St. Agnes Retirement Home provides care and accommodation for up to 26 older people. At the time of our inspection there were 21 people living at the home. The home is not purpose built and has accommodation arranged over three floors. On the ground floor there are bedrooms and communal facilities. The remaining bedrooms are on the second and third floor. The home is situated in a residential area of Weston Super Mare close to the seafront.

The inspection took place on 1 August 2018 and was unannounced. There was a registered manager in post. The registered manager was also the provider. 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 registered manager had appointed a deputy manager for the day to day running of the service. Care plans provided information about how people wished to be supported and staff were aware of people's individual care needs and preferences.

People told us they were involved in their care planning. The electronic care planning system had up to date information relating to people who were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and there were policies and documents to ensure this.

The service had systems to ensure medicines were administered and stored correctly and securely. Medicines records had information relating to people's preferences. However there was no protocols for ‘as required’ medicines to guide staff about administration and creams did not have a date of when they had ben first opened to ensure they were still suitable for use.

There were no hand washing facility at the point of care delivery to prevent cross infection. Recruitment procedures did not always check staff employment history and there were no risk assessments where convictions had been disclosed.

People and their relatives were happy with support arrangements provided. People told us they felt safe and were treated with respect. Systems were in place to protect people from harm and abuse and staff knew how to follow them.

Staff interactions with people were positive and caring. Staff received training to understand their role to ensure the care and support provided to people was safe. All training was up to date.

New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported. People were complimentary of the food provided.

There were systems in place to receive feedback from people who use the service and their relatives. People and relatives were aware of how to raise concerns and they were confident if they raised concerns these would be responded to.

The registered manager and provider had systems in place to monitor the quality of the service. The service had an action plan in place that identified shortfalls in the service and the required improvements.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We made a recommendation about advanced care plans. You can see what action we told the provider to take at the back of the full version of the report.

St. Agnes Retirement Home provides care and accommodation for up to 26 older people. At the time of our inspection there were 21 people living at the home. The home is not purpose built and has accommodation arranged over three floors. On the ground floor there are bedrooms and communal facilities. The remaining bedrooms are on the second and third floor. The home is situated in a residential area of Weston Super Mare close to the seafront.

The inspection took place on 11 May 2016 and was unannounced.

There was a registered manager in post. The registered manager was also the provider. 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 registered manager had appointed a manager for the day to day running of the service.

Care plans provided information about how people wished to be supported and staff were aware of people’s individual care needs and preferences. People told us they were involved in their care planning. The electronic care planning system did not always direct us to the most up to date information relating to the person.

The service had systems to ensure medicines were administered and stored correctly and securely. Some medicines records lacked information relating to people’s preferences.

People and their relatives were happy with support arrangements provided. People told us they felt safe and were treated with respect. Systems were in place to protect people from harm and abuse and staff knew how to follow them. Staff interactions with people were positive and caring.

Staff received training to understand their role to ensure the care and support provided to people was safe. There were some gaps in staff training and the registered manager had plans in place to address this. New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported.

People were complimentary of the food provided. There were systems in place to receive feedback from people who use the service and their relatives. People and relatives were aware of how to raise concerns and they were confident if they raised concerns these would be responded to.

The registered manager and provider had systems in place to monitor the quality of the service. The service had an action plan in place that identified shortfalls in the service and the required improvements.

A single Inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and what the records we looked at.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

People are treated with respect and dignity by staff. People told us they feel safe and are happy with the care, treatment and support provided. One person told us "I chose to come here after visiting four care homes. I have not regretted it at all".

Systems were in place to make sure that managers and staff learnt from accidents and incidents as well as comments received from professionals and relatives of people who used the service.

The service was safe, clean and hygienic. Regular checks were seen to be undertaken on equipment, electrical items and fire safety matters.

Recruitment was seen to be thorough and staff who recently joined the service told us they had a good induction. There were sufficient staff with the right skills and experience to meet the needs of the people using the service.

Is the service effective?

People's health and care needs were assessed comprehensively and they were involved in writing their own care plans. Specialist dietary and mobility needs had been identified in care plans where required.

Is the service caring?

People were supported by staff who took time to listen to the people who used the service. One person told us "the staff are very kind and look after me well". Another person told us "the staff do anything I ask, I am very glad of the help I get".

Is the service responsive?

People told us that they found the manager and staff very approachable. We saw that people had been involved in planning outings for the summer months. We saw care plans which showed us that the care, treatment and support was reviewed in the line with people's changing needs.

Is the service well-led?

The service has a good quality monitoring system which ensures that the manager is aware of any changes in the service and is able to respond proactively.

Good relationships between staff and management were observed on the day of the visit.

Other agencies had written positive comments about the way that the service provides good information and works in a way that improves people's health and well-being.

During the inspection we spoke with eight people who lived in the home; and seven members of staff. We also followed up the issues of concern raised through our website relating to staffing levels and care provision in the home.

All of the people we spoke with gave positive feedback about the home. People we spoke with told us they were happy and safe at St Agnes. One person told us, "It is good here; they look after me very well”. Another person said "they go out of their way to help me”. They said the manager was good and they were confident about talking to them if there were any issues.

All; eight people spoken with told us they found the staff friendly and helpful. They said staff were very knowledgeable and worked well as a team. The staff we spoke with had a clear understanding of the care needs of people who lived in the home. One staff member told us “I love working here”.

People we spoke with said they could choose how to spend their day. We saw there was information for people in the reception area of the home. This included suggestion and complaint forms.

We observed the atmosphere and general ambiance of the home to be friendly, calm and relaxed. We saw staff treated people with respect and dignity.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the manager and provider. They told us there were always enough staff on duty and there was a duty manager on call if needed.

There were 23 people living in the home at the time of the inspection. During our visit to the home we spoke with five people and four staff. We also made our own observations throughout the visit.

People who lived in the home were positive about the service and said they were treated with respect. Each person commented that they were happy living at St Agnes. One person said "It’s very good here."

People told us that staff treated them as individuals and made the changes to their daily routines when they requested it. One person said “the staff are helpful, caring and considerate.”

People told us they had good relationships with the staff and said "on the whole it’s all very pleasant" about the home and people told us they were able to talk to staff if they had any worries or concerns.

We were told people were involved in the decision making in the home by talking to the manager or one of the owners who was regularly in the home. We saw that people’s views were surveyed through regular questionnaires and information was shared through regularly produced newsletters which people shared with their families and friends. Newsletters could also be found near to the main entrance and were available for anyone to read and keep up with what was going on in the home.