We inspected Purbeck House on the 1st February 2018 and the inspection was unannounced.

Purbeck House is registered to provide accommodation for 15 older people requiring personal care who may have a learning disability or associated mental health conditions and or be living with dementia. This service does not provide nursing care at the time of the inspection there were 14 people living at the 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.

There was 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.

We were not assured effective infection control measures were in place. Areas of the home did not appear clean and were in need of deep cleaning. Equipment such as commodes, toilet frames and seats; had not always been maintained to an appropriate standard to ensure peoples safety.

The home had not taken appropriate steps to ensure that effective processes to access, monitor, and mitigate risk relating to health, safety and welfare of service users. Care plans lacked clear information for staff on how to mitigate the risks associated with people’s behaviours.

The service had not notified the care quality commission (CQC) in relation to one safeguarding event which the home had reported to the local authority safeguarding team which meant they had not fulfilled their legal obligation in relation to this matter.

People received their medicines in a safe and effective way from staff that had been trained to administer these. However, there was a lack of guidance where people had been prescribed medicines to be given “when required” (PRN).

There were sufficient numbers of staff on duty to meet people’s needs. Staff worked closely with health and social care professionals to ensure people received effective care in line with their needs.

People’s mental capacity had been assessed where this was appropriate. Staff had training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People’s privacy and confidentiality was mostly respected. Staff knew all people well; they were friendly and helpful. Staff involved people and their families in their care planning as much as possible.

Complaints were managed in line with the provider’s policy. The homes complaints policy was displayed.

We found one breach of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Purbeck House is registered to provide accommodation for 15 older people requiring personal care who may have a learning disability or associated mental health conditions and or be living with dementia. This service does not provide nursing care.

The home has four ensuite bedrooms, four double bedrooms and seven single bedrooms. Three are situated on the ground floor and four are on the first and are accessed by stairs or a stair lift. There is a lounge, two dining areas, kitchen, conservatory and a small patio area to the rear of the property. Public transport and a range of shops are located within walking distance of the service. On the day of our inspection 12 people were living at the home.

There was 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 and associated Regulations about how the service is run.

This inspection took place on 17 December 2015 and was unannounced.

The provider had systems in place to respond and manage safeguarding concerns and make sure that safeguarding alerts were raised with other agencies.

People who were able to talk with us said that they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or manager.

People were involved in their care planning and staff supported people with health care appointments and visits from health care professionals. Care plans were updated to show any changes, and care plans were routinely reviewed monthly to check they were up to date.

People had risk assessments in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and arrangements were in place to manage these safely. Staff knew each person well and had a good knowledge of the needs of people.

There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider had robust recruitment systems in place to assess the suitability and character of staff before they commenced employment.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.

People spoke positively about the way the home was run. The manager and staff understood their respective roles and responsibilities. The manager was approachable and understanding to both the people in the home and staff who supported them.

There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken.

People told us that members of staff were polite, kind and helpful. They told us that their privacy and dignity was respected. We found care records indicated people were involved with their care. They told us they were supported to make decisions regarding their care needs and wishes.

People received the care and support they required to improve their health and well-being. They told us that members of staff knew what their needs were and took care of them “as if they were a family.”

People living at the home told us they felt safe. Members of staff explained to us their role in reporting any concerns.

People living at the home told us that there were enough staff to ensure people were cared for properly and receive the support they required.

People we spoke with said they liked living at Purbeck House Care Home and members of staff provided “good” support. We spoke with one person who told us that members of staff “make me feel very comfortable.” People told us they liked the food served and said there was always a choice of meals available.

We visited the service on 21August and 30 August 2013 as part of our scheduled inspection programme.

Most of the people who lived at the home had dementia and we found that each person's ability to make everyday decisions had been assessed. If a person was unable to give their consent their nearest relative was consulted about decisions affecting their care. This ensured the provider acted in accordance with the person's wishes.

We used the Short Observational Framework for Inspection (SOFI) in the lounge area to help us understand the experience of people who could not talk to us. There was substantial interaction or engagement with various activities including reading newspaper, singing of songs and painting of nails. Most people responded positively although one person became a little agitated. We found members of staff were aware of the person's needs and responded appropriately.

We found that people were well cared for and there were sufficient numbers of skilled and experienced staff to meet their needs. The home had an effective system in place to regularly assess and monitor the quality of service that people received.