dementia condition. We therefore spent much of the time in the communal areas making observations of how people were being cared for. However people we spoke with said, "Absolutely marvellous, “Excellent home,” and also, “The staff here can’t do enough for you, I always feel looked after.”