About the service: Somerville House is a residential care home that was providing personal and nursing care for up to 30 people aged 65 and over. 27 people lived there at the time of the inspection.

People’s experience of using this service:

People were supported by staff that were caring, compassionate and treated them with dignity and respect. People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop positive, meaningful relationships with people.

People and relatives said the service was safe. Staff demonstrated an awareness of each person's safety and how to minimise risks for them. The environment was safe and people had any equipment they needed. Improvements in staffing meant there was enough staff on duty to enable people to receive care in a timely way.

People were supported by staff with the skills and knowledge to meet their needs. Staff had regular training and felt confident in their role. People’s health had improved because staff worked with a range of healthcare professionals and followed their advice.

People were supported in the least restrictive way possible; the policies, systems and culture in the service supported this practice. People were encouraged to socialise and pursue their interests and hobbies. Care plans were detailed and up to date about people’s individual needs and preferences.

People's concerns were listened and responded to. Accidents, incidents and complaints were used as opportunities to learn and improve the service.

The service was well led. People, relatives and professionals gave us positive feedback about the quality of people’s care. They said the registered manager was approachable, organised, and acted on feedback. Quality monitoring systems included audits, observation of staff practice and regular checks of the environment with continuous improvements in response to findings.

Rating at last inspection: Good. (Published 04 October 2016)

Why we inspected: This was a planned inspection based on the rating at the last comprehensive inspection. At this inspection, the service remained Good.

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

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

This inspection took place on the 12 and 16 August 2016 and was unannounced.

Somerville House is a residential care home without nursing. It provides accommodation for 30 people and currently has 29 residents. There is 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People said staff were available when they needed them. However, staffing levels varied and we found a lack of staff presence in communal areas during the afternoon. This led to a delay in people receiving support at times. We recommend the provider review staffing levels in the afternoon to ensure there are always sufficient staff on duty.

Some social activities were provided and people were able to follow their own interests .However, people living with dementia would benefit from regular meaningful occupation and stimulation. We recommend the provider seek advice and guidance on developing activities for people living with dementia.

There was a warm and friendly atmosphere at the service. People said they were safe and well cared for. “People treat me very kindly.” Staff knew how to protect people from the risk of harm or abuse. They had been trained and had access to information to support them. Recruitment practices were followed to ensure that staff were suitably qualified and experienced to work at the service. Staff had the knowledge and skills needed to carry out their roles effectively. There was a strong ethos of teamwork. The manager and deputy used practical demonstrations to augment theoretical training and to supervise staff. They were approachable and staff praised the high level of support they offered.

Risks to individuals had been identified and there was guidance for staff about the ways to keep people safe. There were safe systems in place for the management of medicines. People received their medicines as prescribed. People’s rights were protected by good practice in relation to decision-making. The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People were supported to have sufficient to eat and drink. People living at the service really enjoyed the high quality of the food and the range of choices. The atmosphere was that of a lively café.

The service worked closely with health care professionals to ensure people's health and well-being was maintained as far as possible.

Positive caring relationships were demonstrated with people using the service. People were actively involved in making decisions about their own care. Dignity and privacy were respected and promoted. People received personalised care, which was responsive to their needs. Care plans were well written, accessible and organised.

The service listened and responded to concerns and complaints.

The service promoted a person centred, positive culture where the registered manager made herself readily available to staff for advice and support . She and the deputy worked very closely together and both acted as role models to staff in delivering high quality care.

At the time of the inspection there were 29 people living at the home. We spoke with eight people who lived at the home, two relatives, a visiting GP and district nurse. We spoke with six members of staff, the registered manager and the providers.

People said the food was ‘excellent’ and 'always plentiful'. We saw that lunch consisted of plenty of fresh meats and vegetables with an appetising freshly made desert.

Staff worked closely as a team and we saw how staff supported each other throughout the day. People we spoke with felt the home provided a good level of care. People said ‘the staff are all first class’ and ‘I speak my mind and I say that the staff are very helpful’. Staff said ‘we listen and learn from people here and make sure care is centred on their well-being’.

We examined nine care plans and found they were person centred, and holistic in their content with evidence of monthly reviews.

We spoke with two relatives who confirmed they had no hesitation in recommending the care provided. One relative said they had not realised until their relative came to the home ‘how much they needed a place like this’. They felt confident their relative ‘was safe’.

We found there was a comprehensive quality assurance system in place with monthly monitoring, to cover all essential standards of care. The provider told us they sought to make improvement wherever possible and said ‘we can always find something which we could do better or differently’.

There were 29 people living at the home at the time of the inspection. During our visit we spoke to13 people and made observations throughout the visit.

We reviewed six people's care plans and noted that people were involved in the planning of their care. This person said "I need help with everything I do and the staff make sure that I do not get sore as I have difficulty moving around on my own". We noted in the five care plans that we reviewed that people's individual care needs had been identified and appropriate risk assessments undertaken. This ensured that people received safe care. People told us that they were very happy living at the home. One person said "The staff are very helpful and make suggestions to you about how you would like to spend your day".

Five people at the home told us that they felt safe. One person told us "I feel really secure here and I know I can trust the staff".

We noted in service questionnaires that people at the home were happy with the care and service that they received. One person said " I am very content and happy here".

We spoke to three staff who told us that they were very happy working at the home and were well supported by the registered manager. One person said "I have been supported to develop in my role and really enjoy caring for the older people. This is my dream job".

We observed that people at the home had good relationships with staff which were based on kindness, humour and respect.