Bempton Old Rectory Residential Home provides care and accommodation for up to 17 older people some of whom have a dementia related condition. Accommodation is over two floors with lift access to the first floor. There is an enclosed garden to the side of the building. There were 17 people living at the service at the time of the inspection.

We last inspected the service in September 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

There were safeguarding procedures in place. Staff were knowledgeable about what action they should take if abuse was suspected. The local authority safeguarding team informed us that there were no on going safeguarding matters regarding the service.

Checks and tests had been carried out to ensure that the premises were safe. Medicines were managed safely.

Recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. There were sufficient numbers of staff deployed to meet people’s needs. Records confirmed that training was available to ensure staff were suitably skilled. Staff were supported through an appraisal and supervision system.

People's nutritional needs were met and they were supported to access healthcare services when required.

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.

We observed positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity.

Care plans were in place which detailed the individual care and support to be provided for people. These were clearly linked to risk assessments.

Arrangements for social activities met people’s individual needs. An activities organiser was needed but recruitment had been difficult because of the rural position of the service. The registered manager and staff had organised activities until a replacement could be recruited.

There was a complaints procedure in place. No complaints had been received since our last inspection.

Audits and checks were carried out to monitor all aspects of the service. Action plans were developed to highlight any areas which required improvement. Staff were very positive about working at the service. We observed that they were positive in their roles when supporting people.

Further information is in the detailed findings below.

The inspection of Bempton Old Rectory took place on 28 September 2015 and was unannounced. At the previous inspection on 15 August 2013 the regulations we assessed were all being complied with.

Bempton Old Rectory in the village of Bempton provides care and support to older people who may be living with dementia. There are places for 17 people. At the time of the inspection there were 17 people using the service. Bedrooms are mainly single occupancy and some have en-suite facilities. There are three lounges which all have a dining area, so people can choose where they sit and eat. There is a rear garden for use in the summer months and a passenger lift to the upper floor. Car parking is on the street as only two cars can park by the side of the property

The registered provider is required to have a registered manager in post and on the day of the inspection there was a registered manager in post. This person had recently tendered their resignation due to retirement and so they were unavailable because they were on annual leave. 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 inspection was hosted by the registered provider and a ‘bank’ senior staff member, who had also worked as a relief care worker in past years and therefore knew the service and the people that used it.

We found that people that used the service were protected from the risks of harm or abuse by effective systems in place to prevent and monitor suspected or actual abuse. People were also protected from abuse because staff employed to care for them were trained in safeguarding people and understood their responsibilities to look out for, report and record any potential or actual incidents.

People were encouraged to maintain their independence and exercise their rights. People were encouraged to take reduced risks in maintaining their independence and all risky activities were risk assessed and risk managed. We found that the premises were well maintained and certificates of safety and contracts for maintenance work were kept up-to-date and so the premises were safe for the purpose of providing care and accommodation to people that used the service.

We found that whistle blowing, accident and incident procedures were in place and followed to ensure people were protected from repeated risks of harm occurring. We found there were sufficient staff on duty to meet people’s care and health care needs. People that staff cared for were protected from the risk of receiving support from staff that were unsuitable, because there were effective systems in place to recruit new staff.

We found there were systems in place to manage medicines safely, because medication was appropriately requested, received, stored, recorded, administered and returned when not used. The premises were clean, hygienic and comfortable.

We found that staff were appropriately trained to carry out their roles, some had caring qualifications, all had been inducted to their positions, were regularly supervised and had their performance appraised.

Communication within the service was good and helped to ensure people that used the service received the care and support they required. All care and support was carried out appropriately and especially for those people that did not have the capacity to make their own decisions. In these cases the registered manager followed the law that had to be implemented to ensure people’s rights were protected and upheld.

We found that people’s nutritional requirements and personal health care needs were met according to their individual preferences, medical diets and medical conditions they had been diagnosed with. Staff worked well with other organisations and professionals and establish effective working relationships to ensure people were well cared for.

We saw that while the premises was traditional in its environment there were some features in place to assist people living with dementia. Although the service could build and improve on this. We did not see any negative impact on people’s lives as a result of the environment. The environment was homely, people knew their way around the premises without any difficulty and the levels of dementia some people were living with were low.

We found that people were treated with respect by a staff group that were caring, compassionate and understanding. Staff not only provided personal care and support but they worked at ‘lifting people’s mood’.

People’s general wellbeing and demeanour was taken into consideration by staff that checked if people were alright emotionally and psychologically as well as physically, and people’s privacy and dignity were at the forefront of all care and support that staff provided.

We found that the staff group were responsive to people’s needs in respect of activities, individuality, complaints and concerns. Activities and pastimes were available but had lapsed recently due to the activities coordinator leaving. This was an area the provider was looking at with the view to restoring frequency and variety. People said they had no reason to complain as the service met their needs.

The service was very well led by a conscientious registered manager, who was respected and well supported by staff. The registered manager led by example and took on responsibility for meeting people’s needs by ensuring staff knew their roles and were equipped to carry them out. The service was checked for its quality through the use of satisfaction surveys and a series of audits, information form which was analysed and used to devise action plans for changes and improvement.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We saw documentary evidence that people agreed their care plans and gave written consent to the support they received.

People we spoke with told us they were “quite happy with the way things were”. They said, “Oh we keep ourselves busy”, “The staff are lovely”, and “The food is usually very nice”.

We found that the systems in place for handling medication and the practices in operation for people to receive their medication were safely managed, which meant people received medicines when they needed them and their health and welfare were maintained.

We saw that appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place, so people were protected from the risk of being care for by unsuitable staff.

We found that people that used the service, their representatives and staff were asked for their views about their care and treatment, using a wide range of satisfaction surveys. Their responses were acted on. There was an extensive system of auditing and monitoring regarding the whole of the service provision. People benefitted from these so that they experienced a continuously improving service of care and support.

We spoke with six people that used the service about being involved in their care and having their privacy and dignity upheld.

They told us they felt they had been well treated and that staff had provided the personal care they needed in a way that maintained their dignity.

People told us the staff were "Lovely" and that they felt valued. They said they could make their own decisions or ask for support if they needed it and that they enjoyed some simple pastimes.

Not applicable as people and staff in the home were not interviewed.