Abberdale House provides personal care and accommodation for up to 25 people. On the day of the inspection the registered manager informed us that 24 people were living at the home.

This inspection took place on 16 and 17 November 2016. The inspection was unannounced and was carried out by one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert for this inspection had experience of the care of older people and older people living with dementia.

A registered manager was 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 and associated Regulations about how the service is run.

People using the service and their representatives we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and generally understood their responsibilities in this area.

People's risk assessments provided staff with information of how to support people safely.

Staffing levels were sufficient to ensure people were safe.

People using the service told us they thought medicines were given safely and on time.

There was systems in place to ensure that the premises were safe for people to live in.

Staff were subject to checks to ensure they were appropriate to work with the people who used the service.

Most staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed on relevant issues in order there was assurance to meet all the needs of people.

Staff generally understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives, and the service had obtained legal approval for limiting people's choices when necessary for their best interests.

People had plenty to eat and drink, everyone told us they liked the food served and people were assisted to eat when they needed help.

People's health care needs had been protected by referral to health care professionals when necessary.

People and their representatives told us that staff were friendly and caring and we saw many examples of staff working with people in a kind and compassionate way.

There was some evidence that people and their representatives were involved in making decisions about their care, treatment and support, though evidence was lacking in some care plans.

Care plans were individual to the people using the service and covered their health and social care needs.

There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were organised to provide stimulation for people, though activities tailored to people's needs had not been frequently provided.

People and relatives told us they would tell staff if they had any concerns and were confident they would be followed up to meet people's needs.

People, their relatives and staff were satisfied with how the home was run by the registered managers.

Management carried out audits and checks to ensure the home was running properly to meet people's needs.

Our inspection of 8 April 2013 found that some people's care plans had not been regularly reviewed and another was inaccurate. This meant that people may have been at risk of receiving care that was inappropriate or unsafe. We asked the provider to take action to rectify this and carried out this inspection to check improvements had been made.

At this inspection we found that the service had made sufficient improvements. People's care had been planned and delivered in a way that ensured people's health and safety. Care records had been regularly reviewed and updated and accurately reflected the care being given.

People we spoke with were happy with the care being provided and our observations showed they were comfortable and confident with staff. Staff were attentive to people's needs and demonstrated a genuine rapport with people who used the service.

People we spoke with said they liked living at Abberdale House. Comments included: “they really care” and “they’re very helpful”. We saw that staff were attentive to people’s needs and were polite and friendly in their interactions with people.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people’s experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service. We saw that staff approaches were mixed with some staff taking more time to interact with people than others.

We found that care was provided in accordance with peoples’ wishes and when people did not have the capacity to consent, legal requirements were met.

We looked at the care plans and records of four people who used the service. Daily records showed that people had received appropriate care, however some care plans had not been regularly reviewed and another was inaccurate. This meant that people may be at risk of receiving care that was inappropriate or unsafe.

We found appropriate arrangements were in place for the obtaining, recording and administration of medicine.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people. Staff we spoke with demonstrated a good understanding of the needs of people who used the service.

Records were stored securely and could be located promptly when required.

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Our inspection of 26 June 2012 found that people were not protected from the risks of unsafe or inappropriate care or treatment because records did not record how people were involved in making important decisions about their care. Also, information about people's nutritional intake was not used to assess their needs in relation to nutrition and hydration.

We carried out this follow up inspection to see if the service had taken appropriate action to remedy this. We found that some improvements to people's care plans had been made but did not see sufficient evidence to make the service compliant with this regulation.

We did not speak with people who used the service at this inspection. Please see our previous report for details of people's experiences of the service.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an “expert by experience” (people who have experience of using services and who can provide that perspective) and a practising professional.

We spoke with eight of the 21 people using the service on the day of our inspection. People's dignity was respected. One person said, “The girls are very nice with me, very patient, as I can be a little slow at times.”

They all told us they enjoyed the food. One person said, "I live for my food. It is good here."

We spoke with four people using the service about how safe they felt. They told us that care workers made them feel safe.

People using the service told us there were enough staff during mealtimes. We spoke with one person using the service who said they sometimes had to wait a long time to use the toilet because there were not enough staff in the evenings.