We carried out an unannounced comprehensive inspection of Pendarves Residential Care Home on 6 March 2018. Pendarves is a ‘care home’ that provides care for a maximum of ten adults. 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. At the time of the inspection there were nine people living at the service. The accommodation is spread over two floors. A shared lounge and dining room are on the ground floor. There is a stair lift in place to enable people, who need assistance with mobilising, to access the first floor.

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 on-going 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.

There was a calm and relaxed atmosphere at the service throughout the day of the inspection visit. People and staff welcomed us into the service and were happy talk to us about their views of living and working there. We observed people had good relationships with staff and each other. Staff interacted with people in a respectful, caring and compassionate manner.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Pendarves. People told us they were happy with the care they received and believed it was a safe environment. Comments from people and visitors included, “I feel safe living here”, “It’s a lovely home, I can’t fault it”, “I fell in love with the place as soon as I saw it” and “I think people here are well cared for.”

Incidents were logged, investigated and action taken to keep people safe. Risks to people's health and safety were assessed and clear plans of care put in place to help keep people safe. These had been developed to minimise the potential risk of harm to people during the delivery of their care. Risk assessments had been kept under review and were relevant to the care provided.

Safe arrangements were in place for the storing and administration of medicines. Staff supported people to access healthcare services such as occupational therapists, GPs, chiropodists, district nurses, opticians and audiologists.

Care plans contained personalised information about the individual person’s needs and wishes and people were involved in the planning and reviewing of their care. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted.

People were supported to eat a healthy and varied diet. Comments from people about their meals included, “I really enjoyed the meal today” and “The food is always good.”

People were able to take part in a range of group and individual activities. These included bingo, card games, exercises and pamper sessions. Staff also supported people to go out regularly into the community to visit local attractions and shops.

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs in a timely manner. Staff knew how to recognise and report the signs of abuse. Staff were supported through a system of induction, training, supervision and staff meetings. This meant they developed the necessary skills to carry out their roles. There were opportunities for staff to raise any concerns or ideas about how the service could be developed.

Managemen

We carried out this unannounced inspection of Pendarves on 11 January 2016. Pendarves is a care home that provides residential care for up to 10 people. On the day of the inspection there were 10 people using the service. The service was last inspected in January 2014 and met the requirements of regulation.

The service had a registered manager in post. 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.

The service had safe arrangements for the management and administration of medicines. It was clear from the medicine records that people received their medicines as prescribed. Some people required prescribed creams Cream were not dated when opened. The registered manager responded immediately to this to ensure staff knew when the cream would expire and was no longer safe to use.

There were infection control measures in place to ensure the service was clean and hygienic. However a sluicing facility which was accessed from a corridor did not have a door in place. Cleaning materials were stored in a cupboard in this space. The registered manager recognised the potential for risk and arranged for a door to be put in place with immediate effect.

There were sufficient numbers of care staff to support the needs of the people living at the service.

People were being cared for by competent and experienced staff. People had choices in their daily lives and their mobility was supported appropriately.

Staff understood the needs of people they supported, so they could respond to them effectively. We observed care being provided and spoke with people who lived at the service, their families and healthcare professionals who visited the home regularly. All spoke positively about the staff and the registered manager. One person told us, “It’s the best place. I am so glad I came to live here. I get all the care I need and more”. A family member told us, “They (staff) are just so patient. As a family we are very pleased”.

Staff recruitment files contained the relevant recruitment checks, to show staff were suitable and safe to work in a care environment, including Disclosure and Barring Service (DBS) checks. Pre-employment checks had been completed to help ensure staff had the appropriate skills and knowledge required, to provide care to meet people’s needs. There were enough skilled and experienced staff to help ensure the safety of people who used the service.

Staff supported people to be involved in and make decisions about their daily lives. If people did not have the capacity to make certain decisions the service had systems in place to act in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This was to protect people and uphold their rights.

People were protected from the risk of abuse because staff had a good understanding of what might constitute abuse and how to report it. All were confident that any allegations would be fully investigated and action would be taken to make sure people were safe.

People told us they knew how to complain and would be happy to speak with the registered manager if they had any concerns.

There were a variety of methods in use to assess and monitor the quality of the service. Meetings and surveys had taken place and showed people were engaged with and listened to.

Equipment and supply services including electricity, fire systems and gas were being maintained. Overall satisfaction with the service was seen to be positive.

We carried out this inspection to review a compliance action we set following the last inspection 10th November 2013. We had concerns that people were not protected from the risk of infection because appropriate guidance had not been consistently followed by the registered provider.

We spent time with the providers, reviewed the policies and procedures and took a tour of the home with the provider to observe the changes which had been implemented since the last inspection.

We spoke with six people who used the service about their experience and views of living at Pendarves Residential Care Home. We were told that they liked to live at Pendarves and comments included “they [the staff] respect me and let me choose what I do and when I do it”, “the food is very good, it is proper home cooked food", “the girls [the care workers] are kind and caring towards me” and “It's first class here, the staff are very good”. People who used the service and one member of staff commented that living at Pendarves was just like being with family.

We saw staff were warm, friendly and showed empathy to those they cared for. Conversations we heard were respectful and the language used was suited to the persons’ understanding.

Staff were knowledgeable about people's assessed care needs and the action to take to ensure these needs were met. The care plans were in the process of being reviewed and the system for recording the information had been updated.

We had concerns that people were not protected from the risk of infection because appropriate guidance had not been consistently followed by the registered providers.

A robust recruitment procedure was followed to ensure all staff were suitable to work with people who used the service.

We spoke to eight of 10 people who used the service and they told us they were very comfortable and happy living in the home. They told us they chose what they did each day, and there were activities they could join in if they wished. We saw people socialising with other people who used the service, watching television, and two people were waiting to go out with family. People told us they could raise concerns with either of the providers or the staff if the need ever arose. People told us they had confidence in the registered providers. We saw that the routines being observed during the site visit showed that people were able to get up when they wanted and had choices about where and how they spent their time.

We saw privacy and dignity was respected during our visit, and people told us they “could not be better off anywhere else”. We saw staff talked to people, advised them and offered them assistance. We saw that people’s wishes were respected. We saw care workers providing care to people in a professional, good humoured manner. Staff were seen to have meaningful conversations with people while carrying out tasks.

People experienced care, treatment and support that met their needs and protected their rights.

People who used the service were protected from the risk of abuse, and people were protected from the risk of infection.

We found staff had received appropriate professional development and accurate and appropriate records were maintained.

We reviewed all the information we hold about this provider, carried out a visit on 10 March 2012, observed how people were being cared for, talked with people who use services, talked with staff, and checked records.

Some of the people using the service did comment in detail about the service they received. We spoke with seven of the ten people living at Pendarves Residential Home. Six were unanimous in their praise of the home and the staff. We saw people’s privacy and dignity being respected and staff being helpful. There were no issues raised by people using the service or by staff. People who use the service were moving freely around the home, and staff were seen to engage well with them. We saw that people who use the service were very happy to approach any member of staff. People told us they had confidence in the registered providers. We saw that the routines being observed during the site visit showed that people were able to get up when they wanted and had choices about where and how they spent their time.

Staff confirmed that training and supervision was provided regularly.