Henrietta House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and personal care for up to 25 older people with a range of needs including dementia. At this inspection there were 23 people living at the home.

At the last inspection in August 2015 the service was rated good. At this inspection we found the service remained good.

People and their relatives told us that people were safe living in the service. Risks to people were assessed, and any risks identified were mitigated and reduced where possible. There were sufficient numbers of staff with the right skills and abilities to support people when they needed it.

Staff were inducted to the service when they commenced their employment and received appropriate training and support to enable them to carry out their roles effectively.

Staff were aware of the mental Capacity Act 2005 (MCA) principles and were meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). People were encouraged and supported to make choices and retain as much control of their lives as possible. People were supported to eat and drink sufficient amounts to maintain their health and were supported to access health care professionals to meet their individual health needs.

People who used the service were treated in a kind and caring way by staff who respected their privacy and maintained their dignity. People, their relatives and professionals were given the opportunity to give feedback on the service and their views and opinions were taken into account.

People received individualised care that was personal to them. People were given appropriate support and encouragement to access meaningful activities that were of interest to them.

People and their relatives told us that they knew how to raise concerns if they needed to and were confident these would be listened and any concerns would be addressed.

The registered manager had robust quality assurance systems in place and where shortfalls were identified they were promptly acted upon to improve the service. The registered manager had developed an open, transparent and inclusive culture within the service. People and their relatives gave consistently positive feedback about all aspects of the service.

Further information is in the detailed findings below.

Henrietta House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and personal care for up to 25 older people with a range of needs including dementia. At this inspection there were 23 people living at the home.

At the last inspection in August 2015 the service was rated good. At this inspection we found the service remained good.

People and their relatives told us that people were safe living in the service. Risks to people were assessed, and any risks identified were mitigated and reduced where possible. There were sufficient numbers of staff with the right skills and abilities to support people when they needed it.

Staff were inducted to the service when they commenced their employment and received appropriate training and support to enable them to carry out their roles effectively.

Staff were aware of the mental Capacity Act 2005 (MCA) principles and were meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). People were encouraged and supported to make choices and retain as much control of their lives as possible. People were supported to eat and drink sufficient amounts to maintain their health and were supported to access health care professionals to meet their individual health needs.

People who used the service were treated in a kind and caring way by staff who respected their privacy and maintained their dignity. People, their relatives and professionals were given the opportunity to give feedback on the service and their views and opinions were taken into account.

People received individualised care that was personal to them. People were given appropriate support and encouragement to access meaningful activities that were of interest to them.

People and their relatives told us that they knew how to raise concerns if they needed to and were confident these would be listened and any concerns would be addressed.

The registered manager had robust quality assurance systems in place and where shortfalls were identified they were promptly acted upon to improve the service. The registered manager had developed an open, transparent and inclusive culture within the service. People and their relatives gave consistently positive feedback about all aspects of the service.

Further information is in the detailed findings below.

The inspection was carried out by an inspector who gathered evidence to help us answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive to people’s needs? Is the service well-led?

Below is a summary of what we found.

The summary is based on our observations during the inspection, speaking with people who used the service and their relatives, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is it safe?

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff were trained in how to follow the procedures. The people we spoke with told us they felt safe in the home. One person said, “Yes I feel safe, I like it here. The staff are all so nice and they really care for me.”

Where people lacked capacity to make a decision, we saw that the service was adhering to the Mental Capacity Act 2005 and appropriate assessments of capacity and best interests’ documentation were in place. We saw that people were supported to take informed risks. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards.

Is it effective?

We found there were arrangements in place to involve people in the assessment of their needs through discussions. We saw where people had signed their care plans after discussing their care and support. This meant steps were taken to involve people in making decisions about their care and support.

Care plans gave details of people’s preferences in relation to the way they liked to be cared for and supported. Staff we spoke with had a good understanding of people’s likes and dislikes and how they would prefer to be supported.

Records showed that people’s health was regularly monitored and when people’s needs changed, staff made the appropriate referrals and made changes to care plans to reflect the needs of the person. This meant staff recognised when the needs of people changed and sought advice from the appropriate health professionals.

Is it caring?

We observed interactions between staff and people using the service on the day of our visit. We saw staff engage positively with people, showing them kindness and respect and treating them with dignity.

Staff had a good understanding and knowledge of people’s needs and preferences and we saw that diversity monitoring took place on admission to explore individual needs and preferences such as culture and sexuality.

We spoke with a member of staff who had a clear understanding of the role they played in ensuring people were treated with dignity and respect. Policies and procedures were in place to support this.

People had regular discussions with staff to discuss activities and raise concerns and any issues that they may have. An annual questionnaire was also sent to people using the service, relatives and health and social care professionals with regular contact with the service. This meant people were supported to make their views known about the service.

Is it responsive?

We saw that where people lacked capacity, appropriate assessments of capacity and best interests’ documentation were completed. Advocacy details were available for people who used the service. This meant that the service considered people’s capacity and the support they may need if they lacked the capacity to make a decision.

Staff were observed responding to people who had expressed something that was important to them. Staff knew that details of what was important to individuals were documented in their care plan. People were supported to be involved in a wide range of activities.

People knew how to make a concern if they had one. None of the people we spoke with had any concerns they wished to raise. There was a clear procedure on what action would be taken if people made a complaint. The manager told us there had not been any recent complaints made by people living in the home or by their significant others. Staff were able to explain how they would respond to a complaint.

Is it well- led?

We looked at the processes in place for monitoring incidents, accidents and safeguarding. These were well managed with clear accountability throughout the organisation on how to learn from these.

There were effective procedures in place to monitor and improve the quality of the service provided. People’s views on the service were sought and were responded to. The service carried out a number of checks to ensure that people’s needs were being met.

Staff were organised in their day to day work and they had a clear direction of how they were to meet the needs of people. Staff we spoke with recognised the visions and values of the home and their role in that. They were provided with the right training and support to ensure they had the skills and knowledge they needed.

Systems were in place to ensure there were sufficient numbers of staff to meet people’s needs. We saw that when people needed support or assistance from staff there was always a member of staff available to give this support. The people living in the home and staff we spoke with all told us they felt there were enough staff to support people safely. The registered manager told us that any staff absence was covered by staff directly employed by the service. No agency staff were needed.

We saw there were plans in place for emergency situations such as an outbreak of fire. Staff understood their role in relation to these plans and had been trained to deal with them.

When we inspected Henrietta House on 13 June 2013, we observed a welcoming and friendly environment. We spoke with four members of staff and six people who lived in the home about the care and support people received.

We observed positive interactions between staff and people living in the home, and saw that staff understood the needs of the people they were supporting. Those we spoke with who lived at the home, told us they were happy living there. One person said, "I have been here for a while now. I really like it and have no complaints." Another person told us, "It's nice living here, I am happy with the care. I think the staff are all very good."

We observed staff were polite and respectful of people and involved them in making decisions about their support, and how they spent their time. One person told us, "I always have a lot of choice, about the food I eat and the care that I have from staff. It is nice to be included."

We looked at people's care records and found these to be regularly reviewed and relevant for people's assessed needs. We looked at the staffing systems in place, including staffing numbers, and the training and support provided for staff. We saw evidence that the number of staff on duty was sufficient to meet the needs of people living at Henrietta House.

We found that records were updated on a regular basis and stored appropriately, ensuring that both staff and people's confidentiality was respected.

During our visit on 10 September 2012, we spoke with five residents of the 24 people who were living at Henrietta House, and also seven peoples’ relatives. Everyone we talked with spoke very highly of the care provided to them or their relative and said they enjoyed the friendly, homely atmosphere within the home. People told us they "couldn’t fault the care or staff", and that "nothing was too much trouble".

We observed a friendly, welcoming atmosphere with the home, conveyed by all staff members. We found evidence of respectful, dignified care throughout our visit, and that people were encouraged to be as independent as possible, in line with their needs.

We saw evidence that people and their family members were involved with care decisions and all relatives we spoke with told us they felt supported by the manager and staff within the home. Several of the relatives we spoke with told us they were treated ‘as part of the family’ and felt very reassured by the approach of the manager and staff towards them and their family member.

We found evidence of robust quality monitoring processes in place to ensure peoples’ needs were assessed and met and risks to people were minimised.