This unannounced inspection took place on 2 November 2018. One inspector carried out the inspection.

Mrs Evelyn Larmouth - 45 Westridge Road 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.

Mrs Evelyn Larmouth - 45 Westridge Road is registered to accommodate up to three older people. People had their own bedroom with a private bathroom. People shared the rest of the family home with the provider, who also acts as the manager and lives at the property. The provider does not employ any other staff unless they go on holiday. There were two people living at the service at the time of inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection

The provider’s registration did not require the service to have a registered manager. The provider was the manager of the service, which was based at their family home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and managers 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.

The service was a small, homely environment where people lived alongside the provider in their family home. The provider shared many aspects of their lives with people, including meal times, activities and social events. The provider encouraged people to remain active by supporting them out to take regular day trips out.

People were treated with dignity, kindness and respect. They carried out their daily routines according to their preference and at a pace which they were comfortable with.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The environment was suitable for people’s needs. People decorated their rooms to their preference and had private bathroom and toilet facilities in their rooms.

People followed a diet that met their preference and dietary requirements. The provider cooked fresh food daily and people told us they enjoyed the meals offered.

The home was a clean and hygienic environment. The provider had received a 5-star food hygiene rating when inspected by The Food Standards Agency. This denotes a very good standard of hygiene.

The provider assessed people’s needs to help ensure they received appropriate care. People received their medicines as prescribed and had appropriate access to healthcare services when required. Where people required input from other stakeholders such as doctors, their recommendations were incorporated into people’s care plans.

Where people received care at the end of their lives, they were treated with empathy, respect and given compassionate care.

The provider and deputy manager had a comprehensive knowledge about people’s backgrounds, preferences and needs. The provider lived at the service and apart from the deputy manager, no other staff worked at the service on a regular basis. One additional member of staff was available in the absence of the provider. They had gone through appropriate recruitment checks to help ensure they were suitably skilled and experienced in their role.

The provider and deputy manager had accessed training relevant to their role, which hoped to promote the provision of effective care.

People were protected against risks

The inspection took place on 17 August 2016.

The home is registered for up to three older people who all have their own bedroom. People share the rest of the family home with the provider, who also acts as the manager, and the deputy manager, who both live there. The provider does not employ any other staff unless they go on holiday.

People felt safe and well supported living with the provider and the deputy manager. The provider had a policy in place regarding safeguarding adults and the provider and deputy manager had undertaken training on the subject. People felt there was enough staff to meet their needs. When either of the staff took time off, the provider arranged for an agency to supply additional staff and ensured they worked alongside them in the home for several days to ensure people felt comfortable with them. The provider ensured agency staff had appropriate documents in place to show they were safe to work in the home. The provider and deputy manager had undertaken relevant training to ensure they could meet people’s needs.

Risks to people’s health and safety had been assessed for both the environment and people’s individual needs. The provider ensured fire safety equipment was checked regularly and there were plans in place should there be an emergency.

People were happy with the food provided and the amount that was available. They were also supported to access healthcare professionals when necessary and received their medicines as prescribed.

People shared the house with the provider and deputy manager in a relaxed and family style environment. We observed people moving around the home and spending their time as they wished. We also heard everyone interacting with each other in a positive and respectful way. The provider and deputy manager sought people’s views regarding all aspects of their daily lives. People’s privacy and dignity was respected.

People’s needs were met by the provider and deputy manager who both knew their social histories and knew them well. The provider undertook an assessment of people’s needs before they moved to the home. People had a care plan in place, which they had signed to show they were involved and agreed with the plan. People were involved in a range of activities of their choosing.

The provider had a complaints procedure which was displayed in the hallway but they had not received any complaints.

The provider ensured the culture of the home was person-centred, open and inclusive. The culture was one of a family setting, where the provider and deputy manager shared their lives with the people living there.

The provider told us they ensured their service was well led by welcoming any feedback from people living at the home, their family, friends and associates and healthcare professionals.

At the time of our inspection there was only one person living in the home. We spoke with them about their experiences. They told us they were very happy with the home. They said they were treated with respect and their wishes and views were taken into account. They said they had “no cause to complain as the provider was lovely and would do anything for me”. They told us their room was kept nice and clean and anything that was broken was fixed quickly.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People experienced care, treatment and support that met their needs and protected their rights.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. The home was safe and suitable for the person who lived there.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We did not speak to people on this occasion as it was not appropriate. We found that the provider had taken appropriate steps to update themselves with relevant training. People were cared for by confident staff who were undertaking appropriate training to keep them up to date with current practices.

We spoke with two people who lived at the home. They all told us that they were very happy there and that the owner would do anything for them.

People told us that they all got on but at the same time could have their own private time in their room if they wanted to. They had no concerns about the care and treatment they received and felt they were fully involved in any decisions that affected them.

We spoke with all three of the people who live at the home. They all told us that they loved living there and that it was more like a family home than a care home. They told us that the home was exceptional and just like the sign on the door when we came in a ‘home from home’ atmosphere.

People told us about the many activities that they did from visiting a garden centre to their trip to the church each Thursday for activities and games. They thoroughly enjoyed this. They told us that they all got on but at the same time could have their own private time in their room if they wanted to. We were told about the mobile library which one person valued greatly as they loved to read and had been introduced to different authors that they had never considered before.