This inspection was unannounced and took place on 9 June 2017.

Alison House provides accommodation and personal care for up to 29 older people. On the day of the inspection 22 people were living there.

The home had a registered manager who was present on the day of the 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 felt safe living in the home and staff knew how to safeguard them from the risk of potential abuse. People were protected from the risk of harm because staff were aware of how to maintain their safety. People were cared for by sufficient numbers of staff who had been recruited safely. Medicines were managed appropriately to ensure people received their prescribed treatment.

People were cared for by skilled staff who were supported in their role by the registered manager. People could be confident that their human rights would be protected because staff had included the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their care practice. People were supported to eat and drink sufficient amounts to promote their health. People had access to relevant healthcare services when needed.

People were supported by staff who were caring and attentive to their needs. People were encouraged to be involved in their care planning to ensure they received care that reflected their preferences. People’s right to privacy and dignity was promoted by staff.

People were involved in their care assessment and were supported by staff to pursue their interests. People’s complaints were listened to and acted on.

People were encouraged to have a say in how the home was run. People and staff were aware of the management team and felt supported by them. The registered manager was supported in their role by the registered provider to ensure people received a safe and effective service. Systems were in place to monitor the quality of service provided to people.

This inspection took place on 14 April 2016 and was unannounced.

The service was registered to provide accommodation and personal care for up to 29 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 26 people were using the service.

The service had a registered manager. 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 September 2013, the service was meeting all of the outcomes we inspected against.

Medicines were not always managed safely and correctly though records showed that people received their medicines as prescribed.

People's mental capacity to make their own decisions had not been assessed when required and the registered manager was not clear about which people had appointed attorneys to make decisions on their behalf under the Mental Capacity Act 2005 (MCA). This meant that the service could not be sure they were acting in accordance with the MCA.

People felt safe and staff knew how to protect people from avoidable harm and abuse. People’s risks were assessed and managed to help keep them safe and we saw that care was delivered in line with agreed plans.

There were enough staff to meet people’s needs. People told us and we saw that requests for support were responded to promptly by staff who had been checked to ensure they were suitable to work with the people who used the service. Staff were suitably trained to meet people’s needs and were supported and supervised to help them deliver effective care.

People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with support when required to ensure their nutritional needs were met. People’s health was monitored and access to healthcare professionals was arranged when required.

People were treated with kindness and compassion and they were happy with the care they received. People were encouraged to make choices about their care and their privacy and dignity was respected.

People had support to meet their individual needs and preferences and they were provided with opportunities to participate in activities that interested them. Care plans were detailed and personal so that staff had the information they needed to be able to provide support to meet needs and requirements.

People knew how to complain and complaints were dealt with in line with the provider’s procedure. People and their relatives were encouraged to give feedback on the care provided. The registered manager and provider responded to feedback and changes were made to improve the quality of the service provided.

The registered manager understood the conditions of registration with us. We saw that systems were in place to monitor quality and that the registered manager analysed information and took actions to make improvements when required. There was a positive and homely atmosphere at the service and people felt the registered manager was approachable.

When we inspected Alison House we saw that major refurbishment and building work were being completed. The registered manager explained how this had caused some disruption for people who used the service but the works were near completion. She told us, “Noise has been a problem and we have needed to move things around to keep people happy, but we are in the final few weeks now”.

People who used the service were treated with respect and dignity, they told us they were happy living at Alison House. One person said, “I’m sure I don’t know what I would do if I wasn’t here”.

Care was provided in a way which was planned to meet the needs of the individual. Care records contained risk assessments which assisted staff to provide appropriate care.

People told us they felt safe in the home. Staff understood how to protect people from abuse. A member of staff said, “I would go to a supervisor, or the manager if I saw something I wasn’t happy with”.

There were sufficient suitably qualified staff at all times to provide appropriate care.

There were systems in place to enable the provider to assess and monitor the care provided to people who used the service.