About the service:

• Dr French Memorial Home Limited is a residential care home which provides personal care to older people and people living with dementia.

• At the time of our inspection, 23 people were using the service.

People’s experience of using this service:

• The service was safe and people were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them.

• Risks to people using the service were assessed and their safety was monitored and managed, with minimal restrictions on their freedom.

• There were sufficient numbers of suitable staff to meet people's needs and support them to stay safe.

• Medicines were stored, managed and administered safely. Staff were trained, and their competency checked.

• People using the service were supported to have sufficient amounts to eat and drink and maintain a healthy balanced diet.

• Staff demonstrated a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. People using the service were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People were treated with kindness, respect and compassion. People also received emotional support when needed.

• The atmosphere in the home was calm and relaxed. Staff knew the people using the service well and were knowledgeable about their needs and preferences.

• People and staff spoke highly of the management team and told us they felt supported.

• CQC's registration requirements were met and complied with and effective quality assurance procedures were in place.

• More information is in the full report.

Rating at last inspection:

• At our last inspection, the service was rated "Good". Our last report was published on 11 August 2016.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

This inspection took place on 6 July 2016 and was unannounced.

Dr French Memorial Home Limited is a care home registered to accommodate up to 27 people. Its services focus mainly on caring for older adults including those living with dementia. On the day of the inspection there were 24 people residing at the home.

There was 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.

People told us they felt safe at the home and safe with the staff who supported them. They told us that staff were kind and respectful and they were satisfied with the numbers of staff on duty at the home.

The registered manager and staff at the home had identified and highlighted potential risks to people’s safety and had thought about and recorded how these risks should be reduced.

We saw satisfactory and accurate records in relation to the management of medicines at the home. Staff told us they had attended training in the safe management of medicines and felt confident in this area of their work.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and told us they would presume a person could make their own decisions about their care and treatment in the first instance. Staff told us it was not right to make choices for people when they could make choices for themselves.

People told us they liked the food provided at the home. We saw that choices of menu were available to everyone and the records showed that the menu was regularly discussed with people who used the service.

People had good access to healthcare professionals such as doctors, dentists, chiropodists and opticians and any changes to people’s needs were responded to appropriately and quickly.

People told us staff listened to them and respected their choices and decisions.

People using the service, their relatives and staff were positive about the registered manager and her management of the home. They confirmed that they were asked about the quality of the service and had made comments about this. People told us the registered manager took their views into account in order to improve service delivery.

We spoke to two people who lived in the home and they said that they had lived there for a long time and care workers always looked after them well. They were not able to tell us about their medicines and they said that care workers always gave them to them because that was their wish. The district nurse visited one person to change a dressing when we were inspecting and we saw that the person went to their room so that they could be treated in their own privacy.

We spoke with six people who use the service, four people’s relatives, and two visiting healthcare professionals. There was praise for the service and the care provided. People’s comments included, “it’s an excellent service, very homely and relaxed.” A relative told us, “I’m very pleased with them.” Everyone talked positively about the staff. “The staff are all very nice” one person said. We found that care was planned and delivered in a way that was intended to ensure people's safety and welfare.

Feedback from people and their relatives indicated that the service liaised well with health professionals. Two visiting professionals involved in people’s care told us that the service worked well with them. We found that the service worked in co-operation with other providers involved in people’s care and treatment.

We also found that people were cared for in a clean, hygienic environment, and that people were protected against the risks of unsafe or unsuitable premises.

However, we found that medication arrangements at the service, particularly in terms of handling, administration and recording, failed to protect people against the risks associated with the unsafe use and management of medicines. There was evidence that people did not always receive their prescribed medicines. We judged this as having a major impact on people who use the service.

We are taking action to ensure the provider becomes compliant with the regulations.

We spoke with ten people who use the service and three visitors. People praised the service and the care provided. Comments included, “it’s very well run”, and “they do their best.”

Everybody spoke positively about the staff team. “Delightful staff, very caring,” one person told us. We observed that staff interacted warmly and inclusively with people who use the service. They worked as a team and attended to people in an unhurried and pleasant manner. They were skilled and experienced, and we found that appropriate checks were undertaken before new staff began working with people.

There were systems in place to enable people to experience care and support that met their needs. Staff knew how to engage with people who have dementia. This contributed to there being a calm atmosphere in the home. People’s comments included, “they’re patient with me.” People spoken with confirmed that they trusted staff and felt safe, and that there was no problem in talking with staff or the manager if there were any concerns.

We were supported by an expert by experience during the inspection. An expert by experience has personal experience of using or caring for someone who uses a health, mental health and/or social care service. They sent us a report after the visit which we have used as part of our evidence.

People who use the service spoke positively about the care provided. Comments included, “Staff are very helpful. They always ask if I want an extra blanket.” People generally told us that staff were kind, respectful and easy-going. People told us that their privacy was respected.

Most people praised the food provided, one person calling it “amazing.” People generally told us that they had a choice of meals and drinks, and that there was enough to eat.

People had varied opinions on the activities provided. People generally did not feel that they were asked about what they would like to do, and some people felt that daytime activity provision did not match their preferences.

Relatives told us that it is an ‘excellent’ service. Their comments included that staff were always checking people and paid particular attention to people’s hydration needs.