Homewood provides residential support and care for up to 50 older people. At the time of our inspection there were 41 people living at the home. At the last inspection, in February 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care and there were enough staff to provide support to people to meet their needs. People were protected from the risk of harm and received their prescribed medicines safely. The provider had suitably recruited staff to ensure they were able to work with people who used the service.

The care people received continued to be effective. Staff received training linked to the needs of people who lived at the home. People made day to day decisions about their care and staff sought people's consent before helping them. People were supported to stay well and had access to health care services and enjoyed their mealtime experiences.

The service remained caring towards people. People were treated well and this impacted positively on people’s mental and physical wellbeing. Relatives told us they felt their family members were well cared for. Staff promoted people’s privacy and dignity at all times. People made choices about their care and their views were listened to and acted upon.

The service remains responsive. People and where appropriate their relatives were involved in the planning and reviewing of their care. People were supported to maintain their independence and peruse their interests and hobbies. People and their relatives knew how to make a complaint should they wish to.

The service remained well-led. The registered manager demonstrated clear leadership. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes. The checks the registered manager and provider completed focused upon the experiences people received. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to develop the services offered at the home further.

We carried out this inspection on 26 February 2015. The inspection was unannounced.

Homewood is registered for a maximum of 50 people offering accommodation for people who require nursing or personal care. At the time of our inspection there were 50 people living at Homewood. Of the 50 people, around seven had nursing needs. The home was comprised of

three floors and a basement where the kitchen, staff room, laundry, hairdressers and medication room were situated.

A requirement of the service’s registration is that they have 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection a registered manager was working at the home.

At our last inspection in November 2013 the home was found to be compliant in all areas we inspected.

Care provided at Homewood was effective. People’s care needs were reviewed regularly with appropriate referrals made to other professionals. Staff received suitable training to provide care and they were encouraged to do further training to enable them to do their jobs well.

People told us they liked living at the home. We saw there was a variety of food available and snacks and drinks could be accessed when required. People with special dietary needs were catered for and relatives could come and enjoy a meal with their family member if they wished to.

Everyone we spoke with was positive about the management and the running of the home. We saw good systems were in place to make sure the environment was safe and effective for people that lived there. People knew how to complain if they wished to and complaints were actioned quickly and effectively.

People told us they enjoyed the variety of activities at the home. A chaplain was available to support people regardless of their religious beliefs or faith. Links with the community were strong and we saw schools and other services visited the home. Fundraising was ongoing to improve the service for people and volunteers came in to assist paid staff members.

Staff showed an understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) so people who could not make decisions for themselves were protected. We saw that when there were concerns about people’s capacity to make decisions, appropriate assessments had been made. However we saw DNAR (Do not attempt resuscitation) forms on peoples files were not always filled in consistently.

People told us the staff were caring. People were treated as individuals with their preferences and choices catered for. Staff showed dignity and respect when providing care and all the people we spoke with were positive about the staff at the service.

During our inspection visit to Homewood we spoke with six people who used the service about the care and support that they received. They told us that they were happy with the care and one person said “I would recommend it to anyone”. People who used the service told us they had enjoyed their lunch time meal and we saw staff assisted those people who needed help.

We spoke with the manager and four staff. We found they were knowledgeable about the needs of people who used the service and their responsibilities. Assessments and care plans were in place which identified the care that people who used the service needed and guided staff in the delivery of appropriate care. People who used the service told us that staff asked for their consent before providing care.

Recruitment checks were sufficiently robust to guard against employing unsuitable staff. Comments from people who used the service, about staff were all complimentary and included, “all lovely”.

A relative of one person who used the service told us that the home was always clean. We saw that Homewood was clean and that good systems were in place to reduce the risk of infection.

We found that Homewood was well managed with good systems in place to assess and monitor the quality of care. This meant that there was good oversight of the safety and welfare of people who used the service.

On the day of the visit on 20 September 2011, we spoke with five people living in the home, as well as visitors, staff and health care professionals.

We asked people about the care and support provided to them and looked at the care planning documentation to see what guidance was given to staff, to ensure that people received their care as they required to meet their needs. We looked to see if systems were in place to offer this in a safe way.

People living in the home gave us a mixed response to the care they received.

Some people told us that they were happy with the care they received. They said “I’m quite happy really” and one person spoken with, expressed concern about the care they received not meeting their needs.

We asked people about the staff, their attitude to them and if they spoke to them in way that was respectful. We also asked them if they felt that there were sufficient staff on duty to enable them to attend to them in a timely manner. People said that the staff were “very nice” and “they are very good.” One person said that on occasions staff could be “sharp” and another that at times they had to wait quite a while for a response to a bell call.

We asked people about the quality of the food. Generally people said that the food provided was good, but we received some comments that the food was “not what I would choose at home” and some said that they did not care for the vegetables. One person said that they had not been asked for their opinion on the food.

People said that they were happy with the environment; their personal rooms and communal areas. They were happy that they were kept clean.

Visitors spoken with said that the care was good and that they were “very happy”.

A community support worker said that they thought things were well organised and that staff in the home communicated with them well.

We asked about making complaints and what people would do if they felt unhappy about anything. We were told that they would see the care manager or manager in the home. One person said that they had not felt comfortable making a complaint, but had recently completed the annual survey and had raised some concerns.

Staff spoken with told us that they were well supported by senior staff. They felt that they received a good level of training to ensure that they knew how to deal with incidents and understood how to keep people safe.

Prior to the visit, we had received some information of concern from local safeguarding teams and other people who contacted the commission. Our visit to the home was to look further into those concerns.

We carried out an inspection at Homewood on 5 September 2012. The visit was unannounced so that no one living or working in the home knew we were coming.

On the day of our visit we met with five people using the service, spoke with two staff, one support staff member, the Chaplain for the service and two relatives of people who lived at Homewood.

People we spoke with who used the service told us they received their care as they requested and were aware of their care plans. Two relatives we spoke with made positive comments about the service.

People spoken with said "Staff are all nice to me" and another person said "This is my home, I don’t want to go back to my bungalow.”

We saw that people's needs had been assessed and care plans had been devised to describe how people liked to be supported. Risks to people's health and well being had been identified and measures had been put in place to protect people. Care plans we looked at had been reviewed regularly by senior care staff.

People told us they were encouraged to voice their opinions about their experiences of living in the home.

Staff told us they were happy working in the home and that training opportunities were frequent and planned to ensure staff had sufficient knowledge to meet people's needs.

We saw there were quality assurance systems in place which measured people's satisfaction with the service provided in the home.