Norcrest

When we last visited the home on 19 and 20 August 2015 the service was meeting the regulations we looked at and was rated Good overall. At this inspection we found the service remained Good overall and also for each key question.

There was a registered manager in post at the time 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.

People were protected from abuse and improper treatment. The provider trained staff in safeguarding. The registered manager discussed safeguarding regularly with staff and also people using the service, reminding people how to stay safe. The provider managed risks relating to people's care through suitable risk assessment processes. The provider made improvements when things went wrong and had systems to share learning across the provider's services.

Staff were recruited via recruitment processes to check their suitability. There were sufficient numbers of staff deployed to support people. Processes were in place to manager people's medicines safely.

The premises were well maintained and the provider had good infection control procedures in place. The premises met people's support needs and people had access to all communal areas.

Staff received suitable support with induction, training, supervision and annual appraisal to help them understand their role and responsibilities.

The provider worked with other services to help people receive coordinated care when moving between services such as hospital admissions and admission as a new resident to the care home. People's care needs were assessed though consulting with people, relatives and professionals involved in people's care.

The provider had followed the Mental Capacity Act 2005 in assessing people's capacity in relation to some aspects of their care, such as managing their finances. However, we identified the provider had not assessed people's capacity in relation to some other decisions relating to people's care. The provider told us they would rectify this as soon as possible. The provider applied for and followed authorisations to deprive

people of their liberty (DoLS) as part of keeping them safe.

People received their choice of food and drink and were supported to maintain their health. People had access to the healthcare service they required. However, referrals for speech and language assessment in relation to choking risk were pending and the provider told us they would make the referrals for people who may be at risk as soon as possible.

Staff cared about the people they supported and were respectful. Staff understood people's needs including their communication needs. People were supported to maintain their privacy and dignity and the registered manager encouraged staff to consider people's dignity at all times. People were supported to maintain and build their independent living skills. People were supported to maintain and develop relationships to reduce social isolation.

People's care plans reflected their physical, mental, emotional and social needs, their personal history, individual preferences, interests and aspirations. People were supported to develop care plans setting out their preferences for their end of life care. Staff understood the information in people's care plans and used it in providing people choice. People were provided with activities they were interested in.

The complaints process continued to be suitable although the service had not received any complaints in the past year.

The registered manager and staff had a good understanding of their role and responsibilities and leadership was visible and capable at all levels. The provider had systems in place to audit and improve the service with frequent checks of the service in line with CQC standards. The provider maintained detailed and accurate records in relation to people, staff and the management of the service.

Systems were in place for the provider to communicate and gather feedback from people, relatives and staff. The provider recognised staff achievements with a 'carer of the quarter' award system. The provider worked openly with key organisations.

The five questions we ask about services and what we found