Sherwood

We found the following examples of good practice:

Staff wore appropriate personal protective equipment (PPE) in line with the Government guidance, to ensure people were protected as much as possible from the risk of cross infection. PPE was easily accessible in various places around the home. Staff had received training in infection control, COVID-19 and how to put on and take off PPE safely.

The home was clean and records showed that enhanced cleaning was being completed regularly throughout the home.

There were clear processes in place for visitors to the service. They were screened for COVID-19 symptoms on arrival and were required to wear appropriate PPE and maintain social distancing during their visit. The

provider was facilitating visits in line with the Government guidance and understood how important this was to people living at the home and their families.

Staff and people living at the home were being tested regularly, to ensure that appropriate action could be taken if anyone contracted the COVID-19 virus.

Further information is in the detailed findings below.

The service is a ‘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 we looked at both during this inspection.

Sherwood provides accommodation and personal care for up to six older people. Nursing care is not provided. At the time of our inspection six people were living at the home.

At the last inspection in August 2016, the service was rated 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.

We saw evidence that staff had been recruited safely and the staff we spoke with were aware of how to safeguard adults at risk of abuse. There were safe processes in place for the management of people’s medicines.

People living at the service told us they were happy with staffing levels and they received support from staff when they needed it.

People liked the staff who supported them and felt that staff were kind and respectful. They told us staff respected their right to privacy and dignity and encouraged them to be independent. We observed this during the inspection.

Records showed that staff received an effective induction and appropriate training which was updated regularly. People felt that staff had the knowledge and skills to meet their needs.

People received appropriate support with eating, drinking and their healthcare needs. Appropriate referrals were made to community health and social care professionals, to ensure that people’s needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice.

People told us that they were treated as individuals and received care that reflected their needs, risks and preferences.

Staff communicated effectively with people. They supported people sensitively and did not rush them when providing care.

People told us they took part in a variety of activities in the home. Most people were happy with the activities available. However, one person told us they felt bored at times and would like a wider variety of activities. The registered manager told us she would address this with the person and make the necessary improvements.

The service had a registered manager in post. Relatives and staff were happy with how the service was being managed. They found the staff and registered manager approachable. They told us any concerns were resolved quickly. No-one we spoke with had made a complaint.

A variety of audits of quality and safety were completed by the registered manager and senior staff regularly. We found the audits completed were effective in ensuring that appropriate levels of quality and safety were maintained at the service. The provider visited the service regularly and had oversight of the audits completed.

The registered manager regularly sought feedback from people living at the home and their relatives through meetings and satisfaction surveys. A high level of satisfaction had been expressed by people living at the home, about all aspects of the care and support provided.

Further information is in the detailed findings below.

Sherwood is large terraced type older property located in Rishton, Lancashire and is registered to provide accommodation, care and support for up to six older people. Accommodation is available in single bedrooms on the ground and first floor of the building. There is a stair lift to the first floor to assist people who experience difficulty with managing stairs. There is a communal lounge and separate dining room area and bathing and shower facilities.

The registration requirements for the provider stated the home should have a registered manager in place. There was a registered manager in post on the day of our inspection. 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.

At the last inspection on 15 & 22 April 2014 we found the service was meeting the regulations which were applicable at the time. During this inspection we found the service was meeting the current regulations.

People using the service told us they felt safe and well cared for. They considered there were enough staff to support them when they needed any help. The registered manager followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people.

The staff we spoke with were knowledgeable about the individual needs of the people and knew how to recognise signs of abuse. Arrangements were in place to make sure staff were trained and supervised at all times.

Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained to do this safely.

Risks to people’s health and safety had been identified, assessed and managed safely.

We found the premises to be clean and hygienic and appropriately maintained. Regular health and safety checks were carried out.

Staff felt confident in their roles because they were well trained and very well supported by the registered manager to gain further skills and qualifications relevant to their work. They were highly motivated and committed to provide a high quality of care.

Staff had a good understanding of the principles of the Mental Capacity Act 2005. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.

The home provided a well maintained very pleasant and homely environment for people who described their accommodation as “home from home”. People told us they liked living in a small home because they got to know everyone very well.

People were provided with a nutritionally balanced diet that provided them with sufficient food and drink that catered for their dietary needs.

People’s care and support was kept under review, and people were given additional support when they required this. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs changed.

People using the service had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. Care files contained a profile of people’s needs that set out what was important to each person.

We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. Care plans were written with sensitivity to reflect and to ensure basic rights such as dignity, privacy, choice, and rights were considered at all times.

Activities were varied and appropriate to individual needs and people were supported to live full and active lives and use local services and facilities. Faith needs wereas managed very well.

People using the service told us they were confident to raise any issue of concern with the registered manager and that it would be taken seriously and the right action taken.

People using the service and staff considered the management of the service was very good and they had confidence in the registered manager. Results of surveys showed a very high satisfaction with the service, the facilities, the staff and registered manager.

There were systems in place to monitor the quality of the service to ensure people received a good service that supported their health, welfare and well-being. We found regular quality audits and checks were completed to ensure any improvements needed within the service were recognised. .

The registered provider had achieved the Investors In People (IIP) award and had recently been awarded Employer of the Year 2016 at the Hyndburn Business Awards Ceremony.

This is a summary of what we found:

Is the service safe?

Before people were admitted to the home arrangements were in place to make sure they would be safe in the environment and there was enough skilled and qualified staff to meet their needs.

We found people had been given a contract of residence outlining the terms and conditions of residency therefore protecting their legal rights.

People told us they were treated with respect and dignity by the staff. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Staff had been made aware of who may be at risk of falling, developing pressure ulcers or may not eat enough. There was good evidence staff worked with other professionals to ensure people had the right care.

People's care and treatment was planned and delivered in a way to protect them from any unlawful discrimination within the home and wider community. They had opportunities to continue to practice their faith, vote in elections and access community health and social facilities.

Staff were trained in emergency procedures such as fire and first aid. Staff had all received training in safe moving and handling people.

People told us they felt safe. 'I have to say I feel safe here. Staff come immediately if I ring for them. There is never any question regarding their attitude to us at all. We're like a family with everyone looking out for each other.'

People who use the service were protected from the risk of abuse. Staff had been trained in safeguarding vulnerable adults. They had access to and were familiar with policies and procedures for defining, identifying, reporting and documenting abuse or suspected abuse. People were encouraged to tell the manager and provider if they were ever uncomfortable or unhappy with any aspect of care. At the time of inspection, no safeguarding referrals had been made.

The provider and manager had been trained and understood their obligation to apply the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). This is a legal framework designed to protect the best interests of people who are unable to make their own decisions. No person living at the home had been assessed as needing this safeguard in place.

Care had been taken to make sure people were kept safe by only employing people who had proven good character records. Contractual arrangements meant staff could not gain financially from people they cared for.

Systems were in place to make sure the provider and manager continually checked the service was safe. This reduced the risks to people and helped the service to continually improve.

Is the service caring?

People told us they were happy with the care they received and the staff team. They said, 'I get all the help I need. I can have a shower when I want one. I only have to ask. The staff are very good.' 'They (the staff) are really very nice and helpful. It's very pleasant living here. Whatever I need I get. You don't have to wait long for assistance. My experience living here is good.'

We observed staff were considerate, respectful of people's wishes, and delivered care and support in a way that maintained people's dignity and promoted their independence.

Staff worked to care plans that were sufficiently detailed on how best to meet individual needs. Daily records maintained showed staff responded to people's needs as required day and night. Staff had received training to meet the needs of people living in the home.

Surveys carried out showed people considered the service they received was very good. They wrote, 'I am more than satisfied with the care, the staff and the food. I loved my own home and now I regard this as my home for as long as I live'.

Is the service responsive?

People were given plenty of opportunities to say what they wanted. They discussed their care with staff and had their own routine for daily living. Staff had a flexible approach to their work and daily routines at the home were based around people's needs and wishes. People's assessment of needs and care plans were reviewed regularly and professional help, support and guidance was sought from other health and social care professionals when needed.

People using the service and their relatives had completed a satisfaction survey. Residents meetings were held and people could say what they wanted and they felt listened to. A system was in place for receiving comments, compliments and complaints. People told us that they would know how to make a complaint, should they need to do so.

Is the service effective?

People told us they discussed their care. They had their own preferred routines, likes and dislikes which staff knew about. They said, 'I get all the help I need. I can have a shower when I want one. I only have to ask. The staff are very good.' And, 'They (the staff) are really very nice and helpful. It's very pleasant living here. Whatever I need I get. You don't have to wait long for assistance. My experience living here is good.'

People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care.

People told us they were consulted with and listened to. One person told us they were involved in discussions and decisions about the activities they would prefer. They said, 'I enjoy a walk with the staff to the shops or around the block.'

We saw that good attention was given to people's appearance. Clothes were laundered well and the hairdresser visited regularly.

Is the service well led?

People told us the management of the service was very good. They said 'Everyone is very kind. The manager gets involved in everything we do. It's easy here as there are only a few of us so nothing goes amiss without someone spotting it. I've no cause to grumble.' Another person said, 'We can talk to any of the staff. They always have time for you.'

The service had a registered manager responsible for the day to day management of the home. Staff were clear about their responsibilities and duty of care. Staff said they had very good support from the manager and provider and were confident to give their views or any concern they raised would be dealt with quickly.

We found there were processes in place to ensure, where people may not have had the capacity to make particular decisions, staff had the necessary information, training and policies and procedures to be able to act in their best interest.

We reviewed the care files of two people who lived in Sherwood. We saw that care plans identified the needs of the person and included information on how they wished their care to be delivered and was reviewed on a monthly basis.

We found people were supported to have adequate nutrition and hydration and systems were in place to monitor this. People were provided with a choice of food and drink to meet their dietary and nutritional needs.

People spoken with told us they received appropriate support to take their prescribed medication and staff administered their medication. We found evidence that there were effective systems in place for the safe administration and management of medicines.

We found there was an adequate complaints process in place to ensure that any comments and complaints were listened to and acted upon.