Halliwell is registered to provide the regulated activities of accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury for up to 64 people. At the time of this inspection 59 people were using the service.

This comprehensive inspection took place on 3 November 2016 and was unannounced.

A registered manager was in post at the time of the inspection and had been registered since 2010 under the current legislation. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood what keeping people safe meant and they were knowledgeable about the appropriate reporting procedures. A sufficient number of skilled and trained staff were in place to meet people’s individual care needs. A robust recruitment process was in place to help ensure that staff were suitable to look after people who used the service.

Risk assessments were in place to help ensure people were kept safe. People’s medicines were managed and administered safely and as prescribed.

People’s health care and nutritional needs were supported and met by staff who possessed the necessary care skills.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The registered manager and staff with a management responsibility were aware of and had used the correct procedures to lawfully deprive people of their liberty. Applications to the appropriate authorities to lawfully deprive people of their liberty had been sought and approved. Staff had a good understanding of how to apply the MCA and DoLS codes of practice.

Staff’s training, mentoring and coaching gave them the knowledge and skills they needed to do their job.

Staff respected people’s rights to privacy and dignity. Care staff provided people’s care with compassion and consideration of each person that was cared for. People, and their relatives or representatives, were involved in reviewing people’s care needs and the plans on how this was provided.

A range of options were in place to support people with their independence and to help reduce their risk of social isolation. People’s hobbies and interests were encouraged by staff who wanted to make a difference to people’s individual lives.

People’s complaints were listened to, investigated and effectively acted upon.

The registered manager was supported by a team who were supported with the necessary skills to fulfil their role.

People, staff and relatives views were sought in a variety of ways to help identify where improvements could be made. Quality assurance monitoring, audits and processes were in place and these were effective.

There were 53 people using the service at the time of our inspection. People told us they were happy with the service they were receiving and that the care provided was meeting their needs. People had been involved in planning their care and their views and preferences were respected by staff. Comments included “Very happy, it couldn’t be better”.

People had an assessment of their needs and a care plan that ensured these were met. People received timely personal care and told us that staff were responsive to their health needs. Risks to people’s welfare or safety had been assessed and steps taken to minimise the risk whilst allowing people to remain as independent as possible.

People were cared for in a well maintained and safe environment. The premises were comfortable and designed with the needs of people using them in mind.

The service employed enough staff to meet people’s needs. People told us they were happy with the staff that cared for them and felt they were skilled in their roles. One person said “The staff are very good at recognising different people’s personalities, I like a joke with them and they are always very jovial”. Another person told us “The staff are always happy to be called, it’s never a problem”

People knew how to make a complaint if they needed to and were confident to do so. We found that people had been provided with the information they needed to make a complaint. Where complaints had been made they had been investigated appropriately and a response given to the complainant quickly. The manager responded positively to all complaints and acknowledged where improvements could be made. Where action was needed to improve things in the service this happened quickly.

At the time of the inspection 52 people were living at the service. We spoke individually with ten people and with four relatives. Some people were not able to talk to us directly about their experiences due to their complex needs, so we used a number of different methods to help us understand their experiences. For example observations, reading records and speaking with relatives.

People said they could make choices about their daily lives, were well cared for and that staff were kind and caring. They said “they look after me very well”, “they always have time for you, even the gardener does”, “they are always popping their head round the door, it is little things like that that matter” and “staff are marvellous, you see very few without a smile”.

Overall people said the meals were good and the quality had improved. They said “food has improved; it is nicely presented on the plate” and “there is enough choice”.

People said staff were polite and treated them with dignity. We saw that staff received the training they needed for their roles and were well supported

People and relatives were asked for their views about the service and felt it was well run. People said “this home is run very well” and “I think they work quite hard to get it right”.

People living at the home, relatives and visitors all commented on how good the care was. People told us they were happy with the care and support they received.

Comments we received included “My wife was in here over six years ago and now I am here. All the staff are personal friends, I am very happy here and very well looked after” and “I like the staff, they are very nice”.

People told us that sufficient staff were on duty and staff were kind and caring.

People told us that their privacy and dignity was maintained at all times.

Relatives and visitors we spoke with commented “I am very impressed at how bright the home is and how cheerful people are. There is always lots of laughter in the dining room, people are having fun” and “Staff are very cheerful and helpful”.

People told us the food was very good and they had a choice menu with plenty of fresh vegetables, homemade cakes and fruit.

People told us that the level of cleanliness was very good and that the home was cleaned on a regular basis. People had seen that beds and equipment were cleaned between uses. Comments received were “They clean my room every day” and “The home is very clean”.