About the service:

Homelea is a care home without nursing for a maximum of 19 older people, some of whom are living with dementia. The provider has made a business and care related decision to only care for a maximum of 14 residents There were 11 people at the time of the inspection.

People’s experience of using this service:

People were cared for in a closely knit community at this home. The small size of the home meant that people were always surrounded by socialising people and caring staff. The downstairs lounge was the central hub of the home where people congregated and enjoyed activities together. People enjoyed their privacy and independence as this was respected by staff. People received person-centred care which was supported by detailed care plans.

There were insufficient quality compliance audits recorded and analysed by the registered manager. We made a recommendation regarding this. Where certain auditing needed improvement, the management team and provider were receptive and swift to implement changes. The registered manager led by example in providing person centred care and interacting with everyone who visited the service.

Staff were well trained to safely care for people and knew how to engage and empower them. People had access to health care professionals throughout the week.

People’s needs, choices and preferences were recorded in person centred care plans. The food at the service was enjoyed by people as they were able to choose what they ate from a menu that offered a variety of meals. The care records enabled staff to correctly provide care and support for people in a safe way. Complaints and concerns were recorded, responded to and used to consider improvements at the service.

Rating at last inspection:

Good (August 2016)

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

This unannounced inspection took place on 23 August 2016. We last inspected Homelea on 12 June 2013 where we found the provider was meeting all the regulations we looked at.

Homelea is a care home registered to provide accommodation and personal care for up to 19 older people. The home is located close to Epsom town centre and has a large and secluded walled garden that people living in the home were able to access.

The service was managed by a registered manager. 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 living in the home told us they felt safe and well cared for. This was echoed by relatives of people who we spoke with. We found there were appropriate numbers of staff to support people effectively. The staff were knowledgeable about the individual needs of the people and knew how to recognise signs of potential abuse so they could take appropriate action to protect people. There was a robust recruitment procedure in place that helped to ensure new staff were suitable to work with people who use the service. Medicines were managed safely and people received their medicines as prescribed.

Staff were able to maintain and develop their skills because they had access to appropriate and effective training. Staff confirmed they had access to a range of learning opportunities and told us they were well supported by the registered manager. We saw staff received regular supervision.

All the people living in the home at the time of this inspection had the capacity to make decisions and were able to give consent to their care. Staff understood the principles of the Mental Capacity Act 2005 and knew what to do if people could not give consent to ensure their best interests were met.

People had their nutritional needs met and were offered a choice for their meals. People were offered a varied diet and were provided with food and drink when they needed it.

People were supported to have and maintain good access to healthcare professionals as their needs dictated.

The staff were caring and positive when communicating and supporting people. Visitors told us they were made welcome in the home and people were supported to maintain relationships with their friends and relatives.

Care records and risk assessments were person-centred and were an accurate reflection of the person's care and support needs. The care plans were written with the person, so they were able to influence the delivery of their care. The care plans included the person's likes and preferences and were reviewed regularly to reflect changes to the person's needs and circumstances.

People told us there was a good range of activities that they were encouraged to join in if they wished to do so.

People knew how to raise concerns and complaints and were confident if they needed to they would be dealt with appropriately.

There was an open and friendly atmosphere in the home, which showed people were happy and the staff and registered manager had good relationships and knew the people well. We observed staff supporting people with respect whilst assisting them to maintain their independence.

All the people, their relatives and staff we spoke with said they had confidence in the registered manager and felt the home had clear leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people living in the home and their relatives.

People's views of the service were sought and responded to appropriately.

There were 13 people living at the home at the time of our inspection.

We spoke with three people who used the service and conducted observations throughout the visit. We looked at records and spoke with four staff and a visiting health care professional.

We saw that staff obtained peoples consent before helping with their care. We spoke to people who used the service who confirmed this. We were told “They will always ask” and “They will always explain” in response to whether staff obtained consent.

Each person we spoke with was very positive about the care they received at Homelea. We were told “I couldn’t wish to be anywhere else” and “The care is very good.” People told us that there was enough to do and that they enjoyed activities such as knitting and concerts.

We saw that the environment was clean and maintained, including individual rooms. People advised us that they were satisfied with the cleanliness. One person told us “It’s always very clean here.”

We saw that appropriate recruitment checks took place before staff were recruited, which meant that steps were taken to ensure that staff were suitable for the role.

Each person we spoke with expressed satisfaction with all aspects of their care. We were told “It’s a lovely place to be. “People confirmed that they would know how to complain if they wished to. We saw that there had been no recent complaints. One person said “I have no complaints at all, everyone is nice and friendly."

There were twelve people living at the home when we visited. During our visit we spoke with five people and also made observations throughout the visit.

People using the service were very positive about the service and told us they were treated with respect.

People we spoke with told us that they had good relationships with the staff and made positive comments about staff, such as that staff were “Lovely,” and “Very friendly.”

People told us that they always felt safe in the home and thought that staff looking after them were good and well trained. They felt involved in the decision making in the home and some people using the service told us that they had participated in meetings about the running of the home.

One person using the service summed up the positive comments from the people we spoke with and said that she thought that Homelea was “Aptly named as it is was very homely.”