This inspection took place on 13 March 2018 and was unannounced. At our last inspection in August 2016 the service was rated Good. At this inspection we found the service remained Good and continued to meet the regulations and fundamental standards.

Weybourne provides accommodation and personal care for up to 40 older people and specialises in caring for people living with dementia. There were 32 people using the service at the time of the inspection. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in place. 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. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse and staff were aware of the action to take if they had any concerns. Staff knew about the home’s whistleblowing procedure and told us they would use it if required. Risks to people’s health and well-being had been assessed, and identified risks were managed safely. Medicines managed appropriately. People were protected from the risk of infection. Accidents and incidents were recorded and acted on in a timely manner. There were enough staff deployed to meet people's needs. Appropriate recruitment checks were carried out before staff started work.

Staff received training, supervision and appraisals so that they were effectively able to carry out their roles. The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 (MCA) and staff asked for people’s consent before they provided care. People were supported to have enough to eat and drink and had access to a range of healthcare professionals in order to maintain good health. We saw that the home had recently been refurbished and redecorated.

People told us staff were kind and respected their privacy, dignity and independence. They were involved in decisions about their care needs. People were provided with information about the service when they joined in the form of a 'service user guide' which included the home’s complaints policy.

Care plans were reflective of people's individual care needs and preferences and were reviewed on a regular basis. There were a variety of activities available for people to participate in. People were aware of the home’s complaints procedures and knew how to make a complaint. People's cultural needs and religious beliefs were recorded and they were supported to meet their individual needs.

People told us the home was well run and that the registered manager was supportive. There were effective processes in place to monitor the quality of the service. People and their relatives were provided with opportunities to provide feedback about the service.

This inspection took place on 26 and 28 January 2016 and was unannounced. At our last inspection on 18 July 2014, we found the provider was meeting all the regulations we inspected.

Weybourne provides accommodation and personal care for up to 40 older people and specialises in caring for people living with dementia. The home is located in Abbey Wood, Royal Borough of Greenwich, London.

At the time of our inspection there was no registered manager in post. The appointed manager was in the process of registering with the Care Quality Commission (CQC). 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 using the service said they felt safe and that staff were kind to them. The provider had safeguarding adults and whistleblowing policies in place and staff understood how to safeguard the people they cared for from abuse. Staff knew of the whistleblowing procedure and told us they would use it if required; however, they were confident that the management team would take action if any concerns were raised. The provider had appropriate recruitment and selection processes in place before new staff started work. Risk to people had been assessed and where risks were identified, appropriate action plans were in place to prevent or minimise the risk. People’s medicines were managed safely and people received their medicines as prescribed by healthcare professionals. There were sufficient staff available on each shift to ensure people’s needs were met.

New staff were supported with induction to ensure they were familiar with the service and had appropriate skills and knowledge to undertake the job they were employed for. Staff received regular training and supervision to support their professional development. The care staff and management team demonstrated a clear understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard. People were supported to eat and drink sufficient amounts for their wellbeing. People had access to relevant healthcare professionals that ensured they received safe care and treatment. People were cared for in an environment that was clean and hygienic.

People’s privacy and dignity were respected and staff promoted people’s independence where they were capable. Staff understood people’s needs in regards to their race, religion and sexual orientation and supported them in a caring way. People were supported to maintain relationships with their family and friends. People were engaged in various activities of their choice to stimulate them.

Each person using the service had a care plan in place which was reviewed monthly to ensure their individual needs were met. The provider had a complaints policy in place and people and their relatives knew how to make a complaint. The provider had systems in place to monitor the quality of the service and this included surveys, audits and various meetings such as residents and relatives meetings. Where improvements were identified there were action plans in place and these were followed up to improve the quality of the service. All staff we spoke with told us they were happy working at the home. All health and social care professionals we spoke with complimented the standard of care being provided.

A single inspector carried out this inspection. The focus of the inspection was to answer 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 the staff told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. Staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home. CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Nine applications had been submitted and we found proper policies and procedures were in place to protect people and ensure their needs were met. Staff had a good understanding about adult safeguarding and they told us they would always escalate any concerns. A safeguarding policy was in place and staff attended an annual training session.

Is the service effective?

People told us they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff they understood people’s care and support needs.. One person told us. "It’s all very nice here. The staff look after us.” Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw the care staff were patient and gave encouragement when supporting people. We observed this at lunch time when we saw staff feeding people at their pace and were not rushed. One person told us “I like it here. I have made new friends." A visitor told us "I have no concerns about the care here; staff are very caring.” Another relative said” the staff are kind and respectful.”

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they were happy with the care they received. Records confirmed people’s preferences, history and diverse needs had been recorded and care and support had been provided which met their wishes. People had access to activities and people told us they enjoyed these. One person said “We do lots of different activities.” We spoke to relatives who told us that the home were responsive and kept them informed of any changes. One relative said “they keep me informed and communicate with me if there are any changes.” The district nurse visiting on the day of our inspection described the staff as always responsive and said “staff always ask for advice if they have a concern.”

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Relatives told us the manager made a real difference to the running of the home. One relative said “If you raise something with the manager they will make sure it’s sorted out.” Staff told us the manager had an open door policy and they could raise any issues with them. They said they had regular team meetings and had supervision and an appraisal.

People and families we spoke with told us they were happy with the care they received whilst living in the home. One person told us "staff are polite" and that "they come promptly whenever I've needed to use my call bell". Another person told us the staff were "very friendly and the food is good". One relative told us "staff keep me up to date" with their family member's progress and that they were pleased the care provided.

We found that people were treated with dignity and respect and that they were supported to maintain their independence. People's needs were assessed and care was planned in a way that ensured their safety and welfare. Staff were supported in their roles through training and supervision and were aware of the action they would take if they suspected any form of abuse had occurred within the home. Accurate records relating to people's care had been maintained, were stored securely and could be located promptly when requested.

People we spoke with told us that they felt happy living in the home and that they felt safe and secure. People's relatives told us that they felt "well informed" and that staff we "very supportive" and knew best how to look after their loved ones. They had no concerns about the care provided and were confident that they could always approach the manager if they were worried about anything.However we found some significant problems with the way care was planned and delivered at the home.

People's care had not always been adequately planned and monitored. We found that their were shortfalls overall in the level of staff training and supervision. We also found that records were not always accurate, stored securely or easy to locate when requested.

We found that staff were kind and caring towards people living at the home and engaged with people in a positive way. We observed a pleasant atmosphere in the home. We found that the care people received was delivered in conjunction with others when it was required. We saw that suitable arrangements for obtaining consent were in place.

We found that people experienced care that protected them from abuse or the risk of abuse. There were appropriate arrangements in place for administering medications. There were adequate systems in place to protect people when they refused their medication.

The environment in which people experienced care was adequately maintained.

However, people received care from staff who sometimes had not been supervised or appraised and, in some areas, had not had appropriate training. We found that pre-admission assessments were not proven to be robust and that, on at least one occasion, someone was not referred to a health care professional when it was required. We also found that appropriate information and documents were not always easily accessible in people’s records.

People who used the service were not always involved in decisions about the care. Sometimes they did not experience effective, safe and appropriate care, treatment and support that met their needs and protected their rights. People could not always be assured that the service cooperated effectively with others involved in their care, treatment and support. They were not always protected from abuse or the risk of abuse. They also experienced care in an environment where medicines were not always administered appropriately and where there were inadequate mechanisms in place to protect people when they refused their medication. They received care from staff who were not always appropriately trained, supervised or appraised.

People and relatives told us that they were kept informed of changes and that staff were responsive when concerns were raised. Relatives said that they were made welcome when they visit. A family member told us about how their family had been involved in their relative’s pre-assessment prior to admission.

People said that they were involved in planning the type of care and support they need. They said that they understood the risks and benefits of the care provided to them. People said that they were regularly consulted on how the care was delivered and felt able to express their views to staff. Relatives told us of their input when their issues that were not fully understood by individuals and how these were explained in a sensitive manner.

People said that “We have good staff that help me get washed and dressed”, “they are kind to me when I forget where I am” and “I like having a dog in the home and I sometimes go out with the carer when he takes him for walks”. We also spoke with a number of relatives and they said that people were well cared for.

The people we spoke with said that they were happy with the quality of the food and that they were presented with choice during mealtimes. Relatives also commented that the people who use the service enjoyed the food.

People at the home felt that they received the necessary care from nurses and doctors who were external to the home.

People said that they lived in clean surroundings. Relatives said that hygiene in the home was of a reasonably good standard.