Sedgemoor Care Home is registered to provided accommodation and personal care for up to 30 people. At the time of the inspection 30 people were living at the service. Sedgemoor provides accommodation, personal care and therapies on a short-term basis to help people regain their independence and return to their own homes (reablement). The people living at the home have both physical and psychological support and care needs. The Home is owned and run by Liverpool City Council.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

At our last inspection in January 2015 we found that some staff had not received formal supervision in over 12 months. The service was found to be in breach of regulation in relation to staffing. During this inspection we checked staff records and spoke with people to ensure that they had sufficient access to supervision and support. We saw that each person had a supervision schedule for 2017 and had completed an annual appraisal within the last 12 months. The service was no longer in breach of regulation.

The people living at Sedgemoor and their relatives spoke positively about the safety of the service.

We saw that people were protected from the risk of abuse or harm because staff knew people well and were vigilant in monitoring risk.

Staff had been trained in adult safeguarding and knew what action to take if they suspected abuse or neglect. Each of the staff that we spoke with was clear about their responsibilities to report concerns inside and outside the service. Posters promoting safeguarding and whistleblowing were displayed throughout the service.

Medicines were safely managed within the service by trained staff and in accordance with best-practice guidance for care homes. We checked the storage, administration and record-keeping for medicines on two out of the three units and found that stock levels were correct and records were completed correctly.

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.

People were supported to maintain a varied and healthy diet in accordance with their preferences and healthcare needs. People’s nutritional and fluid intake was monitored where there was an identified risk or health need.

We saw from care records that staff supported people to access a range of community based healthcare services on a regular basis. Some people were also supported to access specialist healthcare services to improve their independence and support them to return to their homes.

People were extremely complimentary about the caring attitude of the staff. It was clear from our observations and discussions that staff knew people well and tailored the provision of care and support to meet individual needs. We saw that staff took time to discuss matters with people and confirm their understanding. The language and approach used by staff was gentle and caring. The people living at Sedgemoor were clearly relaxed and responded very positively to the communication and engagement of the staff team.

People’s right to privacy and dignity were supported by staff in the provision of care and support. Personal care was given in locked bathrooms or people’s own en-suite facilities. A member of staff told us, “Dignity comes with independence.”

People and their families spoke extremely positively about the quality of the service and the impact that it had on their lives. People were clear that they had been involved in the assessment and care planning process and were kept well informed as they progressed in their recovery.

People’s progress was reviewed on a weekly basis at a multi-disciplinary team meeting. The meeting was attended by a range of external health and social care professionals as well as representatives from Sedgemoor. We saw clear evidence i

We found that improvements had been made with this outcome since our last inspection.

Staff told us they felt well supported in their roles and that they knew who their supervisor was. Staff also confirmed that they had had a formal supervision which involved them meeting on a one to one basis with their supervisor to discuss their work, training needs and their performance. People who used the service made the following comments about the staff, “They are very good. They know what they are doing.” “I think the staff do a brilliant job, they are really good at what they do.” The staff are smashing.”

We had previously inspected this service on 22 November 2012. We found areas of non compliance for which compliance actions were set. During our visit we found there had been improvements with regards to the safe management of medicines and in effectively assessing and monitoring the quality of the service. Further improvements were still needed to support workers in their training, supervision and development reviews.

We spoke with five people who used the service and their relatives. People told us that the care they had received had been delivered in a way that respected their privacy and dignity. Their comments included:

"We are always made welcome ".

"The staff are excellent".

"The staff are very good with my relative".

"The staff are nice they come if I call".

"The staff are absolutely lovely".

During our visit we saw evidence that care plans were detailed and identified people’s individual needs and wishes. We looked in detail at care records belonging to seven people who used the service. We saw that their records were up to date and included relevant risk assessments and risk management plans. People who we spoke with told us that they felt safe and had no concerns about the care and treatment they received from staff.

We spoke with six people who used the services, they told us:

“Most of the staff are kind“.

“Staff are brilliant”.

”Staff come straight away if I press the call bell”

During our visit we spoke with people who used the service who told us that the care they received was delivered in a way that respected their privacy and dignity. We looked in detail at five care records of people using the service and saw that they were up-to-date and comprehensive. We saw evidence of risk assessments in people's files and their care plans.

We looked at a selection of personal files. The records showed that the relevant checks were carried out on staff. We spoke with several people about their medicines and the way they were handled. Nobody raised any direct concerns about the way their medicines were managed. Comments included:

“Creams are applied okay”.

”They give me my medicines correctly”.

Overall we found some improvements are needed to help make sure medicines are always handled safely.

Staff we spoke with told us that they were behind with training and had not had a performance review this year.

We were shown copies of audits completed this year which identified shortfalls in supervision, case file record keeping and medication. We saw little evidence of any actions taken or timescales for improvement. This means that the provider was not effectively assessing service provision.

Relatives praised the staff of the home and told us that people were

looked after well. One daughter said "The home is excellent". Another told us “My Mum looks so much better since she has been here. They seem to make getting the medicines right a priority here”.

During our visit, we spoke with several people staying at the home. All of the people we spoke with were happy with their care and accommodation. People said they were comfortable and the food was good.

We received good feedback about the staff. One person said “They are looking after me very well.” Several people described the staff as “nice.” One person told us they always get the doctor if needed.

We spoke with eight people whilst visiting the home and all said that care workers gave them the right amount of support and help with their medicines and they had not experienced any problems.

This unannounced inspection of Sedgemoor Care Home took place over two days on 21 and 22 January 2015.

Sedgemoor Care Home is registered to provide accommodation and personal care for up to thirty people. The home accommodates people who require respite care, short-term care as well as permanent residential care. The home is no longer admitting people who require long term care. Sedgemoor is a purpose built single storey building that is fully accessible to people who are physically disabled. The home is owned and run by Liverpool City Council and it is located in the Norris Green area of Liverpool.

A registered manager was 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.

During the inspection we spoke with 12 people who were either living or staying at the home. We also spoke with a number of visiting relatives and six members of the staff team including care staff, senior care staff and the registered manager.

We found that people who used the service were protected from avoidable harm and potential abuse because the provider had taken steps to minimise the risk of abuse. Procedures for preventing abuse and for responding to allegations of abuse were in place. Staff told us they were confident about recognising and reporting suspected abuse and the manager was aware of their responsibilities to report abuse to relevant agencies.

Each of the people who lived at the home had a plan of care. These provided a sufficient level of information and guidance on how to meet people’s needs. Risks to people’s safety and welfare had been assessed and guidance on how to manage identified risks was included in people’s care plans. Care plans also included information about people’s preferences and choices and about how they wanted their care and support to be provided.

Staff worked well with health and social care professionals to make sure people received the care and support they needed. The service worked on a multi- disciplinary basis to meet people’s needs and support the purpose of people’s stay. We spoke with a number of health and social care professional who worked into the home and they gave us positive feedback about the service.

Medicines were safely administered by suitably trained care workers. We found that medicines were stored safely and adequate stocks were maintained. Regular medicines audits were being carried out to ensure that medication practices were safe and to ensure that any medication errors could be promptly identified.

The manager had knowledge of the Mental Capacity Act 2005 and their roles and responsibilities linked to this and they were able to tell us what action they would take if they felt a decision needed to be made in a person’s best interests.

During the course of our visit we saw that staff were caring towards people and they treated people with warmth and respect. People we spoke with gave us good feedback about the staff team. People described staff as ‘helpful’ and ‘friendly’. One person said “Nothing seems to be too much bother for them, they are lovely.”

Staffing levels were good and people told us there were always sufficient numbers of staff on duty to meet people’s needs safely and effectively.

Staff told us they felt supported in their work. They told us they had the training and experience they required to carry out their roles and responsibilities. The majority of staff held a relevant qualification and all staff had worked in care for a number of years. However we found there was room for improvement in staff training as some staff had not been provided with up to date training. Regular staff meetings were held and handovers took place three times per day. Systems were in place to provide supervision and appraisal to staff. However, we found there was room for improvement in the frequency at which these were provided.

The premises were safe and well maintained and procedures were in place to protect people from hazards and to respond to emergencies. The home was fully accessible and aids and adaptations were in place in to meet people’s needs and promote their independence.

The home was clean and people were protected from the risk of cross infection because staff followed good practice guidelines for the control of infection.

Systems were in place to check on the quality of the service and ensure improvements were made. These included surveying people about the quality of the service and carrying out regular audits on areas of practice.