Yoakley House Care Home is a residential care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Yoakley House accommodates up to 31 older people in one adapted building. There were 30 people using the service at the time of our inspection, including four people who were receiving a short term service to support them to recover from an illness and return to their own home.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People told us that Yoakley House was their home and they felt safe living there. One person’s relative told us, “The standard of care is excellent. I can speak highly enough of it”. The provider and registered manager had oversight of the service. They checked all areas of the service regularly to make sure it met the standards they required. The registered manager worked to continually improve the care people received and had supported staff to continually develop their skills to meet people’s needs.

Staff felt supported by the registered manager and deputy manager, they were motivated and enthusiastic about their roles. A senior member of staff was always available to provide the support and guidance staff needed. Staff worked together to support people to be as independent as they wanted to be. All the staff we spoke with told us they would be happy for their relatives to live at Yoakley House. Records in respect of each person were accurate, complete and kept secure.

Staff were kind and caring and treated people with dignity and respect. They took time to get to know each person well, including people who received a short term service and provide the care each person wanted in the way they preferred. People received the care and support in the way they preferred at the end of their life.

Assessments of people’s needs and any risks had been completed and care had been planned with them, to meet their needs and preferences and keep them safe. Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager or provider. People were not discriminated against and received care tailored to them. A process was in place to investigated and responded to complaints and small day to day issues had been resolved immediately to people’s satisfaction. People had enough to do during the day, including activities to keep them physically and mentally active.

Changes in people’s health were identified quickly and staff contacted their health care professionals for support. People’s medicines were managed safely and people were supported to continue to manage their own medicines where they chose to. People were offered a balanced diet of food they liked and that met their cultural needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. The registered manager knew when assessments of people’s capacity to make decisions were needed. Information was available to people in a way their understood to help them make decisions and choices. Staff treated people with dignity and gave them privacy.

There were enough staff to provide the care and support people needed when they wanted it. People were involved in recruiting new staffed safely. Disclosure an

We spoke with five people who used the service and one of their relatives, the manager and members of staff. Everyone we spoke with said that they were satisfied with the service they received.

People’s needs were assessed before they started using the service and they were involved in planning their care and support. People told us they were asked for consent before any care was given and their wishes were respected. We found that people who were unable to make decisions for themselves had best interest meetings with relatives or their representative and other relevant agencies.

The staff we spoke with had knowledge and understanding of people's needs and knew people's routines and how they liked to be supported. There were safe recruitment processes in place to make sure staff were checked and were safe to work with vulnerable people

We found the service to be clean, tidy and free from unpleasant odours with infection control policies in place. Relatives and people using the service told us they did not have any complaints but would not hesitate to speak to the manger or staff if they had any concerns.

People told us that they were treated with respect by the staff that supported them and that their privacy was maintained. They told us that staff were polite and they responded promptly when they called them.

They said there were varied menu choices with a good choice of food. One person said: "They will do something different if you don’t like what’s on the menu."

People told us that they felt safe using the service and they felt comfortable to raise any concerns they may have with the manager and care staff.

They told us that they had been asked by the staff if they were happy with the service and had the opportunity to voice their opinions about the care being provided.

People told us that there were happy with the care and support they received. They told us they were involved in their plan of care and were aware of their records. The home and the agency works well with health and social care professionals to make sure peoples care is coordinated.

People who use the service told us they received care from regular staff that were trained to do their jobs well. They said they felt safe living in the home and staff were polite and caring. They told us they had the equipment they needed and received their medicines safely. They said the standards of hygiene and infection control by staff was good. People had the equipment they needed to make sure they were safe. Recruitment checks were carried out on staff. The staff in the care home also provided domiciliary care for people living in the cottages within the grounds and continuity of care was good. People did not have any complaints but felt if they did these would be dealt with. People’s records were held securely. They said that the service carried out checks to make sure they were satisfied with the care being provided. Comments from the people using the services, relatives, health care professionals and staff were very positive.

This inspection was carried out on 29 and 30 September 2015 and was unannounced.

Yoakley House is part of complex of accommodation provided by Michael Yoakley’s charity, the complex also includes 47 almshouse cottages and bungalows. Yoakley House provides accommodation for up to 31 older people who need support with their personal care. Staff employed by the service also provide personal care for up three people living in the almshouse cottages or bungalows.

The service is a single story purpose built property, with 31 single bedrooms with en-suite facilities. Yoakley House provides permanent residential care services for up to 26 people, pre-booked respite for up to three people at a time and emergency short term care for a maximum of two people referred by their GP. There were 28 people living at Yoakley House at the time of our inspection. Three people living in the almshouse cottages were receiving a personal care service.

The registered provider, Michael Yoakley's Charity is a registered charity and a committee of trustees oversees the running of the service. A registered manager was working at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The manager and deputy manager provided strong leadership to the staff and had oversight of all areas of the service. Staff were motivated and felt supported by the management team. The staff team had a clear vision of the aims of the service. Staff told us the managers were approachable and they were confident to raise any concerns they had with them. Plans were in place to continually improve the service.

There were enough staff, who knew people well, to meet peoples’ needs at all times. The needs of people using both services had been considered when deciding how many staff were required on each shift. Staff had the time and skills to provide the care and support people needed. Staff were clear about their roles and responsibilities.

Staff recruitment systems were in place and information about staff and volunteers had been obtained to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff were supported to provide good quality care and support. The manager had a plan in place to keep staff skills up to date. Most staff held recognised qualifications. Staff met regularly with their supervisor to discuss their role and practice and any concerns they had. Action was taken to improve staff practice when shortfalls were identified.

People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to keep people safe and support them to be as independent as possible. A plan was in operation to make sure that staff had detailed guidance about how to provide all areas of the care people needed. People received consistent care as staff knew them well. People were supported to participate in hobbies and activities they enjoyed.

People got the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care they needed to keep them as safe and well as possible.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. People living at Yoakley House were free to come and go as they pleased and their liberty was not restricted. Systems were in place to assess people’s capacity to make decisions and to make decisions in people’s best interests. Most people had capacity and were supported to make decisions and choices.

People were involved in choosing their own food and drinks and were supported to have a balanced diet. A variety of cups was provided to support people to remain independent when drinking. Choices were offered to people and staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained.

People were confident to raise concerns and complaints about the service. When necessary safeguarding alerts had been raised with the local authority. Complaints and concerns were investigated and people had received a satisfactory response. Staff knew the possible signs of abuse and were confident to raise concerns they had with the management team or the local authority safeguarding team. Staff knew how to keep people safe in an emergency but more detailed plans were required to support staff to take consistent action.

The manager and trustees completed regular checks of the quality of the service provided. When shortfalls were found action was taken to address these and prevent them from occurring again. People, their relatives, staff and visiting professionals were asked about their experiences of the care. These were used to improve and develop the service.

The environment was safe, clean and homely. Maintenance and refurbishment plans were in place. Appropriate equipment was provided to support people to remain independent and keep them safe. Safety checks were completed regularly.

Accurate records were kept about the care and support people received and about the day to day running of the service and provided staff with the information they needed to provide safe and consistent care and support to people.

We last inspected Yoakley House in December 2013. At that time we found that the registered provider and manager were complying with the regulations.