About the service:

• Otto Schiff is a care home registered to provide accommodation and personal care for up to 54 older people including people with dementia.

• The home is operated and run by Jewish Care, a voluntary organisation.

• At the time of our inspection, 52 people were living in the home.

People’s experience of using this service:

• People were provided with person centred care at the service. They told us staff were kind and they were treated with dignity and respect.

• Care records and risk assessments were in place to guide staff in caring for people.

• The service had a tool to determine appropriate staffing levels, some people told us that the usage of agency staff impacted on their experience of care.

• The provider was working to address recruitment issues across the organisation and was continually developing strategies to minimise the impact of agency staff on the quality of people’s experience of care.

• Staff were trained and supported in their caring role.

• Although there was no evidence of harm to people, we had minor concerns with some areas of the management of medicines. Following the inspection the provider made improvements to documentation and processes.

• The provider and local management team had systems to monitor the quality of the service.

• The service met the characteristics of Good in all five domains; the overall rating for this service is Good.

• More information is in the full report.

Rating at last inspection:

• At the last inspection on 6 July 2016 the service was rated Good; the last report was published on 25 August 2016.

Why we inspected:

• The inspection took place as part of a schedule of planned inspections based on previous rating.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

This inspection took place on 6 July 2016 and was unannounced. We last inspected the home on 31 January 2014 when we found the provider was meeting all the areas that we looked at.

Otto Schiff is a care home registered to provide accommodation, nursing and personal care for up to 54 older people including people with dementia. The home is operated and run by Jewish Care, a voluntary organisation. At the time of our inspection, 52 people were living in the home.

The home has 54 bedrooms with ensuite facilities split into five units across three floors. Each floor has assisted bathrooms, open plan dining and lounge areas. The ground floor has a large activity room that is used for multiple purposes. The two floors are accessible via two lifts and there is an accessible garden. On the campus where the home is situated there was access to a shop, café and library.

The home had a registered manager who has been registered with the Care Quality Commission since 19 October 2015. 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 they felt safe at the service. The service had robust safeguarding policies and procedures. Staff were able to explain their role when raising safeguarding alerts and concerns relating to abuse. The service had systems to identify and manage risks. Risk assessments were detailed and individualised, and care records were maintained efficiently.

The service was clean and had effective measures to prevent and control infection. The service kept accurate records of medicines administered by staff. There were effective systems for medicines collection. Care plans and risk assessments supported the safe handling of people's medicines.

The service followed safe recruitment practices. Staff files had records of application forms, interview notes, criminal record checks and reference checks. Staff told us they were supported well and we saw records of staff supervision. Staff told us they attended induction training and additional training, and records confirmed this.

The registered manager told us there were sufficient numbers of staff employed to ensure that people’s individual needs were met. However some people and staff told us there were not enough staff at all times to meet people’s needs.

There was choice of food at meal times, and staff supported people to eat when this was needed. People using the service and their relatives told us they found staff kind and caring. People told us staff listened to them and their individual health and care needs were met.

The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff asked people their consent before supporting them. There were appropriate referrals for DoLS authorisation for people who were unable to consent to care to ensure their rights were protected.

The service was reviewing people’s care plans. The care plans were personalised and people’s life histories, individual needs and likes and dislikes were recorded. People and their relatives were involved in planning their care. People and their relatives were asked about their views at residents’ and relatives’ meetings. People were supported to carry out activities in and outside of the service. People and their relatives told us they were asked for their feedback and their complaints were acted upon promptly.

The service had systems and processes in place to assess, monitor and improve the quality and safety of service provided. There was evidence of regular monitoring checks of various aspects of the service.

People were involved in making decisions about their care and treatment. Consent to care and treatment had been asked for and recorded, and family members were involved where the person was unable to give consent. Staff members demonstrated that they understood capacity and consent.

Care plans and other records showed that people's care was planned and described in a person-centred manner. Care plans were outcome based, and we saw evidence that these were reviewed regularly and that the person or their representatives were involved in the process.

We saw that a range of activities were provided and that people's cultural and religious needs were met. People who used the service were able to tell us that they liked living there. We were told that "Staff are nice." A family member told us that "if I can't come in, I know that he is being cared for."

We saw that procedures were in place to ensure cleanliness and prevent the risk of infection, and that staff members were aware of these.

Procedures were in place to ensure that people were supported by staff who were suitably qualified, skilled and experienced. We saw a recorded recruitment process and that checks had been undertaken to ensure a person's suitability before they were able to work at the service.

The provider had effective quality assurance procedures that were used to inform service improvements.

People who use the service told us that staff were kind and respected their privacy and they were offered choices in relation to how they wanted to be supported.

People confirmed that staff assisted them when they needed support with their care and that staff were helpful. One person commented, “they have high standards.”

Staff had a good understanding of the needs of the people they supported and people told us they had good access to healthcare professionals such as doctors, district nurses, dentists and chiropodists.

People told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or the care worker if they needed to. One relative told us, “if we find something’s wrong we say so.”

Medicines were being stored and administered in line with the service’s medicines policy.

People told us the staff were “friendly” and a relative we spoke with told us, “they seem to go on training days all the time.”

Records in relation to the care and treatment of people using the service were being stored securely and were accessible to staff and people using the service when needed.

During this review, we spent time talking to and observing people using the service to gain their views about what it was like living in the home. We saw people interacting with staff and other people using the service. People told us they could make choices about their care and treatment and they were involved in their assessments. People told us they attended "residents'" meetings in which they talked about menus. We observed people had suitable equipment and environment which enabled them to access the facilities. People appeared to be relaxed with the care and support they were receiving. The following were some of the comments people made:

"They listen to everything I have got to say".

"Staff are caring".

People we saw looked relaxed and comfortable. People were seen to be interacting and engaging with staff. People using the service told us they were happy with the support and care they received from staff. We observed people moving freely and accessing communal areas.

We noted that staff interacted with people in an understanding and respectful manner by taking time to explain how they were supporting them. A relative told us a person using the service “was looked after very well”.

People told us they trusted staff and felt safe in the home. People we saw looked happy and confident when interacting with staff and other people using the service. Visitors and people who use the service said they could talk to staff and the manager if they had concerns or worries. Visitors told us staff were “unbelievably patient” and “understanding” when providing care and support to people whose behaviour could be challenging. People using the service felt staff were dedicated and caring.

We noted from observations that staff were caring and attentive to people's needs. We saw people who use the service were confident when interacting with staff. People told us they trusted staff. They said staff knocked on the doors before entering their bedrooms. People felt that staff responded to their needs promptly and effectively.

People told us they found staff supportive and approachable. People using the service and visitors felt they were listened to and were confident staff would respond to any feedback they gave about the service. Observations showed staff listened to the people. We heard staff asking people’s opinions about activities or meals. People told us staff and the manager were approachable and they could talk to them. People who use the service told us they were satisfied with the care they received at the home.