This inspection was unannounced and took place on 14 and 15 December 2016.

Whitecliff Care Home provides accommodation for up to 28 people who have a dementia type illness. It is situated in St Leonards on Sea.

There are two managers in post who are going through the process to enable both of them to become registered. 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.

Staff were very attentive and people were at the heart of everything they did. Staff provided kind, considerate, compassionate care. Staff provided a range of activities and ensured people were engaged with these. Staff knew about the things that were important to people.

Relatives told us people were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

There were suitable recruitment procedures and required employment checks were undertaken before staff began to work at the home. Staffing levels and skill mix were planned, implemented and reviewed to keep people safe at all times. Any staff shortages were responded to quickly and appropriately.

The staff understood their role in relation to the Mental Capacity Act 2005 (MCA) and how the Deprivation of Liberty Safeguards (DoLS) should be put into practice. These safeguards protect the rights of people by ensuring, if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm.

Systems, processes and standard operating procedures around medicines were reliable and appropriate to keep people safe. Monitoring the safety of these systems were robust.

Assessments were undertaken to assess any risks to the person using the service and to the staff supporting them. This included environmental risks and any risks due to the health and support needs of the person. The risk assessments we read included information about action to be taken to minimise the chance of harm occurring.

Staff knew the needs of the people they supported and provided a personalised service. Care plans were in place detailing how people wished to be supported and families were involved in making decisions about their care.

People were supported to eat and drink. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

Staff told us the managers were accessible and approachable. Staff and relatives felt able to speak with the managers and provided feedback on the service.

The managers and provider undertook spot checks to review the quality of the service provided and made the necessary improvements to the service.

Our inspection team was made up of one adult social care inspector. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we have found. The summary is based on our observations during the inspection. 25 people were resident in the service at the time of our inspection. The purpose of the inspection was to ensure that the provider had met their action plan for non-compliance in March 2014 and had an effective system to regularly assess and monitor the quality of service that people receive.

We spoke individually with the registered manager and two care staff. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

Is the service safe?

There were clear systems in place to make sure that the provider, management and care staff learnt from events such as incidents and accidents and concerns.

Staff training was available to access to undertake their roles in the service. We saw that systems to track training and refresher courses had been developed and monitoring systems were in place.

Is the service effective?

People’s care plans and medication records had been regularly audited and reviewed. This had ensured that people’s care needs were up to date and effective.

Is the service caring?

People had been asked to complete quality assurance satisfaction surveys and the provider acted on their comments.

Is the service responsive?

There was a complaints policy and procedure in place if people or their representatives were unhappy, which was monitored by the provider. We saw that a pictorial complaint format was available to the people who used the service. People told us they had not had to raise any concerns and they were aware who to speak with if they had any concerns and that they felt they would be listened to. The manager operated an open door policy so family and visitors could always speak in private if they had questions or concerns. People could therefore be assured that complaints were investigated and action taken as necessary.

Is the service well lead?

The service had quality assurance systems to develop and improve the service provided, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all time.

We used a number of different methods to help us understand the experiences of the people who lived at the home, because they had complex needs which meant that not everyone was able to tell us their experiences. On the day of the inspection we 26 people were living at Whitecliff Care Home. We spoke with people who lived at the home and their relatives. We spoke with visitors, care staff, kitchen staff, housekeeping staff and the manager. We left comment cards at the home, for people to complete if they wished, and we received 19 completed cards. All of the comments were positive about the support and care provided at Whitecliff. The comments stated that the staff were very caring, the home was welcoming and that the activities provided were very good.

We found that people were comfortable living at the home. One person said, "I am quite happy here." A relative we spoke with said that the staff were very good and provided the care people needed. From direct observations we saw that staff were kind a caring, they spoke with people face to face and supported them to make decisions; and treated people with respect and protected their dignity when providing personal care.

The home works with health professionals and the local authority to ensure that people have access to appropriate health and social care as required.

There were systems in place to assess and monitor some aspects of the service provided. However, an effective monitoring system, to look at all aspects of the services provided, was not in place.

We carried out an inspection to follow up on an outstanding issue with regard to record keeping which we found during our previous inspection of 22 April 2013.

We found that the provider was now compliant. People's records were up to date and accurate. They reflected people's individual needs.

People who lived at the home told us they were happy living there.

Staff knew people well and were able to tell us about people’s care needs and choices. Visitors to the home told us the care was good.

Not all of the people who lived at the home were able to tell us about their experience of living at the home. This was due to their dementia type illnesses. We used a number of different methods to help us understand the experiences of people using the service. We used the SOFI tool; we spoke to people’s relatives and visiting professionals.

People that could talk to us told us they were happy living at the home. One person told us, “I like it here.” Another person told us, I like it, I have my friends here.” We spoke with one person who had stayed in their room. They told us it was their choice. They said, “I just wanted to have a lazy morning so I stayed here.” A visitor to the home told us they were happy with the care their relative received. They said, “it’s like a big, happy family here.”

We saw that people were consulted about their care and activities throughout the day. A visitor told us, “we are kept involved with everything.”

Staff knew people well, and the care people received was good. However, not all of the care plans were up to date.

We examined the systems and processes in place for the safe management of medicines and found they were in order. We assessed that there were sufficient staff on duty to meet the assessed needs of the people living in the home.

We spoke to people using the services but their feedback did not relate to the standard we inspected.

People that we spoke to expressed that they were happy at the home.

Visitors to the home that we spoke with told us they felt people were well looked after and respected. They said they liked the atmosphere at the home.

Relatives we spoke with told us they were involved with care meetings.