About the service:

Landemere Residential Care Home provides accommodation for up to 41 people who need personal care and support. The service provides care for older people and people living with dementia. There were 40 people living at the service at the time of our inspection.

Rating at last inspection: Good (report published 27 July 2016).

What life is like for people using this service:

Improvements were needed to one person’s risk assessment to ensure they, other people, and staff were safe at the home.

People said they felt safe at the home because staff checked on them and assisted them to move safely. The home was well-staffed and people had their needs promptly met. Medicines were overseen and administered by trained senior staff. All areas of the home were clean, tidy and fresh and staff were trained in infection control.

Staff were well-trained and people said they were kind and helpful. People said they liked the food served. At lunchtime the dining room was well-presented with menus, condiments and serviettes on the tables. Staff ensured people’s healthcare needs were met knew when to seek medical assistance for people. The home was purpose-built and accessible throughout to people with limited mobility.

People made many positive comments about how caring the staff were. They said the staff talked with them and helped them to make choices about their lives. The home had an inclusive atmosphere, for example the staff had their Christmas party there because they wanted the people they supported to attend. Staff respected people’s privacy and dignity and encouraged them to be as independent as possible.

Staff were knowledgeable about how best to meet people’s needs. People had the opportunity to take part in a wide range of one-to-one and group activities at the home including chair-based exercise classes, bingo, quizzes, monthly cocktail parties with visiting entertainers, and church services. People knew how to complain if they needed to and were confident that complaints would be listened to and addressed.

The registered manager was approachable and knew the people using the service well. When she took up her post she moved her office downstairs so she could be nearer and more accessible to the people using the service. The provider had quality assurance systems in place to monitor the quality of the care provided and make improvements where needed. The home had links with organisations in the wider community, for example local schools and churches.

More Information is in the detailed findings below.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection visit took place on 7 June 2016 and was unannounced. We last inspected this service on 3 December 2013 and found that the service lacked consistency in establishing people's capacity to make decisions. We followed this up with a desk based review in February 2014 and found that the service had made improvements and met their legal requirements.

Landemere Residential Care Home provides accommodation for up to 41 people who need personal care and support. The service provides care for older people and people living with dementia. Accommodation is provided on two floors arranged into separate units. The service has single bedrooms with toilets. There were 38 people living at the service at the time of our inspection, with one person in hospital.

The registered manager of the service had been in post since January 2016. 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 using the service told us that they felt safe. There were good systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse.

There were robust recruitment processes in place. Staff completed thorough checks before starting work at the service.

People's medicines were managed in a way that kept them safe. People received the medicines they needed when they needed them. The arrangements for the storing and recording of medicines was good and this meant that people were protected from possible errors.

There were enough staff to provide safe and effective care. Staff understood the specific needs of people using the service and how to respond when people were agitated or confused. We saw that staff provided compassionate support that met people's needs.

The risks to people's safety and well-being had been assessed and minimised. Staff knew what action they needed to take to keep people safe. Staff followed risk assessments and promoted people's safety. This meant that people were protected from risks to their welfare whilst being supported to be as independent as possible.

Staff told us they felt supported in their roles and the registered manager provided staff with clear guidance and leadership. Staff had completed training and qualifications they needed and we saw they used this knowledge to provide people with safe and effective care.

Staff were caring, compassionate and attentive in their approach to meeting people's needs. Everyone we spoke with praised the approach of care staff. Staff knew people well and took time to chat with them and provide assurance. Staff were friendly and helpful and showed warmth and affection towards people.

Throughout our inspection we saw examples of good care that helped make the service a place where people felt included and consulted. People and, where appropriate, their family members were involved in the planning of care. People were treated with dignity and respect.

People could choose how to spend their time. There was support for people to participate in activities and events.

There was a complaints procedure in place and people we spoke with felt confident their concerns would be listened to and acted upon.

People had their health needs assessed and care plans were put in place to meet their needs. Detailed plans were in place to guide staff in meeting people's specific needs to maintain their health and well-being. People's needs were reviewed on a regular basis and we saw that the service was responsive to changes in people's needs.

The registered manager operated an open and inclusive culture in the service, where the opinions of people who lived there, their relatives and staff were valued and respected

Most people we spoke with said they understood their care plan or had agreed to the help provided but we found there was a lack of consistency in assessing people's capacity to make decisions.

People we spoke with told us they were satisfied with the care and support they received. One person told us “I can’t fault the care, it’s excellent” and another “it’s very good here” and a third said “I always get two people to move me”. A relative described the care as very good. We saw that staff had warm relationships with people and one person told us “The staff are lovely”. One person said “They always call the doctor when I need one”. This meant that the service ensured people’s health needs were addressed.

Most people using the service also told us they enjoyed their food and described the meals as good, although we saw some people were not always offered encouragement with their meals in a timely manner.

We saw there were activities taking place during our inspection visit and people we spoke with confirmed they were able to go out into the community if they wished and that staff accompanied them where necessary.

We found medicines were well managed and there were sufficient staff on duty to meet people’s needs. Complaints were dealt with properly.

We saw that the provider had in place systems and processes to ensure that peoples care needs were reviewed monthly and that changes to their needs were acted on.

We saw that the provider had quality checking systems to manage risks and assure the health, welfare and safety of people who receive care. The provider had also put in place additional monitoring systems to ensure that people are protected against the risks associated with the unsafe use and management of medicines.

People we spoke with told us that they enjoyed living at the home and that they felt their care needs were being met. One person we spoke with told us “it’s nice here, the staff are lovely”, and another told us “I feel safe here and I have a lockable cupboard in my room to keep things in and I have a key to my own room”.

We also spoke with three relatives of people living at the home. They were all satisfied with the care received by their family member. One person told us “it has been brilliant here, the staff have bent over backwards to assist my mum, she had fantastic and great care here”.