This inspection took place on the 12, 13 and 14 October 2016 and was unannounced. St. Catherine’s View is registered to provide accommodation for people who require nursing or personal care and the treatment of disease disorder or injury for up to 56 people. At the time of the inspection there were 54 people living there. The home was purpose built to meet the needs of people living with dementia. Accommodation is provided in single en suite rooms over three floors and organised into five smaller house groups based around people’s needs.

The service had 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 told us they felt safe at St Catherine’s View and people’s relatives confirmed staff provided safe care and kept them informed of any concerns. There were procedures in place to protect people from the risk of abuse. The registered manager acted on safeguarding concerns promptly and appropriately and staff had the knowledge and confidence to identify and report safeguarding concerns. Risks to people’s health and well-being had been assessed and plans were in place to minimise these risks. We found staff were aware of people’s risks and acted to support them safely.

We received mixed feedback about the staffing levels in the home. Staffing levels had been calculated using people’s individual needs as a guide. Some staff told us that changes in staffing levels and the way that staff were deployed in the home had resulted in them having less time to spend with people but people’s care needs were met. However, people and their relatives told us they thought there were sufficient staff to meet people’s needs. The provider’s operational managers were aware of the need to embed and monitor the changes to staffing arrangements and were keeping this under review. Overall it appeared there were sufficient staff to meet people’s needs safely.

Staff were recruited safely, the provider carried out all the required pre-employment checks to protect people from the employment of unsuitable staff.

People’s medicines were managed safely. Arrangements were in place to receive, store and dispose of medicines safely. Staff who administered people’s medicines were trained and had their competency assessed at regular intervals.

People and their relatives spoke positively about the staff in the home. Staff completed training to enable them to meet people’s needs effectively and to achieve professional development in their role. Systems were in place to provide support and supervision for staff. Staff had not always received the level of one to one supervision in line with the provider’s policy. The registered manager was taking action to address this at the time of our inspection.

Decisions about people’s care when they lacked mental capacity were guided by the principles of the Mental Capacity Act 2005 (MCA). People’s care plans evidenced specific decisions had been made in their best interests when they lacked the capacity to make these. When it was deemed to be in people’s best interest to restrict their freedom to keep them safe their rights were protected by an application for a Deprivation of Liberty (DoLS) safeguard. We observed people being offered choices and people and their relatives told us their decisions were respected.

People were supported with their dietary, nutritional and hydration needs. People and their relatives told us the food was good and drinks were encouraged and available. We saw people were supported to eat and drink when they required assistance and were offered choice. Particular attention had been given to supporting the needs of people living with dementia by creating appetising smells to s

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We used SOFI in this inspection because St Catherine’s View provides a service for people with dementia and many of the people using the service were not able to provide direct feedback to us about their experiences. During the observations we saw examples of good staff interactions with people who used the service, for example, responding to questions and providing support and reassurance when people were distressed.

People we spoke with directly told us staff provided the care and support that they needed. Comments from people included: “I can’t fault the staff, they are excellent” and: “Staff know what they are doing and are very kind and polite”. People said they felt safe in the home and were confident that staff would respond appropriately to any concerns they raised.