We carried out a comprehensive inspection of Spring Cottage on 26 and 27 September and 14 October 2016. The first day of the inspection was unannounced.

Spring Cottage provides care and accommodation for up to 24 older people. Accommodation is provided over two floors and there is an outside accessible enclosed garden. The home is located in Hapton near Burnley in East Lancashire. At the time of this inspection there were 20 people living at the home.

At the time of our inspection the service had a registered manager who had been registered with the Care Quality Commission (CQC) since 2010. 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.

The service was last inspected on 24 April 2014 and was found compliant in all areas inspected.

Some people we spoke with were happy with staffing levels at the service. However, others told us there were sometimes delays in staff responding to them. Many people living at the home felt that staff were often busy and did not have time to speak with them.

People living at the home felt that they received safe care. Relatives also felt that people were kept safe at the home.

There were appropriate policies and procedures in place for managing medicines and we observed staff administering people’s medicines safely.

Records showed that staff had been recruited safely. The staff we spoke with understood how to safeguard vulnerable adults from abusive practice and what action to take if they suspected abuse was taking place.

People told us they felt staff were able to meet their needs. We found that staff received an appropriate induction and effective training when they joined the service.

Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service had taken appropriate action where people needed to be deprived of their liberty to keep them safe. Where people lacked the capacity to make decisions about their care, their relatives had been consulted.

People living at the home and their relatives were happy with quality of the food provided. They told us they had lots of choice.

We received positive feedback about standards of care at the home from community healthcare professionals who were involved with the service.

People told us their care needs had been discussed with them and they were involved in decisions about their care.

We observed staff communicating with people in a kind and caring way. People told us staff respected their privacy and dignity and encouraged them to be as independent as possible.

We received mixed feedback about activities at the home. Not everyone living at the home was aware of the activities available and some staff felt that activities could be improved.

We saw evidence that the registered manager requested annual feedback about the service from people living at the home and their relatives. A high level of satisfaction was expressed about standards of care at the home. The registered manager planned to introduce more regular ways of gathering people’s opinions about their care and any suggestions for improvement.

People told us they thought the home was well managed and organised. They felt that the registered manager was approachable.

The registered manager carried out regular checks to ensure that appropriate standards of care and safety were maintained at the home.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This a summary of what we found:

Is the service safe?

The manager told us there had been no application for deprivations of liberties safeguards.

We saw evidence of comprehensive and appropriate care planning in place to ensure people living in the home received safe and effective care.

There was evidence of enough skilled staff in place to care for people living in the home. We were told the home was fully staffed and there was one member of staff in the process of completing an induction programme at present.

We were told regular assessment of people’s needs was carried out prior to entering the home to ensure their needs could be met by the staffing numbers in the home.

We saw evidence of certificates in place for checks on fire, electric, gas and water. The manager confirmed potable appliance checks would be completed the day following our inspection.

Is the service caring?

We spoke with people living in the home who told us staff were caring and kind. We observed a welcoming atmosphere for relatives, potential residents, visitors and new staff.

We saw evidence of refurbishment taking place. All the bedrooms we looked at were decorated with personal items and mementoes. Evidence of activities equipment for example books were available for people in the lounges. We were told there were ongoing activities taking place and people living in the home told us they enjoyed the activities taking place.

We looked at three care files and they reflected their needs so that staff could care for them safely and effectively.

Is the service responsive?

There were copies of minutes from staff meetings with reference made to topics that were discussed. The staff we spoke with confirmed they attended these meetings.

We saw evidence of completed questionnaires by people living in the home. We saw positive results documented from these.

We were told the home responded to maintenance and repairs promptly.

Is the service effective?

There was a programme of activities taking place in the home. People living in the home we spoke with confirmed they took part in activities.

We saw evidence in care files that people who used the service were seen by external professionals for example the GP or optician.

There was evidence in people’s care files that their care needs were being met and reviewed regularly. There was evidence of people being involved in the care files and people we spoke with confirmed they had discussed the care with the staff.

Is the service well led?

The manager is registered with the Care Quality Commission. The staff we spoke with were positive about the manager. People who used the service gave us positive feedback about the manager.

We brought forward our inspection in view of some concerns in relation to incidents that had been reported to the Care Quality Commission. We asked the manager about this. The manager provided us with evidence that appropriate actions, including referral to relevant agencies had been undertaken.

We saw up to date evidence of monitoring and audits taking place. Some examples of these were, care plan reviews, training and weights.

There was evidence of supervision taking place with evidence of notes and feedback from staff seen.

We spoke with three people who used the service. We were told people were happy with their care. People confirmed they were involved in choices of care. We observed people had a relaxed and friendly banter with staff however one person we spoke with told us they sometimes felt a ‘nuisance for staff’. We observed staff knocking on doors prior to entering people’s bedrooms. The people we spoke with confirmed staff knocked on their doors

We looked around the home and we spoke with people who used the service. We were told, “The food is good”, “I am given choices of food”, and, “The food is very good and warm. I have no complaints I get choice and I would be able to pick something if I didn’t like the choices. The staff come regularly with drinks”.

We looked at the care files for two people who used the service and saw evidence of involvement of others for example the GP, district nurse, speech therapy and podiatrist.

We spoke with three people who used the service about the staff. Comments received were, “I am quite happy here the staff are good very pleasant” and, “The staff know what they are doing”.

We spoke with three people who used the service. Comments received were, “I have no complaints really”, “I have not raised any complaints” and, “I am unsure who I would complain to but I have no complaints”.

We carried out this inspection to follow up the progress made following our scheduled visit to the service in August 2012.

People we spoke with told us they were happy with the care and support they received at the home. They told us, "The staff are marvellous. They’re really helpful” and “We couldn’t be better looked after” also “They’re so good to us”.

We asked two people if they had been involved in developing their care records and they told us, “I can remember signing something but my daughter usually deals with all of that” and “They always ask me if I’m alright and what else they can do for me”. All other records seen were complete and up to date.

People told us they were happy with the care and support they received and were treated well by staff. Comments included, "I go to bed and get up when I want” and “We can tell the staff anything”.

People told us they were able to express their views and opinions and could influence the way the service was run. They said they could raise any concerns with the staff or the manager. They were confident they would be listened to.

We found staff had received training on safeguarding vulnerable adults and had access to appropriate policies and procedures. People told us they were able to voice any concerns about the service to a member of staff and they felt confident appropriate action would be taken. A person told us, “We’re safe here”.

People made complimentary comments about the staff team. They also told us, “The staff are good” and “They know what to do”. We spoke with two members of staff. They told us they were given the training, development and support they needed to do their jobs properly.

People were being consulted about their opinion of the service. They told us they could talk about any issue concerning the home and were confident the manager and staff would listen and act if necessary. They knew that records about them were held at the home.