The inspection took place on 17 and 21 March 2017 and was unannounced on the first day. The Retreat Care Home (known as The Retreat) provides care and accommodation for up to 20 people. On the day of the inspection 19 people were using the service (two people were in hospital). The Retreat provides care for people who are elderly and frail and may have mild mental health and / or physical care needs.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service had a registered manager in post. 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.

On the day of the inspection staff within the service were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were organised, clear, easy to follow and comprehensive.

People were comfortable with staff and we observed positive interactions between people and staff. Care records were personalised and gave people control over all aspects of their lives. Staff responded quickly to people’s change in needs. People or where appropriate those who mattered to them, were involved in regularly reviewing their needs and how they would like to be supported. People’s preferences were identified and respected.

Staff put people at the heart of their work; they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed and practice was person focused and not task led. Staff had appreciation of how to respect people’s individual needs around their privacy and dignity.

People’s risks were managed well and monitored. People were promoted to live full and active lives. Staff were motivated, and creative in finding ways to overcome obstacles that restricted people’s independence.

People had their medicines managed safely. People received their medicines as prescribed, received them on time and understood what they were for. People were supported to maintain good health through regular access to health and social care professionals, such as GPs, social workers, occupational therapists and physiotherapists.

People we observed were safe. The environment was uncluttered and clear for people to move freely around the home and equipment was well maintained. All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were supported by staff that confidently made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected. Families were involved in decision making where necessary. The service followed the laws and processes were in place which protects people’s human rights and liberty.

People were supported by staff teams that had received a comprehensive induction programme, and tailored training and ongoing support that reflected their individual’s needs.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

The service had a policy and procedure in place for dealing with any concerns or complaints.

No written complaints had been made to the service in the past twelve months.

Staff and relatives all described the management to be excellent, supportive and approacha

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced.

The Retreat Care Home provides care and accommodation for up to 20 people. On the day of the inspection 17 people were using the service. The Retreat Care Home provides care for people who are elderly and frail and may also suffer with mild mental health conditions and/or have restricted mobility. The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

During the inspection staff and people appeared relaxed, there was a calm and friendly atmosphere. People told us the freedom they had to move around, was one main reason for choosing the home. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.

People all spoke highly about the care and support they received, one person said, “When I knew I needed more help, I straight away chose here and I haven’t ever regretted it, I’m well looked after.” Another stated: “You can’t better the care you get here, marvellous.” Care records were person centred, gave people control and were reviewed monthly to assist the home in quickly responding to people’s change in needs. People were involved in identifying their needs and were supported to give their preferences on how they wished them to be met.

People’s risks were managed well and monitored. People were promoted to live full and active lives and were supported to access the community. Activities reflected people’s interest and individual hobbies.

People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers, occupational therapist and district nurses.

Staff described the management to be very open, supportive and approachable. Staff talked positively about their jobs. Comments included: “I’m really happy here, such a good team of people and the management are so approachable, they listen to you.”; “The best home I have ever worked in” and “The support I get makes me full of confidence.”

Staff received a comprehensive induction programme. There were enough staff to meet people’s needs. Management and staff told us the importance the provider placed on training to make sure their staff had the correct skills to carry out their roles effectively. One staff member said: “The standard of care here is excellent and I put that mainly down to how much training we are given.”

Staff were up to date with current guidance to support people to make decisions. Any restrictions placed on them was done in their best interest using appropriate safeguards.

. All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated. People told us they felt safe whilst care was being delivered.

There were effective quality assurance systems in place. Incidents were appropriately recorded and analysed. Feedback from people, friends, relatives and staff was encouraged. This was all used to help make improvements and ensure positive progress was made in the delivery of care and support provided by the home.

The home was registered to provide personal care and accommodation to up to 20 people who were elderly. On the day of the inspection we spoke with fourteen of the people who lived at The Retreat Care Home. We were also able to speak with two people’s relatives.

People we spoke with were happy with the home’s standards. The comments we received included “it is a wonderful place, they treat you very well,” and “I love it, the staff are very helpful and they work very hard.”

Everybody we spoke with told us staff were kind, supportive and treated them with respect and dignity. Nobody who we spoke with had any concerns or complaints.

The accommodation was furnished, decorated and maintained to a high standard. The home was very clean and there were no offensive odours. Some additional work needed to be completed to ensure the building’s health and safety standards were maintained appropriately.

The medication system was well organised and operated effectively. There were satisfactory numbers of staff on duty. Staff training provision was to a satisfactory standard.

The service had a suitable quality assurance system to ascertain the views of people.

We carried out this inspection to check on the care and welfare of people using this service. The inspection was unannounced which meant the provider and the staff did not know we were coming.

We spoke with five people using the service, three visitors, one member of staff and the registered manager. Everyone we spoke with was happy with the service they received. One person told us, “If I compare it, it is one of the best I can think of.”

We found people's privacy and dignity were respected. We heard the staff were courteous, friendly and polite. We saw that care was provided by trained staff who knew the needs of people well.

We looked at safeguarding procedures; this is how the service ensured people using the service were protected from harm. We saw suitable systems were in place to support and protect vulnerable adults.

We looked at the recruitment procedures for staff and found that the necessary checks had been carried out prior to staff working in the service. This meant vulnerable adults were suitably protected.

We checked the records were stored safely and correctly and systems were as required. This was to ensure people’s confidential information was stored appropriately.

People we spoke with said they felt safe and supported at the home. We received many positive comments including ‘very happy here – couldn’t be better’, ‘wouldn’t want to be anywhere else’ and ‘I really like it here’. People living at the home told us that the staff were ‘very nice and always helpful’ and that ‘nothing is too much trouble.’

We staff treating people with dignity and respect and heard much friendly chatter between them.

Risk assessments and care plans provide staff with enough information to ensure the support people receive is consistent, promotes independence where possible and keeps the individual safe from harm.

People told us there was always something to do, either playing skittles, bingo, out for a drive or a party.

We heard lots of friendly chatter between staff and people living at the home.

The home was clean and tidy throughout and had a warm and comfortable feel. We saw a variety of moving and handling equipment throughout the home. We saw that this was serviced as required. We saw that there is a stair-lift available to people to enable them to access the upper floors; we saw that this was also serviced as required.