Riccall House provides residential care for up to 18 people, some of whom may be living with dementia. Residential accommodation is provided on the ground and first floor in three shared bedrooms and 12 single bedrooms. A stair lift is available to the first floor. There is communal dining and lounges on the ground floor, which lead to an accessible outside space. At the time of this inspection there were 17 people living in the home.

At the last inspection in January 2015, the service was rated Good. We made recommendations regarding the recruitment procedure and staff supervision arrangements. At this inspection we found the service remained Good.

People were supported by staff who had been checked and vetted as suitable to work in a care service. We found there were enough staff to assist people in a timely way. We asked the registered manager to keep the hours individual staff worked under review.

Environmental and individual risk assessments were completed. These were used to identify and minimise the risks to people who used the service. We have made a recommendation about using best practice guidance to assess and reduce the potential risk of falls on stairs for people living with dementia.

People’s medicines were managed in a safe way.

Staff received updated training including safeguarding training to ensure they could meet people’s needs safely.

People were supported to have 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.

People’s nutritional needs were effectively met. People spoke positively about the quality of the food, which they enjoyed.

People were supported to access health care professionals when needed. Feedback we received from visiting healthcare professionals was positive. A healthcare professional told us that the staff acted on any advice given and this resulted in improved outcomes for people.

People and relatives said the registered manager and staff were helpful and friendly. Staff understood the importance of respecting people's dignity and treating people with respect.

People felt there was a good range of activities of their choosing. They knew who to speak with if they had any worries or concerns and were confident that action would be taken if they raised any issues.

There was a registered manager in post. The registered manager made sure regular audits were carried out to ensure the service was well managed and organised.

Further information is in the detailed findings below.

We spoke with people who lived at Riccall House Care Home, their relatives, a visiting GP, two nurses, the management team and other staff members on the day of our inspection. Some people living at the home were unable to tell us about their experiences so we observed them in the communal areas.

We found people looked well cared for and relatives told us they thought people were treated well and their experiences in the home were positive. We observed the care staff being kind and respectful to people.

We looked at people's care records and saw arrangements were in place to identify those people at a greater risk of poor nutrition and dehydration. This was continually monitored. Comments from people who lived in the home included: “The food is very good.”

Medicines were prescribed and given to people appropriately; we saw people were given the right medicine, in the right way and at the right time on the day of our inspection.

Staff we spoke with told us they received training which helped them to deliver care and support safely to people.

The provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service. This meant people who lived and staff who worked there were protected from potential risks to their well-being.

Some people living at the home were not able to tell us how they felt due to their care needs. We were however able to talk to some people who told us they were happy living at Riccall House Care Home. They said they were treated well by the care staff. One person told us,” They always ask me if they can help me.”

Whilst we saw the care plans were person centred we did however find, not all of them had been formally agreed to and we asked the provider to review the process of obtaining consent.

People said they thought everybody was very kind to them. One person told us, “They couldn’t be kinder.” One of the relatives we spoke with said, “It’s the little things they do that make people happy.” We observed the care staff treating everyone with respect. They were unhurried and gentle when supporting people. They sat down and encouraged people to communicate with them.

We spoke with two relatives and one health care professional who were visiting on the day of our inspection. They told us they felt there were always ‘enough staff caring for the people who lived here.’ The care staff we spoke with also confirmed the staffing levels were satisfactory.

We saw the provider had systems in place to assess and monitor the quality of the service provided. This included residents and relatives meetings where people discussed the running of the home and could make suggestions for changes if necessary.

People we were able to speak with told us they were happy living at Riccall House. They made comments like “I’m very comfortable and happy here. We’re never short of anything. We get nice food.” Another person told us “ I think they’re (the staff team) are doing their job properly. They’re very kind to us.”. Another said “I’m happy here. I can’t complain. They look after me properly”. And a fourth person commented “I’m happy here. The staff are courteous and kind”. They added though: “The only thing is that they get you up early”. They said they would like to stay in bed for longer They explained that they were helped up at 7 oclock, but would prefer to stay in bed until 8 oclock. With their agreement we discussed this comment with the person in charge.

This inspection took place over two days, 29 and 30 January 2015 and was unannounced. At our last inspection on 18 November 2013 we had not found any breaches of legal requirements.

This service is registered to provide accommodation for 18 older people some of whom have dementia. Accommodation is provided over two floors; the home is set in private secure gardens. There is a small car park for visitors. The home is situated on Main Street in Riccall village close to local amenities. Staff are available twenty four hours a day to support people.

The home has a registered manager. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service were cared for by staff who understood they had a duty to protect people from harm. Staff knew how to report abuse and said they felt able to raise any issues, which helped to keep people safe.

We observed that there were enough staff available to support people during our visits. Staff knew people’s care needs and risks to their health and wellbeing which enabled them to support people appropriately. Training was provided to all staff to help them to develop and maintain their skill.

People lived in a well maintained, clean environment, bedrooms were personalised with memory boxes placed outside people’s bedroom doors to help them find their bedroom. Pictorial signage was provided to help guide people to bathrooms, toilets and lounge areas.

People were offered home cooked food with appropriate fluids to maintain their nutrition. Those who required prompting or support to eat were assisted by patient and attentive staff. Staff monitored people’s dietary intake and gained help and advice if people were losing weight. This ensured that people’s nutritional needs were met.

Visiting health care professionals that we spoke with informed us that they had no concerns about the service people received and they were positive about the help and support provided to people by staff. They confirmed staff acted upon their advice to promote people’s health and wellbeing.

People were involved in making decisions about their care. Staff supported people to make decisions for themselves. People’s privacy and dignity was respected.

A complaints procedure was in place, anyone wishing to make a complaint could do so. There were systems in place to deal with complaints in a timely manner.

People living at the home and their relatives were asked for their opinions about the service provided. The registered manager undertook regular audits which helped them to monitor and maintain the quality of the service. However, we have made some recommendations throughout the report for the registered provider to consider.