Dovehaven House is situated in the village of Birkdale near Southport town centre with all amenities being a short drive away. The home provides single room accommodation for up to 40 adults who need assistance with personal care, including those with a dementia related illness. There are lounge and dining areas on both floors, the first floor being served by a passenger lift. En-suite facilities are available in some rooms, but toilets and bathrooms are also located throughout the building. At the time of the inspection there were 36 people who lived at the home.

A registered manager was in place. 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.

At the last inspection on 23 July 2015 we rated the service as ‘Requires Improvements’. This was because breaches of legal requirements were found. The provider did not have adequate systems in place for the safe management of medicines. In addition the provider had failed to ensure care was only provided with consent in accordance with the Mental Capacity act 2005. We found at this inspection on 06 November 2017 the provider had addressed the concerns and met the requirements of the regulations.

Although a number of people had limited verbal communication due to living with dementia we were able to speak with five people who lived at the home. They told us they were happy and supported by staff who cared for them and treated them well. One person who lived at Dovehaven House said, “These are my girls who work here and are truly wonderful caring people.”

We observed staff providing support to people throughout our inspection visit. The staff were kind, patient and treated people with respect.

We found staff had been recruited safely, received ongoing training relevant to their role and supported by the registered manager. They had the skills, knowledge and experience required to support people in their care. Staffing levels were sufficient to meet the needs of people who lived at the home.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

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.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available around the building for staff to use 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.

People told us they had choices of meals and there were always alternatives if they didn’t want what was on offer. They expressed positive views on the provision of meals that were purchased by the management team. One person said, “Lovely meals and the right portions.” Also another person said, “You do get plenty and they are really good.”

We found during the inspection visit and observing interactions between staff and people who lived at the home, there was a culture on promoting dignity, respect and independence for people. People told us staff treated them as individuals and delivered person centred care. Care plans seen confirmed the service promoted people’s independence and involved them in delivering person centred care that suited each individual.

The design of the building and facilities provided were appropriate for the care and support provided.

People who lived at the home and their relatives told us they enjoyed a

People living at the home, who we spoke with, told us they felt safe living at Dovehaven House, with their needs being met by a kind and caring staff team. They said they were able to make decisions and choices about what they wanted to do, whilst using the service.

We found staff to be well supported and appropriately trained and those living at Dovehaven House looked comfortable in their presence. People we spoke with were very complimentary about the staff team and the managers of the home.

Methods for monitoring the quality of service provided had been well established. Systems had been developed, in order to protect the health and safety of those living at the home.

Comments from those living at the home included:

"We have so much fun with the staff, you wouldn't believe it!"

"It is blooming marvellous. I get everything I need and they (the staff) are so helpful."

"The staff genuinely care about us. They go over and above their call of duty."

People living at the home, who we spoke with, told us they felt safe living at Dovehaven House, with their privacy and dignity always being respected and their needs being met by a kind and caring staff team. They said independence was promoted and they were able to make decisions and choices about what they wanted to do, whilst living at the home.

We found staff to be well supported and appropriately trained and those living at Dovehaven House looked comfortable in their presence. People we spoke with were very complimentary about the staff team and the managers of the home.

Methods for monitoring the quality of service provided had been well established. Systems had been developed, in order to protect the health and safety of those living at the home.

Comments from those living at the home included:

"They (the staff) are very good. They take me to the bathroom in a hoist and usually it is the two people who are looking after me, who bathe me so I know them and trust them."

"The food is good. The home is clean and well kept. The staff are kind. This room (the lounge) was painted last week. I like the Christmas decorations."

"I went to Liverpool in the summer, but the weather hasn't been so good and I would rather be warm inside instead of out in the cold, but if the weather is OK there is usually a trip out."

During our visit to this location we spoke with a number of residents, relatives and staff members. We received positive feedback about most outcome areas and we were told that a good quality of service was provided at Dovehaven House.

Comments from those we spoke with included:

"We can do as we please. No-one tells us what we have to do",

"I get up in the morning when I want and I can get in to bed when I want. I think I would be able to go out if I wanted to",

"I am very comfortable living here. I have everything I need. I feel safe, you know, which is important. The staff are very good. They look after us well and are not the bossy type".

Dovehaven House is situated in the village of Birkdale near Southport town centre with all amenities being a short drive away. The home provides single room accommodation for up to 40 adults who need assistance with personal care, including people living with dementia. There are lounge and dining areas on both floors, the first floor being served by a passenger lift. En-suite facilities are available in some rooms, and toilets and bathrooms are also located throughout the home.

The last inspection of the home was carried out on 29 April 2013. The service was found to be compliant with all the regulations assessed at this time.

This inspection was carried out on 23rd July 2015 and was unannounced.

We were assisted throughout the inspection by the long-term 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.

People who used the service and their relatives expressed satisfaction with the way their care, or their loved one’s care was provided. People described staff as kind, caring and helpful and told us they were treated with respect and dignity.

People expressed confidence in the skills of care workers and felt care workers understood their needs. People told us they felt involved in the planning of their or their relatives care and able to express their views about the service as whole.

We found that the arrangements to protect people against the risks of unsafe medicines practice were not always effective. We identified a number of concerns about the way medicines were managed that could compromise the health and wellbeing of people who used the service.

The support for people who did not have capacity to consent to any aspects of their care was inconsistent and not always in accordance with the Mental Capacity Act (2005). This meant that some people could be at risk of having their liberty unlawfully restricted.

People were satisfied with the support they received to maintain good health. Staff were able to identify any new health related problems and took action to ensure people had access to community health care support when they needed it.

People’s nutritional needs were assessed and addressed. People felt the standard and variety of food provided was good and expressed satisfaction with this area.

Much consideration had been given to how the environment could be adapted to meet the needs of people who used the service. We saw some innovatively designed areas in the home including an old style pub and hair salon.

People felt their care plans reflected their, or their loved one’s, needs and felt able to express their views and choices.

The registered manager demonstrated a positive view of staff training and support. We saw that the training programme was constantly reviewed and developed to help ensure it reflected ongoing developments in best practice.

People described an open culture within which they could express concerns as well as share their ideas and opinions. All staff spoken with were fully aware of the procedures to follow if they were concerned about the safety or welfare of someone who used the service. They were confident managers would support them and respond appropriately in the event they had to report suspected abuse or poor practice.

There were processes in place which enabled the provider to monitor safety and quality across the service. We saw evidence that the majority of these processes were effective and that action was taken when any areas for improvement were identified. However, the systems had not identified the issues we found in relation to medicines management and mental capacity.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to consent and medicines management. The action we have asked the provider to take is detailed at the end of this report.