This unannounced inspection took place on 9 and 10 May 2017. Henley House is a residential care home registered for 23 people. The service is over two floors with a lift in the service for people to access the first floor. There were 23 people living at the service when we visited.

At the last inspection on 17 March 2015, the service was rated ‘Good’. At this inspection we found the service remained Good.

The service had a registered manager who was also the provider. 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’s medicines were administered safely, as prescribed. Medicines were also managed and stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans put in place to ensure people’s health and well-being were maintained.

People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and understood their responsibilities in relation to MCA and DoLS.

People were safeguarded from the risks of abuse and improper treatment. Staff had received training on safeguarding and they were knowledgeable on the procedure to follow if they had any concerns. There were sufficient staff available to safely meet people’s needs.

People told us staff were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.

People’s nutritional needs were met. People told us they enjoyed the choice of food that was available to them. People had access to food and drinks throughout the day. People were kept occupied and encouraged to participate in activities.

Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they supported. Staff received regular support and supervision to carry out their duties effectively.

The service liaised with various healthcare professionals to meet the needs of people. People at the final stages of their lives were supported in line with their wishes and were cared for in a dignified way.

People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People and their relatives had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular quality checks to ensure the service was of good quality and met people’s needs.

We carried out an unannounced comprehensive inspection of this service on 15 and 16 October 2014. We found that the registered person had not protected people against the risk associated with negative behaviours. This was because of the lack of risk assessments and management plans to address this. We also found people who use services and others were not protected against the risks associated with storage of unused equipment that was a safety hazard.

The provider sent us an action plan to tell how they would meet this breach. We undertook a focused inspection on 17 March 2015 to check that they had met the requirements of the regulation. We found that the provider had followed their plan which they had told us would be completed by April 2015.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Henley House’ on our website at www.cqc.org.uk’

The home provided care to up to 23 older people in single room accommodation.

The home was managed by two registered managers. 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 2014 and associated Regulations about how the service is run.’

We found that risk assessments and care planning had improved. Work was on-going to provide staff with written guidance on how to manage distressed reactions from one person who used the service. We found staff had received relevant training to help them deal with difficult situations like this. There had been continuing input from health and social care professionals to support staff.

Equipment not in use was stored safely. A lockable door had been fitted to the storage space in addition to a lock on a storage cupboard that was used for craft and various maintenance tools.

People using the service told us that they liked living at Henley House and were satisfied with the care provided. One person said, “I’d recommend it to anybody.” Another person said, “The staff are very good, they’ll do anything for you.”

We found that the home was clean, tidy and free from offensive odours. Training for all members of staff was in place for the prevention and control of infection.

We saw that members of staff were attentive to people’s needs and responded promptly when people required assistance. One person said, “They come right away when I buzz.”

We found improvements to the system for monitoring the quality of the service provided had been made. The manager regularly checked most aspects of the care and facilities provided at the home.

We saw that improvements to care planning had been made. All sections of people’s care plans were accessible to all care workers.

People using the service told us that they liked living at Henley House and were satisfied with the care provided. One person said, “The staff are grand and very helpful.” All the people we asked told us the meals were good.

We found that members of staff had a good understanding of safeguarding procedures and told us they would report any concerns immediately.

We noted that recruitment procedures and members of staff received the training they needed in order to provide safe and appropriate care for people using the service.

We found that some improvements to the monitoring of the quality of the service had been made. However, the system did not cover all aspects of the care and facilities provided at the home.

We saw that people’s individual care plans lacked clear guidance for staff to follow in order to ensure that identified risks were effectively managed. Care records stored electronically were inaccessible to care workers.

Since our last inspection the required improvements in the way medicines were managed have been made.

People told us they were treated with respect and liked living at Henley House. One person said, “It’s very pleasant, I’m quite content.” Another person said, “The staff are very nice, they look after me.”

Visitors to the home told us they were always made to feel welcome and offered refreshments. All the visitors we asked said they had no complaints and people were well looked after.

The daily routine was flexible and people could choose when to get up and go to bed. One person said, “I please myself what I do there aren’t any rules.”

All the people we asked told us they enjoyed the meals. One person commented that the food was excellent.

However, we found some problems in the way in which the quality of the service was monitored. This meant that any issues such as those with the management of medication had not been identified and addressed.

We carried out an inspection of Henley House on 15 and 16 October 2014. The first day was unannounced. We last inspected Henley House on 7 June 2013 and found the service was meeting the current regulations.

The home is a 23 bedded care home providing care to older people. Accommodation is provided in single rooms. At time of the inspection there were 22 people accommodated in the home.

The home was managed by two registered managers. 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.’

There was evidence that the right of a person to take control over their own life and make their own decisions and choices was considered. People identified as having some difficulty making choices were supported. People who would act in their best interests were named, for example a relative.

People told us they were cared for very well. People also considered their privacy and dignity was respected. However we raised two issues to the registered manager that we found during this visit that differed with this view.

We found staff were attentive to people’s needs. Staff gave a good account of and showed understanding of the varying needs of different people we had discussed with them. Staff said they enjoyed their work and worked well together for the benefit of people living in the home. Staff were clear about their responsibilities and duty of care. However we found staff were not supported with adequate training to manage behaviours that challenge from people that placed them and others at risk of harm and of receiving inappropriate or unsafe care.

People were cared for by staff that had been recruited safely. Staff had relevant training to support them in their role and in response to people’s changing needs. Staff were kept up to date with changes in people’s needs and circumstances. They were supervised on a daily basis which allowed work performance and development needs to be monitored and developed.

We saw that referrals had been made to the relevant health professionals for advice and support when people’s needs had changed. Arrangements were in place to make sure essential information was relayed when people used or transferred between services to support their continuing care.

People’s lifestyle was centred on them and they did not have to conform to any institutional practice such as set times for getting up or going to bed. Meals provided met with their tastes, needs and choice.

People told us they were encouraged and supported to express their wishes and opinions. One person said “I definitely want to be in control of my life and I believe in speaking out. The manager is very helpful.” People told us they knew how to make a complaint and felt confident any issue they raised would be dealt with promptly.

People told us the management of the service was very good. There were processes in place to support the registered managers to account for the actions, behaviours and the performance of staff. People living in the home, their relatives and staff spoken with had confidence in the registered managers, and felt the home had clear leadership.

The home was warm, clean and comfortable and people were satisfied with their bedrooms and living arrangements. However, we found sanitary waste facilities in toilets were not adequate in minimising the risk of cross infection and storage of unused furniture/aids was unsafe.  

The service had achieved the Investors In People (IIP) award. This is an external accredited award for providers who strive for excellence, which recognises achievement and values people.

We found two of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.