This unannounced comprehensive inspection took place on the 11 and 12 September 2018. It was the first inspection of this home since it was registered with the Care Quality Commission.

Austin Rose is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Austin Rose can accommodate 80 people in one adapted building. At the time of our inspection there were 71 people living there. Austin Rose is a purpose-built nursing home and has a number of dining rooms, lounges outside spaces and other facilities for people to use such as a small cinema.

There was a registered manager 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.

The service was not consistently safe and had not kept people free from the risk of potential harm due to poor staff knowledge about risks and a lack of risk assessments concerning how to support people to eat safely.. Other areas of the service were safe such as the processes to report safeguarding and the administration of peoples’ medication. Austin Rose was clean and people were protected from the risks of cross infections.

The service was not consistently effective as staff had received very little supervision and had not received timely training in all areas. While the home was clean and spacious it did not meet the needs of people living with dementia well. People had food to eat that they enjoyed but were not supported to eat their meals in a way that encouraged them to enjoy the mealtime as a social activity. There were policies and systems in place to support appropriate practice in relation to the Mental Capacity Act. However, people were not consistently supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible. The provider was following the legal requirements of the MCA and had submitted DoLS applications as necessary. Where these had been authorised, the provider was compliant with the conditions of the authorisation. However, the provider had not properly trained or prepared staff to understand the specific requirements of DoLS. People had good access to healthcare professionals.

People were not consistently supported in a caring manner as some aspects of how people were supported to move was not dignified. We saw that independence was promoted for people who lived at Austin Rose for short periods of time but there was no focus on this part of peoples’ life if they lived at the home on a long-term basis. It was not clear how people were meaningfully involved in their care. People and relatives told us that staff were kind and caring and we saw examples of compassionate care.

The service did not always respond to people’s needs well. People did not have sufficient access to activities or meaningful occupations. People and relatives had access to a complaints process but not all complaints had been recorded and dealt with by this process, so some learning may have been missed. Peoples’ needs had been assessed but this process did not always include the person or their relatives in a meaningful manner. People had basic end of life plans if needed.

Austin Rose was not always well led. There were concerns about the poor quality of the auditing process which meant that issues were missed and improvements not made. We also found that people were not as involved in the running of the home or their care as they could be. Everyone we spoke with said they thought the management of the home was good and the registered ma