Florence House Residential Home provides accommodation and personal care for up to 20 older people, some of whom may live with dementia. There were 16 people living at the home at the time of our visit. The home is an adapted residential building and is located in the town of Ramsey in Cambridgeshire.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The provider (owner) acted as the manager and therefore there was no requirement for them to register with us.

Staff knew how to respond to possible abuse and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were stored and administered safely.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People received a choice of meals, which they liked, and staff supported them to eat and drink. They were referred to health care professionals as needed and staff followed the advice professionals gave them.

Staff were caring, kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records guided staff in how to do this. There was a variety of activities for people to do and take part in during the day, and people had enough social stimulation. Complaints were investigated and responded to and people knew who to speak with if they had concerns.

Staff worked well together and felt supported by the management team. The monitoring process looked at systems throughout the home, identified issues and staff took the appropriate action to resolve these.

Further information is in the detailed findings below.

Florence House Residential Home is registered to provide accommodation and non-nursing care for up to 20 people. The home is located in a residential area of the fenland market town of Ramsey. Short and long term stays are offered. At the time of our inspection there were 17 people living at the home.

This comprehensive inspection took place on 04 August 2015 and was unannounced. Our last inspection took place on 16 May 2014 when we assessed the provider was meeting the requirements of the regulations that we had inspected.

The registered owner was responsible for managing the service on a day-to-day basis and therefore a registered manager was not required.

Staff were knowledgeable about reporting any incident of harm that people may experience. People were looked after by enough staff to support them with their individual needs. Satisfactory pre-employment checks were completed on staff before they were allowed look after people who used the service. People were supported to take their medicines as prescribed and medicines were safely managed.

People had sufficient amounts of food and drink. People were offered choices of food and drink although some people felt that the quality of the breakfast and tea time food could have been better. People were supported to access a range of health care services and their individual health needs were met.

People’s rights in making decisions and suggestions in relation to their support and care were respected. Where people were not able to make such decisions, their needs were met in their best interest.

People were looked after by staff who were trained and supported to do their job.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The owner was aware of the process to follow should DoLS applications were to be made.

People were treated by kind and attentive staff. They and their relatives were involved in the review of people’s individual care plans.

People’s care was provided based on their individual needs and they were supported to maintain contact with their relatives. People were encouraged to take part in a range of hobbies and interests. There was a process in place so that people’s concerns and complaints were listened to.

The owner managed and supported staff to enable them to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Monitoring procedures were in place to review the standard and quality of people’s care.

The inspection team was made up of one inspector. We set out to answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

If you wish to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe. Procedures in place to protect people from abuse or harm were robust and staff demonstrated an awareness of these. Care plans included detailed risk assessments and we saw examples of these being followed. One person told us, “I feel very safe here. Staff come quickly when you pull the bell.”

Is the service effective?

Care plans were up to date and reflected people’s current needs. There were enough staff to plan and deliver care in a way that was intended to ensure people’s safety and welfare. Additionally, staff enjoyed their work and team working was strong.

Is the service caring?

People were supported by kind and attentive staff. We observed that people were relaxed and interacted well with staff. One person commented, “Staff are very kind, they can’t do enough for you.” Another said, “The staff are extremely good and very friendly.”

Is the service responsive?

Senior staff were available to people and their relatives throughout the day. Staff were not rushed and spent quality time with people. Relatives and people who used the service told us that they were able to raise issues and concerns with staff

Is the service well led?

The provider had a quality assurance system in place and people were asked for their feedback about aspects of the service. One person told us, “I am asked for my views. There is a survey now and then, and resident meetings.” There was evidence that the provider took action to improve the service when this was required.

We spoke with a number of people who lived at Florence House, and to some relatives who were visiting. People told us they were happy with the service being provided. One person said, “It’s very nice here. Everyone’s very friendly and we’re looked after well.” Relatives told us, “[Name’s] never moaned about anything or anybody. It really is lovely and I’d recommend it to anyone.”

On the day of our inspection there was a very relaxed, homely atmosphere at the home, with people who lived there and the staff getting on well and enjoying each other’s company. Staff treated people with respect and supported them to remain as independent as possible.

Care records were personalised and gave staff clear guidance on meeting each person’s individual needs. Potential risks to people had been assessed and plans put in place to minimise the risks. Medicines were managed well.

The provider had a recruitment procedure in place to ensure that staff employed were suitable to work at the home. People told us they knew how to complain, but had never had to.

Record keeping had improved since our last inspection. Records were now maintained well: those we looked at were accurate, relevant and up to date.

People and their relatives told us that they were treated with respect by care staff and had been involved in making decision about their care. One person said, "I am more than satisfied with living here. I am treated with great respect by all the staff and the manager and can make decisions about by daily routines what to eat and where I want to go. I feel I am listened to when staff assist me".

Another person who had lived at the home for some years said, "I have choices I can make about everything. If I don’t like or want to do anything I tell them. I like some of the activities which are gentle exercises".

One person said, "I am supported and assisted to do everything that I want. When I need help the care staff are there for me. They are good carers". Another person said, "This is the best home that I have lived in and I have lived in two other homes before I moved here".

People also told us they felt safe living at the home.

The majority of the comments shared with us about the care people have received were very positive. One person told us, "This is not a business, it's a family affair". Another person told us that the staff were, "All very good" and that they were, "Very kind".