Royal Garden Hotel

People were supported by enough staff who were trained and competent in their role. However, record keeping in relation to recruitment processes required some strengthening. The staffing team were consistent, and many told us they felt well supported and valued in their roles.

People chose to live at the Royal Garden Hotel and were aware of the provider’s vision for them to remain as independent as possible and in control of their own lives. Staff worked by the values of the service and supported people to retain their autonomy. Staff worked with healthcare professionals to promote positive outcomes for people; however, specialist involvement had not been quickly sought for a person whose needs had rapidly increased.

People received person-centred care and they had opportunities to pursue new interests, maintain relationships and remain involved in their local communities. New activities had been introduced and people told us they felt included and engaged.

There was a positive and inclusive culture where people, relatives and staff felt able to raise concerns and share their feedback to contribute to the running of the service. They told us the management team were approachable and listened to them. The management team demonstrated a commitment to learning and had introduced changes in response to feedback from people, their relatives and staff.

People living at the service had full mental capacity. Staff offered choices and respected people’s decisions. Risk assessments were undertaken to support people with the self-administration of medicines and where people had differing requirements of medicine support staff used various person-centred approaches in line with their abilities.

Governance systems were in place, for example, to ensure medicines were managed safely, the environment was clean and well maintained. However, some areas required strengthening to ensure fully effective oversight and action. We identified a concern which had been managed internally but not referred to the local authority in line with the provider's policy. There were some inconsistencies within care records, recruitment records and risk management documentation. Despite these shortfalls, they had not resulted in poor outcomes for people and staff demonstrated a good understanding of people's needs. The registered manager responded positively to our feedback and took immediate action to address the areas identified during the assessment.

Feedback from people, their relatives and visiting professionals was positive about the quality of care staff provided. People told us they felt safe and were treated fairly with kindness and respect by staff who knew them well. People’s relatives described the service as welcoming and like a family setting, while professionals spoke positively about the quality of care and the provider's partnership working.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). As people had full mental capacity, no DoLS authorisations were required for people. However, the registered manager demonstrated their understanding of the principals of the MCA.