About the service: Edmore House Residential Home is a ‘care home’. People in care homes receive accommodation and personal care. The care home accommodates 18 older people in one adapted building. There were 17 people living at the home when we inspected.

What life is like for people using this service:

• People enjoyed living at the home and were complimentary about the way it was managed. One person told us, “It’s really good, for everything. I’m very happy here; it’s like living in a hotel.”

• People, relatives and staff told us they saw the provider and registered manager regularly, and found them approachable.

• A health professional who visited the home to support people living their emphasised how well staff knew people’s health and well-being needs, which helped to ensure their health and well-being was promoted.

• Staff understood risks to people’s safety and supported them to stay as safe as possible.

• There were sufficient staff to care for people at times people wanted assistance.

• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed. People’s medicines were reviewed, and staff worked closely with health and social care professionals to ensure people’s medicines were managed well, and their health outcomes improved.

• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.

• Staff spoke warmly about the people they cared for. People were confident to ask for assistance and reassurance from staff when they wanted this, and staff took time to provide this in the ways people preferred.

• People told us staff respected their rights to make their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

• Staff had received training and developed the skills they needed to care for people, through induction and on-going training. People told us staff knew how to help them.

• People had good access to other health and social care professionals and staff followed any advice given. This helped to ensure people experienced good levels of well-being and physical health. Relatives were confident their family member’s health needs were promptly met and told us staff kept them informed of any concerns.

• 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.

• Staff ensured people had opportunities to do things which they enjoyed and people were supported to keep in touch with others and faith groups, who were important to them.

• The views of people, relatives and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met, and based on people’s preferences.

• Procedures were in place to take any learning from complaints and to further improve people’s care.

• People’s wishes for their care at the end of their lives had been planned and the views of their relatives considered.

• The registered manager and provider checked the quality of the care provided and encouraged suggestions from people and staff to improve people’s care further. One relative told us because of this, “It’s brilliant here. I’d like to be here myself. If I need to go in to a home, this is where I would like to come.”

• The registered manager kept up to date with best practice developments, so they could develop the care provided further.

• We found the service met the characteristics of a “Good” rating in all areas; For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good. The last report for Edmore House Residential Home was published on 8 January 2016.

Why we inspected: This was a planned inspection based on the

Our inspection was unannounced and took place on 17 November 2015.

Edmore House is registered to provide accommodation for 18 older people who require personal care. At the time of our inspection there were 17 people living at the home.

The home had a 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 and their relatives told us they were confident that the service provided to them was safe. Staff working at the home had a good understanding of how to raise concerns and whistle blow. The registered manager could demonstrate learning from accidents and incidents and used this to make changes where required.

We saw that there were a suitable amount of staff on duty, and that staff had the skills and training to meet people’s needs.

We saw that people’s capacity to make decisions had been made in line with the Mental Capacity Act 2005.

People were given a choice of food and drink that met their dietary requirements. People were supported to have input on what food was included on the menu.

People were supported to access a range of healthcare professionals to ensure their health needs were met.

Staff interacted with people in a caring way and showed an understanding of how to maintain privacy and dignity.

People and their relatives were involved in the assessment and reviewing of their care. People were supported to express their preferences and wishes and had these reflected in their care plan.

People were supported to have their religious or spiritual needs met.

People were made aware of how to make complaints and were encouraged to provide feedback on the service in meetings and from questionnaires.

People spoke positively about the leadership at the home. Staff received regular supervision to support them in their role.

Systems for auditing were not always effective. Medication audits did not identify issues with the recording of medication quantities.

We carried out this inspection to check on the care of people. On the day of the inspection there were 18 people living in the home. We spoke to three people, three relatives, three members of staff, the manager and the provider.

People told us their consent was sought before care was given although records showed that people’s consent to care was not always being recorded. One person said, “I am always asked before care is given”.

People told us that the care they received was what they had expected. Relatives told us that people had access to social activities and staff were caring.

Records showed that people’s nutritional needs were being met and that people had access to nutritional advice when needed. One person said, “Meal pretty good”.

There were enough appropriately qualified and skilled staff to care for people.

Records were being managed appropriately and stored within the guidelines of the provider.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practising professional, a person who can provide an expert perspective.

We spoke with eight of the 18 people using the service on the day of our inspection. Some of the people who lived in the home were not able to talk directly with us because of their health conditions. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

One person told us, “The staff treat us well, they are polite”. Another person told us, “They are respectful, I think so, and they make sure I’m covered”. This meant people were treated with respect and dignity.

People told us they had enough to eat and meals were hot and on time. We saw alternative meal choices were limited. Some people did not have their food or drinks presented in a way they could eat safely.

Gaps in care records and observation of the care practice showed people did not always receive appropriate support to eat and drink enough.

We spoke with three people using the service about their safety; they all told us they felt safe. One person told us, "If I was worried about anything I would tell the staff, I’m confident they would do something”. We found further improvements in regards to managing the needs of people at risk of weight loss were needed before this impacted upon the wellbeing of people who lived in the home.

There were enough staff to meet the needs of the people. People who lived in the home told us that when they needed assistance staff responded promptly. We saw staff did not fully understand the nutritional needs of people, or have the appropriate skills, knowledge and training to always meet these needs

Care records were not up to date and not accurate so people were at risk of receiving inappropriate care.

There were 17 people living in the home at the time of our visit. We spoke with five people, one relative and a hair dresser that was visiting the home. We also spoke with three staff, the registered manager and the registered provider.

People we spoke with had no concerns about the home or the care that they received. They said they were happy living at the home and felt they were well cared for. The person’s relative we spoke with said that their only concern was that should his aunt’s needs change, and require her to move from the home into nursing care. People we spoke to made some of the following comments:

“ I have no complaints, they have a lot of activities and I join in everything that’s going on.”

“I like living here, I like the food and I like the staff.”

On the day we visited the home was warm and welcoming. The home was well decorated , observed to be well furnished and maintained to a high standard. We saw positive interactions between staff and the people living at the home.

We saw that people were fully involved in agreeing and planning their care. They were treated with dignity and respect and supported to maintain their independence.

We saw that people’s needs were assessed and planned for, so the home should be able to meet their needs.

We saw that the registered provider ensured that there were systems in place to protect people from abuse.

We saw that staff received the training and supervision they needed to care for people safely.

We found that the home was well managed, with both the registered provider and the registered manager demonstrated a strong commitment to providing a high standard of service.