Granville House provides accommodation and personal care for up to 23 older people. Twenty people were living at the home at the time of our inspection visit. At the last inspection, the service was rated Good. At this inspection we found the service remained Good in all five questions and Good overall.

There was a registered manager in post. 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 were protected from the risks of abuse because staff received training in safeguarding and understood their responsibilities to raise any concerns. The registered manager checked staff were suitable for their role before they started working at the home and made sure there were enough staff to support people safely. Medicines were stored, administered and managed safely.

People and their families were included in planning how they were cared for and supported. Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks. The provider and registered manager regularly checked the premises, essential supplies and equipment were safe for people to use.

People were cared for and supported by staff who were well trained and sufficiently skilled to meet their needs effectively. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to maintain a balanced diet that met their preferences and were referred to healthcare professionals when their health needs changed.

People, relatives and staff felt well cared for. Staff understood people’s diverse needs and interests and encouraged them to maintain their independence according to their wishes and abilities. Staff were happy working at the home. The registered manager understood the nature of staff’s role and considered staff’s skills and wellbeing in planning how people should be supported.

The manager and staff understood people’s individual needs, preferences, likes and dislikes. People were supported and encouraged to maintain their interests and to socialise in the home and in the local community. Staff respected people’s right to privacy and supported people to maintain their dignity.

People and relatives knew the registered manager well and had no complaints about the service. Staff were inspired by the registered manager’s leadership, skills and experience to provide a caring service.

Further information is in the detailed findings below.

We inspected this service on 27 May 2015. The inspection was unannounced.

There was a registered manager in post. 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 service provides accommodation and personal care for up to 23 older people. Seventeen people lived at the home on the day of our inspection.

Staff understood their responsibilities to protect people from harm and were confident the registered manager would investigate any concerns. The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks.

There were enough staff to meet people’s physical and social needs effectively. The registered manager checked staff had suitable skills and behaviours before they were employed. The provider regularly checked the premises were maintained to minimise risks to people’s safety. Medicines were managed, stored and administered safely by trained staff.

Staff understood people’s needs and abilities because they worked with experienced staff, spent time getting to know people and read their care plans. Staff received training and support that ensured people’s needs were met effectively. Staff were encouraged to reflect on their practice and to develop their skills and knowledge at regular meetings with their line manager

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They sought advice from the supervisory body to ensure care and support was delivered in accordance with the requirements. No one was subject to a DoLS at the time of our inspection. For people with complex needs, their representatives or families and other health professionals were involved in making decisions in their best interests.

People were offered meals that were suitable for their individual cultural and dietary needs, which minimised risks to their nutrition. People were supported to eat and drink according to their needs and preferences.

Staff were attentive to people’s moods and behaviour and supported them to maintain their independence. People were supported to obtain advice and support from other health professionals to maintain their health and when their needs changed.

Staff understood people’s individual needs and preferences and treated then with kindness and compassion. People were treated with dignity and respect by staff who understood their diverse cultural and personal beliefs.

People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs, abilities and preferences. Care plans were regularly reviewed and updated when people’s needs changed.

People who lived at the home, their relatives and other health professionals were encouraged to share their opinions about the quality of the service. The provider and registered manager took account of others’ opinions to make sure planned improvements focused on people’s experience. The provider’s vision and values were shared with people, visitors and staff so everyone knew what they could expect of the service.

The provider’s quality monitoring system included regular checks of people’s care plans, medicine administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.

Prior to our visit we reviewed all the information we had received from the provider. During the inspection we spoke with a total of seven people who used the service and asked them for their views. We also spoke with two care workers, two senior care workers, the assistant manager and the registered manager. We were also able to speak to a visiting social care professional. We looked at some of the records held in the service including the care files for 10 people. We observed the support people who used the service received from staff and carried out a brief tour of the building.

The summary below describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

We found that that people’s needs were assessed and care and support was planned and delivered in line with their individual care plans. These assessments and plans included consideration of risks to the person and how these could be managed to keep the person safe.

There were arrangements in place to deal with foreseeable emergencies. We were told by staff members we spoke with that they were able to contact a manager when they needed to.

We found the home was clean and hygienic. There were arrangements in place to control the risk of infection.

The provider had carried out recruitment checks on new staff before they started working with people.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications had been made by the provider. The manager told us they were aware of the most up to date rulings regarding Deprivation of Liberty Safeguards and were working with the appropriate authorities to reassess each person’s circumstances as a result.

Is the service effective?

People we spoke with told us their needs were met. One person told us, “They look after us well”. Another told us, “They do whatever you need them to”. 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 them well. We saw people being cared for and supported in accordance with their plans.

Staff had received training to meet the needs of the people living at the home. Care staff we spoke with told us they had received the training they needed to provide care and support to people at the home.

We saw in care plans that risk assessments had been completed that promoted people's independence. We saw in care plans that where people undertook aspects of their care independently this was clearly stated. One person being supported told us they valued being able to go and see a friend of theirs independently.

Is the service caring?

People told us the staff were kind and met their needs. We saw staff talking with people in a kind, considerate and respectful manner. We saw staff took care to ensure people had enough to eat and drink.

Care staff we spoke with told us, "We are here for people”, and “People are treated well, just as they should be”.

Is the service responsive?

We found that each person's needs were regularly reviewed and care plans were updated if needed. Records showed that people were supported in line with their plans.

People had access to activities and had been supported to maintain relationships with their friends and relatives.

We found the provider worked in co-operation with other providers to ensure people’s needs were met. We were told by a social care professional visiting the service the provider had worked with others to ensure people’s wishes were taken into account and their needs met.

Is the service well-led?

We found the provider had systems in place to seek the views of people and that these were acted on. People who lived at the home told us they would feel able to raise any concerns they had with the provider and were confident their concerns would be dealt with.

Quality checks were carried out by the provider and we found that the health and safety of people was monitored.

Care staff we spoke with told us the manager was supportive. One staff member said, “The manager has very high standards and expects us to as well”.

We spoke with six people who lived at the home. They told us they were happy with the care and support they received. One person said, "I came here to live because the people are nice." People told us they chose how and when staff supported them. They said staff respected their right to choose. Staff we spoke with knew and understood individual’s needs and preferences very well.

We found that people's care and support plans were agreed with them and their relatives when they first moved to the home. The manager and senior carers reviewed people's care plans every month. The four care plans we looked at included personal evacuation plans, so that staff knew how to support people to leave the premises in an emergency.

We spoke with two care staff who told us they received appropriate training and regular supervision from the manager. They said they felt this enabled them to give people the care and support they needed.

The manager explained how they regularly checked that staff made decisions and took action that was appropriate to their level of responsibility. The manager told us they were supported by the provider to maintain their own continuing professional development.

We spoke with seven people during this visit and met several others. We spent time observing the interactions between staff and those living at the home. People told us that there had been staff changes since the new owner took over the home. Some people told us that the staff were good whilst others said that they can be a bit rushed. Everyone said that the food was good.

We observed that some staff went about their duties in an unhurried way but did not take any time to chat to people. Information was passed to people but there was limited two way conversation noted. Occasionally staff did not respect people's privacy or dignity in the lounge area when they told people loudly that they were taking them to the toilet.

We were told that an activity organiser works at the home for three days per week. We saw activities taking place on the day of our visit. People were involved in a quiz and appeared to be enjoying the experience.

The new owners of the home have plans in place to improve the fixtures and fittings at the home and some work has already taken place. We saw that training has been booked for staff and new systems and practices have been put in place. The new owners have been in place for approximately five months.

We spoke with two people who lived at the home about the quality of care. They told us they had lived there for several years and were happy with the care and support they received. One person said, “There have been lots of changes, it is much more modern now.” Another person said, “It was the best move I made and I have made friends here and am friends with other people’s families.”

Many of the people who lived at the home were not able to talk directly with us because of their dementia so we used different methods to see whether they received the care and support they needed. We talked with three staff and looked at the care plans for three people who lived at the home to see how well the care plans described their individual abilities and support needs and observed how staff interacted with people throughout the day.

We saw that people behaved as if they were at home and spent their day doing things that pleased them. Some people chose to join in with the activities in the lounge and some people spent time in their rooms. Staff supported people to make their choice and encouraged them to do the things they wanted to do. We saw that staff engaged with people in a polite and friendly way. We saw staff patiently supporting and encouraging one person to move independently around the home. We heard staff talking with another person about previous events in their life, which encouraged the person to reminisce with obvious enjoyment.