About the service: Garsewednack Care home provides accommodation with personal care for up to 21 people. There were 20 people using the service at the time of our inspection.

People’s experience of using the service:

• People were happy living at the service. “They [staff] look after me well,” “I like it here, I feel safe” and “They always give me something that I like, they are very good to me here; I don’t think that I would have lasted this long if they hadn’t been so good”

• The registered manager was very visible in the service working alongside staff and providing care and support to people. People told us, “[Registered manager] is very pleasant and friendly and I often see her” and “She’s [Registered manager] always around and in the mornings, she’ll have a chat with us.”

• 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 practice.

• There were sufficient numbers of suitably qualified staff working at the service. The staff group was stable with many having worked there for years. Staff were happy working at the service and told us they felt the registered manager was approachable and supportive.

• People received their prescribed medicines in a safe manner. Recent medicine audits had highlighted that improvements were needed in handwritten medicine records. We saw this had taken place and the subsequent audit recorded no further concerns in this area.

• The premises were well maintained. There were regular checks of the service to identify any improvements required.

• People had access to good nutritious food. Staff provided support to people with their meals as needed.

• Risks were identified, recorded and monitored. People were supported to live as independently as possible. Any accidents were reported, recorded and audited to help address any patterns or trends and help reduce further events.

• Staff were kind and caring. We observed many positive interactions between staff and people living at the service. Staff respected people’s dignity and privacy.

• People had access to activities. Care staff provided a varied programme of activities which were planned and advertised in advance.

• Care plans were person centred and regularly reviewed to take account of any changes in people’s care and support needs.

• People were able to see their GP and other healthcare professionals as needed.

• The service had a complaints policy which was available to people should they need to raise any concerns. There were no complaints in process at the time of this inspection. People were happy living at the service and told us they had no cause to complain.

Rating at last inspection: At the last inspection the service was rated as Good (report published 23 February 2017)

The service remains Good following this inspection.

Why we inspected: This inspection was bought forward due to information of concern received by the Care Quality Commission. Anonymous allegations had been made around the management of incidents which took place at the service, a lack of maintenance to the building, poor staff management and a lack of respect and dignity provided for people. A concern had been raised by the family of a person living at the service about poor communication between them and the staff when their family members needs had changed. We looked at the risks associated with these concerns. We did not substantiate these concerns at this inspection.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Garsewednack is a care home which provides accommodation for up to 21 older people who require personal care. At the time of the inspection 21 people were using the service. Some of the people who lived at the service needed care and support due to dementia, sensory and /or physical disabilities.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We inspected Garsewednack on 18 January 2017. The inspection was unannounced. The service was last inspected in December 2013 when it was found to be meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them.

People told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

Staff training was delivered to a satisfactory standard, and staff received updates about important skills such as moving and handling at regular intervals. Staff also received training about the needs of people with dementia. However staff had not received any training about the Mental Capacity Act 2005 or Deprivation of Liberty Safeguards.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals.

There were enough staff on duty and people said they received timely support from staff when it was needed. People said call bells were answered promptly and we observed staff being attentive to people’s needs.

Care was provided appropriately and staff were viewed as caring. Comments received included: “I am well looked after here,” “Mum is very pleased with everything,” “No complaints at all…excellent, very friendly and helpful,” and “I would not hesitate to recommend it to anybody.”

The service had some activities organised. These activities included, bingo, hand massage, ‘games afternoon’s’ Karaoke, and quizzes. However people who used the service said they would like more variety of activities and the opportunity to go out on trips. As a consequence we have recommended the registered persons review the current activity programme.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

Most people were happy with their meals. Everyone said they always had enough to eat and drink. People said they were provided with a choice of meals. People said they received enough support when they needed help with eating or drinking.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.

People felt the service was well managed. There were suitable systems in place to measure, and as necessary improve, the quality of the service.