Simonsfield Care Home is a residential home that is registered to provide accommodation and personal care for up to 63 older people and people living with dementia. At the time of our inspection there were 63 people living there. Accommodation is over two floors, with communal lounges and dining areas, a bar area, hair salon and secure garden.

People's experience of using this service:

Staff were very kind and caring. Feedback from people being supported and their families highlighted positive interactions and compassion of the staff teams. Activities were varied and well organised with positive feedback from people at the home especially with accessing weekly trips out.

People told us that the service was safe. People were protected from abuse and the risk of abuse and staff understood their role in relation to this. Risks to people and others were identified and measures put in place to minimise harm.

Well managed checks were carried out on the environment and equipment to maintain people’s safety. The environment was well maintained and continually adapted with innovation and design to meet the needs of people with dementia.

People were offered a nutritious and balanced diet with snacks and drinks accessible to everyone throughout the day.

People's needs and wishes were assessed and planned for. Care plans were very well managed and identified ongoing outcomes for people and how their needs were to be met.

People knew how to raise a concern or make a complaint about the service.

Everyone we spoke with told us that the service was well-led and described the registered manager as approachable and supportive. The registered manager was highly motivated to contribute to continual improvements. They had piloted a new way of supporting people with dementia at night by trialling the use of ‘nursing scrubs outfits’ that replicated the style of pyjamas. Data collated showed a positive impact to people in reducing the number of falls on the dementia unit. Staff felt the initiative helped people to have focus with day and nights and helped them to orientate to their night time routines.

Details are in the key questions below.

Rating at the last inspection: Good (report published on 16 December 2016).

Why we inspected:

This was a planned inspection based on the rating of the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 27 & 29 September 2016 and was unannounced.

The home was last inspected on 12 December 2013 and met the requirements of the legislation at that time.

Simonsfield Care Home is a care home situated in Runcorn. It has good transport links and access to public transport. Simonsfield Residential Home provides residential and dementia care. The home is situated near to shops and the town is within easy reach of public transport. The home can facilitate up to 63 people. On the day of our inspection 62 people were living in the home.

The home had a registered manager who had been registered in 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.

We found that the administration, storage of medications was safe. Improvement was needed in recording discontinued medication awaiting return to the pharmacy in a more timely manner.

Staff received training and understood the principles in protecting vulnerable adults. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s needs and that safe and effective recruitment practices were followed.

Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and where shortfalls were identified the management was using the information to improve the service.

During our inspection we spoke to two relatives, five people who used this service, one community psychiatric nurse and four members of staff. We reviewed six care plans. We saw evidence of a person centred approach throughout the six care plans we reviewed.

People we spoke to who used the service told us that the staff were “very nice, they are like our friends” and that they were well cared for.

Staff told us “we are like one big family”. All five service users and both relatives told us they were very happy with the service. Both relatives said the care was “excellent”.

We looked at five medication charts, we saw all medicines were given as per their prescription. When asked, staff were aware of the risks and side effects associated with certain medication, for example, anti-coagulants and anti-cancer medication. We also saw evidence that the manager conducted a monthly medication audit which looked at safety of administration, correct storage of medication and safe disposal.

We saw feedback from a survey completed by people who used the service, relatives and professionals from October 2013, all comments were positive. All three professionals who visited the service deemed it as “excellent”.

We spoke with eight people who were living at the service and one relative during our visit.

Their comments overall were very positive. They all agreed that they liked living at the service and used word to describe it such as; “It’s wonderful”; “excellent”; “we have no problems here.” and “Were very happy here.”

One person told us, “I’ve really landed on my feet moving in here, I’m well looked after.”

They all praised the staff and felt they were, “kind.”

One person told us if they had a complaint their relative would help them to deal with it and would get things sorted.

Two people showed us their room and their en suite which they really liked. They told us they had everything they needed and that they had brought a lot of personal items in especially photos which they had put up.

One relative was able to tell us that they were very happy with the care and that the standard of care was always very good whenever they visited. They felt that the home was beautifully furnished and always clean and tidy and never had any unpleasant smells. The told us if they had a problem they would be able to discuss it with the home’s manager. They expressed a lot of confidence in the staff and the manager and felt they had no problems at all.

When we visited Simonsfield care home we had the opportunity to observe the care that was being given to people living at the home. This was called a “short observational study, a SOFI ”. SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.”

We saw many examples of good communication and patience by care staff, who interacted with people in a positive manner. For example staff spoke quietly and bended down to eye level to talk to people they were supporting. We noted staff supporting one person who was upset and staff were very reassuring and respectful to this person. We noted staff asking people if they would like a drink while they were waiting for their evening meal to be served. Staff were warm, friendly and respectful to the people they were supporting.

We had also contacted the local authority contracts and monitoring team for Halton Social services before we visited the service. They shared a detailed positive report from their visit in March 2012.

The 6 people using the service who were spoken with were happy with the care they receive at the home. They said that staff are always polite and respectful towards them. They said that they are asked their views about the care they receive. Some comments made were;

"I'm very happy with the service and the standards at the home."

"The staff are very kind and very helpful."

"The staff are very obliging. They are very good."

"The staff look after us all well."

"The staff are respectful, caring and nice."

Relatives spoken with said that people have their needs met by caring and attentive staff. Some comments made were;

"I've been coming here for a number of years and I cannot fault the care given. The staff are all exceptionally good."

"A very good service is provided."

All 6 people spoken with said that the food at the home is good. They said the meals provided are varied and look appetising. They said that an alternative is always available.

Relatives spoken with said that the food appeared to be of a good quality and that their relatives seem to enjoy the meals provided.

People using the service said that the home is kept clean. Relatives said that the home is always clean on their visits.

The visit by Halton Borough Council in September 2010 found that there are systems in place to gain the views of the people using the service. They found that care plans are in place which are agreed with the resident, carers and family (where possible) and that care plans are reviewed with the families and/or advocate if appropriate. They found evidence of good links with health and social care professionals to ensure that the needs of the people using the service are met. Information received from Halton Borough Council indicates that the service refers any safeguarding matters appropriately.

Halton Borough Council made observations of a meal time and commented "the meal time experience was good with several residents commenting to officers how much they enjoyed their food." They found the home welcoming and clean with evidence of ongoing improvements being made for the benefit of the people using the service. They made observations and as a consequence asked the manager to take steps to address some issues to improve medication administration. The report indicates that the manager indicated that this would be addressed by having additional trained staff in place. They found arrangements in place to ensure that staff are appropriately supported in terms of training and meetings. They were happy with the systems in place to monitor quality at the service and found the new owners to be very positive and senior management to be extremely knowledgeable and professional.

The report of a visit by Halton LINk in March 2011 shows that observations were made of how people are respected and involved. They found the home to be clean and well presented. They thought some attention was needed to the outdoor areas at the home. The manager reported that she is in the process of addressing this. They found that meals are varied and food is available throughout the day. They discussed staff training with the deputy manager and concluded that the level of training appeared appropriate and is currently on going.