Whitby Dene is a care home for up to 60 older people. Some people may be living with the experience of dementia. Accommodation is provided over two floors. The service is provided by Care UK Community Partnerships Ltd, part of Care UK, a national organisation providing health and social care. At the time of our inspection there were 58 people living at the service.

There was 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 and associated Regulations about how the service is run.

At the last inspection on 1 October 2015 we rated the service Good.

At this inspection on the 31 October 2017 the service remained Good. We rated the key question of Responsive as outstanding. We have rated the key questions of Safe, Effective, Caring and Well-Led as Good.

People received a personalised service. Their care needs were met, but more than this they were supported to make choices about how they lived their lives. The registered manager told us they promoted an ethos where ''anything is possible''. They had created a wishing tree, an interactive feature where people could physically post their wishes and dreams. The staff worked hard to make these come true, however unusual they were. As a result people had experienced life changing activities, such as learning to fly an aeroplane. For people who were unable to make individual requests, the staff worked closely with others who knew them well to understand their hopes and dreams. They supported people in a way that they hoped every day would be meaningful for them. For example, supporting a retired priest to continue to provide mass to others.

There was a close partnership with other organisations within the local community. The provider recognised the debilitating effects of loneliness for many older people. They had worked with other care homes to start a pen pal initiative where people had a friend living in another care home who they wrote to, invited for events and meals and visited. The provider had also made links with local schools where they were helping to educate young people about dementia with the hope that they would become 'dementia friends' (part of an initiative to support people living with the experience of dementia through befriending and better understanding). Older people living within the community were invited for meals and respite stays to help alleviate some of their anxieties about needing care in the future.

The provider supported the staff to develop their skills and competencies. The registered manager had created staff development programmes where staff wanting to work toward a promotion were given the opportunity to shadow senior staff and complete a competency framework in order to prepare them for this role.

People were able to contribute their ideas and felt listened to and valued. They were happy living at the service. They told us the staff were kind, caring and friendly. We observed a positive and happy atmosphere at the home. The staff all spoke about their enjoyment of their work and told us they felt supported. People looked happy and the staff regularly interacted with and engaged with people, making sure that when people spent time on their own this was through choice and not for another reason. Each day at 3pm all of the staff stopped any other non-essential work they were doing to sit with people and share a cup of tea and have a chat. There were fun and diverse organised group activities which were popular. People were involved in planning their own care, as were their relatives and other representatives. Each month, or more often if needed, all aspects of people's experience living at the home were reviewed and they were able to contribute their ideas and preferences.

The staff had crea

The inspection took place on 27 January 2015 and was unannounced.

Whitby Dene is a care home that provides accommodation and care for up to 60 people. The accommodation is divided over two floors. The ground floor accommodates 30 people who are living with the experience of dementia and the first floor accommodates 30 older people.

There was 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 and associated Regulations about how the service is run.

People living at the home and their relatives told us they were happy there and they felt they had their needs met. Some of the things people said were, ‘’I am very happy’’, ‘’everything is fine, no complaints’’, ‘’I am happy with everything’’, ‘’the staff are kind, they don’t fuss over you but are there if you need them.’’ The staff also told us they felt well supported and happy working at the home.

However, we found some areas of the service where people’s needs were not being met and there were risks to their health and wellbeing.

During our inspection we observed some practices where people were put at risk because the staff were not supporting them in a safe way. For example, some people were supported to eat their lunch in a way which could have caused them to choke.

People were not always supported to take their medicines in a safe way. The staff who were responsible for managing medicines did not have the information they needed to make sure these were administered in a safe way. Records of medicines were not always accurate. Some people were prescribed medicines with side effects but the staff were not aware of these and they had not been risk assessed.

The provider had not always sought the consent of people to provide care and treatment. In some instances decisions had been made for people but there was no evidence to say how these decisions had been reached and if they were in the person’s best interest.

Some of the interactions we observed were not caring or respectful. For example, people were supported to eat their lunch by staff who did not engage with them or show an interest in their enjoyment. We saw staff ignoring one person who asked them questions. We saw someone being touched by staff without them giving clear information or asking for their consent.

You can see what action we told the provider to take at the back of the full version of the report.

We also saw some positive interactions and staff acting with kindness. The staff we spoke with knew individual likes and preferences. There was a range of activities which reflected people’s interests. Care plans recorded people’s individual needs and their health needs had been assessed and were being met.

People were given a variety of freshly prepared food and their nutritional needs had been individually assessed.

The staff had a range of training and felt supported by the managers in the home. The provider undertook regular checks on the service and had an action plan where problems had been identified.

We spoke with the manager, four other members of staff, eight people who use the service and two relatives. We found that people were asked for their consent to any planned care at the assessment stage and people told us they were asked for their consent when being supported with daily tasks.

People's needs had been assessed and appropriate care plans developed so that staff could meet their needs effectively. We saw that people's health needs were responded to and followed up to promote people's wellbeing.

People told us that they were well looked after by staff. One person told us, "I'm very happy here, I'm well looked after, they [staff] are very kind" and another said, "the staff always help me."

People said that they felt safe in the home and we found that the provider had systems in place to protect people from the risk of abuse. Staff were able to demonstrate that they would take appropriate action if they were concerned about a person's welfare.

We found that staffing levels were sufficient to enable staff to meet people's needs effectively and staff and the people using the service told us there were always enough staff on duty.

There was an effective system in place for managing complaints about the service. We saw that complaints were responded to promptly and appropriately.

We visited the home to check whether the service had made the necessary improvement with regards to ensuring that care plans comprehensively reflected the needs of people and the care they received. We had visited the home on 1 November 2012 when we had found that the provider needed to make improvement in this area as people were at risk of receiving unsafe and inappropriate care.

On this occasion we did not speak to people using the service but we were able to observe them briefly and to check the care records of four people.

We found that the home had made the necessary improvement to protect people from the risks that could arise if people did not have appropriate care plans describing how their needs should be met.

During the inspection we talked with ten people using the service, three relatives and four members of staff to get their views about the quality of the service that is provided in the home. People we spoke with told us staff took the time to explain their care and support so they understood what staff were doing for them. They all said they had the opportunity to make choices in their daily life and staff respected these.

People were satisfied that their needs were being met in the home. During the inspection we saw that all people appeared well cared for. They told us about the various activities that were arranged in the home to keep them engaged and stimulated. Whilst, relatives were informed of the changing needs of people, we found that they had not always been involved when people’s care plans were updated or reviewed. We also found that some areas of care planning had improved but there were other areas that also needed to improve. This included making sure that care plans addressed all the needs of people, including the management of pain, when people experienced pain.

The home had a quality management system which included people being given the opportunity to express their views in satisfaction surveys and in meetings. There was also a range of audits that were carried out to monitor the quality of the services provided to people. Where necessary, actions plans were in place to address areas that required improvement.

People received information about the services offered by the provider when they moved into the home so they knew what to expect. Some of them were involved in making decisions about the décor of their rooms to personalise and make their rooms ‘homely’.

Staff supported people to make choices about their daily life and promoted their independence and privacy. One person said “I can choose what I do and I go to the lounge for activities when I want to”. Another said “staff explained things to me when they do things for me”.

We observed that all people looked well cared for and were appropriately dressed.

People were involved in the way services were provided for them. They confirmed that monthly meetings were arranged when they had the opportunity to share their views and make suggestions about the provision of the service. Relatives meetings were also arranged quarterly.

The inspection took place on 29 September 2015 and 1 October 2015 and was unannounced.

The last inspection of the service was on 27 January 2015 where we identified breaches in the Regulations. These related to safe care and treatment of people, management of medicines, consent to care and treatment, respecting and involving people and good governance. The provider wrote to us with an action plan telling is how they would make the necessary improvements.

Whitby Dene is a care home that provides accommodation and care for up to 60 people. The accommodation is divided over two floors. The ground floor accommodates 30 people who are living with the experience of dementia and the first floor accommodates 30 older people. At the time of our inspection 54 people were living at the home. There was 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 and associated Regulations about how the service is run.

The provider had taken action to reduce risks to people’s safety and wellbeing. There were clear up to date risk assessments and the staff had received training to ensure they followed safe practices.

People received their medicines in a safe way.

There were appropriate safeguarding procedures and the staff were aware of and followed these.

There were enough staff employed to meet people’s needs. The staff recruitment procedures were designed to make sure staff were suitable.

People had consented to their care and treatment and this had been recorded.

The staff received the training and support they needed to care for people.

People’s nutritional needs were met.

People were supported to stay healthy and saw healthcare professionals as needed.

The staff were kind, polite and caring. People said they had good relationships with the staff.

People’s privacy and dignity was respected.

People’s needs had been assessed and care was planned to meet these individual needs.

There was a range of organised social activities and people were supported to take part in these.

People knew how to make a complaint and felt the provider listened to and acted on concerns.

The provider undertook a range of audits and checks on the service. There had been improvements to the service since the last inspection and new audits had been introduced to maintain these improvements.

The provider was working with other professionals to improve their understanding and support of people who had dementia.