About the service: Edmund House is a care home providing personal care and accommodation for up 56 people aged 65 and over, some of who may be living with dementia. At the time of the inspection 49 people were living at the service.

People’s experience of using this service: People told us they were happy with the service they received and felt staff had a clear understanding of their needs and preferences. They told us staff listened to them and knew them well, and were responsive to their needs and wishes. People’s dignity and privacy were respected.

There were enough staff. Safe recruitment processes had been followed. Staff were trained and their skills and knowledge checked through competency assessments.

People were protected from abuse and avoidable harm. Staff had completed training in how to safeguard people and risk assessments were completed to identify potential hazards. People received their medicine as prescribed.

People’s choices were respected, and proper legal processes had been followed when people were unable to make their own decisions.

The home was undergoing an extensive refurbishment programme and people were happy with the improvements. Cleanliness and health and safety were well managed.

People accessed local facilities and activities and the home worked with other organisations, including health professionals, to meet people’s needs.

People and their relatives were involved in the service. Care was planned around people’s choices and preferred routines. People and their relatives were supported to receive information in an accessible way to enable them to be involved in their care and support.

There was an effective quality monitoring system which ensured checks and audits were carried out, people's views were obtained and listened to and shortfalls were addressed. Accidents and incidents were analysed so that lessons could be learned. Senior management had oversight of the service and completed regular checks.

The culture of the service was open and people felt able to raise concerns.

At the last inspection the service was rated Good (published 18 July 2016).

Why we inspected: The inspection was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

A full description of our findings can be found in the sections below.

This inspection was undertaken on 5 November 2015, and was unannounced. The service was last inspected on 23 November 2014 and found to be compliant with all of the regulations that we assessed.

Edmund House is owned by Hadrian Healthcare Limited and provides care and accommodation for up to 56 adults, some of whom may be living with dementia. The home is separated into four separate units, each with its own kitchen, dining room and communal areas. Accommodation comprises of single bedrooms situated at ground floor and first floor level.

There was a registered manager at the service at the time of our inspection who had been in post for over five years. 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 lived at the home were safe. Care workers had been trained to recognise the signs of potential abuse and knew what actions to take if they suspected abuse had occurred.

A pre-admission assessment had been completed for each person who used the service which was then used to develop an individual plan of care. Risk assessments were in place to reduce the risks to the people who lived at the home.

People’s nutritional needs were assessed and monitored; their preferences and special dietary needs were known and were catered for. Advice from relevant health care professionals was requested and recorded as required.

Staff supported people to make decisions for themselves and remain independent; suitable adaptions and equipment were used to support people’s independent living skills. People were treated with dignity and respect throughout our inspection.

People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

A quality assurance system was in place that consisted of audits, checks and feedback from people who used the service. When shortfalls were identified action was taken to improve the level of service. The registered provider’s senior management team were aware of the day to day running and management of the service.

Systems were in place to manage medicines safely. Staff who administered medicines had completed relevant training to enable them to do so safely. Staff were recruited safely. Checks were undertaken to ensure prospective staff and volunteers were suitable to work with vulnerable people.

The inspection was carried out by an adult social care inspector. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report

• Is the service caring?

The service was caring. We saw that care workers showed patience and gave encouragement when supporting people.

Staff demonstrated a good understanding of the needs of the people who used the service and could describe how to maintain people's dignity and how to ensure people's choices were respected.

People who used the service, their relatives, friends and other professionals involved with the service, completed an annual satisfaction survey. Where suggestions or concerns had been raised; the provider had listened and made changes to the service.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

• Is the service responsive?

The service was responsive. Care records demonstrated there had been changes in people's needs. We found that other health care professionals, for example doctors and district nurses had been consulted and their advice sought.

We saw that people's care needs were kept under review and care plans, risk assessments and support plans were updated when required.

• Is the service safe?

The service was safe. Systems were in place to make sure that the registered manager and staff learnt from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped to ensure that the service continually improved.

The people who used the service told us they were happy and that they felt safe. We saw that people were treated with respect and dignity by staff.

Staff had completed training in how to safeguard vulnerable adults. This meant that people were safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly so people who used the service were not put at unnecessary risk.

• Is the service effective?

The service is effective. People’s health and care needs were assessed with them, and they were involved in writing their plans of care when possible. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

The majority of staff had received appropriate training and professional development. Specialised training had been completed to ensure the needs of the people who used the service could be met.

• Is the service well led?

The service is well led. The service had quality assurance systems in place and records we looked at showed that identified shortfalls were addressed promptly.

The provider consulted with people about how the service was run and took account of their views.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

What people who used the service and those that matter to them said about the care and support they received.

People who used the service told us that they felt safe. One person said, “Yes I feel safe. I like the staff and I’m treated very well.” Another person told us, “They (the staff) keep me safe, they give me my tablets every day and send for the doctor if I’m ill.”

A relative we spoke with said, “I don’t have the worries I used to have about Mum, I worried about her falling or not taking her medication but I don’t have to worry now, Mum is safe here, the staff look after her Mum is happy.”

People and their relatives told us they had made a positive decision about moving into the service. They said they were, “Very happy with the home” and participated in decisions about support that was provided.

We saw people looked comfortable, well cared for and that staff interacted with them in a friendly and compassionate manner. People told us that staff were, “Smashing” and “A great bunch”. Visiting relatives told us that staff were, “Very caring and kind" and good at keeping them informed about changes concerning their members of family.

Staff were familiar with their professional responsibilities to ensure people who used the service were protected from harm. We found that safeguarding policies were available to guide staff and the service adhered to the local authority's adult protection procedures.

We saw that cleaning schedules were available, that included regular ‘deep cleans’ of people’s rooms. The manager told us they competed daily ‘walk rounds’ of the building to ensure it was clean, tidy and well maintained. We saw records and checks that were completed, to ensure the building and equipment was kept safe to use.

There were policies in place for checking staff were safe to work with people and that disciplinary procedures were followed to ensure issues of staff misconduct were acted on.

A range of monitoring systems were in place, to assure the quality of the service and the health, safety and welfare of people was promoted.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not always able to tell us their experiences.

We observed that staff adopted an open and positive approach and listened to people to ensure their wishes and feelings were respected.

We spoke to three relatives of people who used the service, who told us staff were "Wonderful” and did a "Great job." Relatives told us they had "No complaints and that potential issues were “Quickly followed up.” Relatives told us they were included and involved in making decisions and confirmed staff took appropriate action when required.

People that used the service told us they largely enjoyed living in the home and one said it was “The best home" they had been in.

We found that care practices were generally well documented and monitored to ensure changes in people’s needs were appropriately met.

We talked to the local authority as part of our inspection, who they told us they had no concerns about the home.

Staff told us they “Loved doing their jobs” and we saw they worked closely as a team and were provided with a range of training to help them carry out their roles.

We saw evidence of regular visits and checks by the people that own the home, to ensure that quality of the service was assured.

As part of our inspection we talked with a number of people who use the service.

Although some people were not able to communicate with us other people told us that they liked living at the home. We asked people questions about the home, the care they received and staff caring for them. Their responses indicated that they felt safe and were happy with the care they received. One person told us “If I am worried about anything I can talk to the staff.” We received other comments such as “The staff are very good”, “The staff support us and encourage us to do things for ourselves, they help us when we need it” and “It’s lovely, like home from home.”

People told us they enjoyed the activities provided by the home and that the meals were good.

People we spoke with told us that staff treated them with respect and maintained their dignity. They told us that they could choose what time they wanted to get up in the morning and what time they went to bed.