The inspection took place on 16 September 2016 and was unannounced.

Frintondene Care Home provides accommodation and personal care for up to eight older people. The service does not provide nursing care. At the time of our inspection there were eight people using the service.

There was a registered manager in post at the service. 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. The registered manager was supported with the day-to-day running of the service by a competent deputy manager.

People were safe because the management team and members of staff understood how to manage risk and recognise abuse or poor practice. People received safe care according to their individual needs.

There were sufficient staff who had been recruited safely and who had the knowledge and skills to meet people’s needs safely and in ways that they prefer.

The provider had safe systems in place to manage medicines and people were supported to take their medicines as prescribed.

People’s health needs were managed effectively with input from relevant health professionals. People were provided with food and drink that met their nutritional needs as well as their individual preferences.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

The registered manager and deputy manager supported staff to provide appropriate care that was centred on the person and staff understood how to treat people as individuals.

People were treated with kindness and courtesy by staff who knew them well. Staff respected people’s choices and took their preferences into account when providing care and support. People were encouraged to spend their time in ways that they preferred and were supported to maintain relationships with friends and family so that they were not socially isolated.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected.

There was a family culture and the management team encouraged and supported staff to provide a good standard of individual care.

The provider had systems in place to check the quality of the service and take people’s views into account to make improvements to the service. They also had systems so that people could raise concerns and there were opportunities available for people or their representatives to give their feedback about the service.

The manager and deputy manager were freely available and actively involved in supporting people and staff. Staff were enthusiastic about the culture of the service and confident that their views were valued.

Our inspection team was made up of one inspector who answered our five questions. Below is a summary of what we found. The summary is based on our conversations with the deputy manager, two staff, three people who used the service, three relatives and from looking at records. Where it was not possible to communicate with people who used the service we used our observations to gather information.

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Staff had received appropriate training and guidance. Records contained detailed assessments of people's needs that had been carried out prior to them moving to the service. This ensured that the staff had the relevant skills and knowledge required to meet the individual's identified needs.

Where people did not have the mental capacity to provide consent the provider complied with the requirements of the Mental Capacity Act 2005. Staff had received training in this area. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Whilst no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

The provider had clear policies and procedures regarding medication, we saw that medication was stored, administered and disposed of in line with their policies and procedures. Staff received annual refresher training in administering medication. The provider carried out regular audits of medication.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. One person said, "I feel safe here, staff know my likes and dislikes and what support I need."

Is the service effective?

It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew the people well. People we spoke with told us that, "Staff are well trained, polite and caring and they encourage me to be independent as much as possible.”

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One person who used the service said, "The staff always listen to my wishes and acts upon them.”

Is the service responsive?

The manager had regular contact with the relatives of people who used the service. People told us that they had specific agreements regarding frequency of contact. Relatives told us that the communication between them and the staff was excellent, ” They have kept us informed of my relatives changing health needs and provided additional staff to care for them when needed.”

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. One relative told us, “The home ensured that the relevant health care professionals had been involved in assessing, planning and meeting my relatives changing health needs, they also ensured that we were closely involved in the process.”

We saw two responses from medical professionals to the stakeholder survey and both people commented positively on the quality of the care provided to the people who lived in the home.

The service had a quality assurance system in place. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and that they received excellent support and supervision from the manager. Staff had a good understanding of the ethos of the service. This helped to ensure that people received a good quality service at all times.

We spoke to four people living in the home and two of their relatives. All of the comments about staff were very good. One person said “The staff are very nice you can have a laugh and joke with them, good friendly banter. I have no complaints." Another person told us "The food is very good lots of choices of what to eat. Staff regularly checks to make sure I am ok and help me to remain independent." One relative told us " My relative is very happy here he likes to eat his meals in his room and staff support him with this"

We found that staff had received regular training to ensure that they have the skills and knowledge to meet the needs of the people who used the service. They receive regular supervision from the manager and have access to the manager during the out of hour’s period.

We saw that the service carries out regular audits of health and safety, medication and care plans and risk assessments and then takes the appropriate action to address any concerns. An annual customer, stakeholder and staff survey takes place and the information is used to improve the service.

During our inspection on 24 January 2013, we spoke with four people who lived at the home, relatives who were visiting, the manager and one member of staff. We saw that staff encouraged and supported people to be independent. Staff showed a good understanding of people’s needs and preferences. One relative told us, “I think it’s wonderful here, the care they give X is wonderful. It couldn’t be better.”

People told us they were involved in the planning of their care. We saw that staff were polite and respectful when speaking with people. People appeared comfortable with staff and we saw good humoured conversations between people and staff.

The home had a variety of systems in place for the protection of people who used the service and to monitor the quality of the service provided. We saw that actions had been taken by the manager to address any issues that were highlighted as needing improvements.

We had conversations of differing lengths with all the people living in the home and with two of their relatives. All the comments about the staff and services provided in the home were positive and very complimentary. One person told us “Staff are all friendly and caring. I’ve no complaints at all.” Another said “Staff are excellent, they’re very kind to me. I couldn’t ask for better. I feel happy that the staff are well trained. I’ve never had any concerns.” People in the home told us that the standard of food was good and there were always choices available.

A relative described the home as having a ”Wonderful, caring family atmosphere. Staff are very approachable, nice, concerned and appear to be well trained and experienced. I’ve not had any concerns.” In a complimentary letter a relative said “The home far exceeded any expectations we had.” Another relative said that the home provided “Quiet, dignified and unobtrusive care which suited X as the intelligent and independent person they were.”