This inspection took place on 14 and 15 February 2017. The inspection was unannounced on day one and we told the registered provider we would be visiting on day two.Vida Hall provides residential care for up to 70 people who may be living with dementia. It is purpose built and consists of a main reception area with four ‘houses’. Two of the houses provide nursing care and two provide residential care. At the time we visited 69 people lived at Vida Hall.
The home had a registered manager in place. 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 in November 2014 the service was rated outstanding. At this inspection we found the service was good.
We observed extremely positive interactions between people and staff. People were supported to live a full and stimulating life and innovative ways to engage with people and involve people in activities were sought. For example one person was supported to share the poetry they had written. This demonstrated staff had good relationships with people and they treated people with dignity and respect.
People’s feedback about the service was consistently high and people told us the care they received was, “Amazing” and “Nothing is too much trouble.”
Safe recruitment and selection procedures were followed. Staffing ratios were flexible and responsive to people’s changing needs and circumstances. This meant that people received attentive, timely care that met their needs. Staff told us that managers were supportive and they mentored and coached staff to enable them to provide compassionate, quality care.
There were systems and processes in place to protect people from the risk of harm. Staff knew about different types of abuse and were aware of action they should take if abuse was suspected.
There were inconsistencies in the recording and reporting systems. Measures were in place to reduce potential risks however people’s records did not contain a thorough monitoring of the outcome. Not all incidents of abuse and serious injury had been reported to the CQC as the law requires. We have dealt with this issue outside the inspection process.
Not all good practice in relation to medicines was in place and we have made a recommendation about the management of medicines.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Although we found some records required updating the policies and systems in the service support this practice.
People had a choice of healthy food and drinks and their preferences were taken into consideration to ensure they had the diet and menu of their choosing. People were supported to maintain good health and the service had good relationships with professionals who supported people to maintain their health.
People’s care plans were extremely person centred and written in a way to describe their care, and support needs. People, their relatives and professionals all told us the amount of effort and time the staff take to ensure everyone was involved to ensure a person received the support they wanted and needed.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. Accidents and incidents were recorded appropriately and lessons were learnt following reviews of patterns and trends. The design of the building enabled people living with dementia to be independent and safe. For example, each house had an accessible outside space, either a balcony or a courtyard garden.
Effective leadership promoted a culture of learning and continuous improvement. The management team fostered mutual respect between staff at all levels. Managers supported and listened to staff ideas to develop the service. Staff had key roles as ‘champions’ with a focus on continuous improvement and excellence.
The service acted on staff and people’s views and regularly consulted with them about how to improve. The registered manager and care director understood the home’s strengths, where improvements were needed and had plans in place to achieve these with timescales in place.