Blenheim Care Home is registered to provide accommodation with personal care for up to 57 older people, including care and support for people living with dementia. There were 33 people living in the service when we inspected on 18 July 2017, plus an additional five staying for short-term

re-ablement following a time in hospital. This was an unannounced inspection.

At the last inspection, the service was rated good and at this inspection we found that although some improvements were needed the service remained good overall.

There was a registered manager in post. 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.

There was a positive, open and inclusive culture in the service and the atmosphere was warm and welcoming .

There were sufficient numbers of well trained staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service.

People presented as relaxed and at ease in their surroundings and told us that they felt safe. Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. People knew how to raise concerns and were confident that any concerns would be listened and responded to.

People were complimentary about the way staff interacted with them. Independence, privacy and dignity was promoted and respected. Staff understood the importance of gaining people’s consent and were compassionate, attentive and caring in their interactions with people. They understood people’s preferred routines, likes and dislikes and what mattered to them.

Care plans were written in a person centred manner and reflected the care and support each person required and preferred to meet their assessed physical needs. More information was needed to guide staff how to support people’s social needs.

For some people there was a lack of opportunity to engage in meaningful activity throughout the day. The management team were already aware of the shortfalls with regard to activity provision and a lifestyle co-ordinator had recently been employed. Plans were in place to improve this aspect of the service.

The mealtime experience was not a positive one for many. Staff were not deployed appropriately to ensure that people had the assistance they required with their meals and choices were limited. We discussed our concerns with the management team who took immediate action to make changes to improve this aspect of the service provision.

People’s nutritional needs were assessed and professional advice and support was obtained for people when needed. They were supported to maintain good health and had access to appropriate services which ensured they received ongoing healthcare support.

The management team and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Our observations told us that staff sought people’s consent and acted in accordance with their wishes. However, additional work was needed to ensure people were always supported to make their own decisions wherever possible.

People were provided with their medicines in a safe manner. They were prompted, encouraged and reassured as they took their medicines and given the time they needed.

The service had a quality assurance system in place which was used to identify shortfalls and to drive improvement. However, these were not always effective as they had not identified some of the shortfalls we found during our inspection. A new auditing tool was in the process of being implemented to enable the management team to make improvements to quality monitoring. The management team were open and transparent throughout

The inspection took place on 28 January 2015 and was unannounced. This was the first inspection of the service since the provider changed in August 2012.

Blenheim Care Home provides care and accommodation for up to 57 people who may be elderly or living with dementia. Accommodation is provided over three floors. The service does not provide nursing care. At the time of our inspection there were 33 people using the service; the top floor was not in use as building work was in progress to renovate the rooms in this area.

A registered manager was in post at the service. 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 safe because staff were aware of their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

There were enough staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred.

People’s health needs were well managed by staff who consulted with relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs.

People were treated with kindness and respect by staff who knew them well.

People were encouraged to follow their interests and hobbies and were supported to maintain relationships with friends and family so that they were not socially isolated.

There was an open culture and the registered manager encouraged and supported person centred care.

The provider had systems in place to check the quality of the service. The views of people and their relatives were taken into account to make improvements and develop the service.

We gathered evidence of people’s experiences of the service by talking with people. We observed how people spent their time and noted how they interacted with other people living in the home and with staff. We spoke generally with some people who told us they liked living at the home. We saw that people smiled and chatted with staff.

During our inspection we saw that people received good care. Relatives who completed surveys as part of the home’s quality monitoring processes were complimentary about the standard of care their relatives received. One relative stated: “Overall we are very satisfied with the care that X is receiving.”

We saw that people were comfortable with staff and others living in the home and there was a relaxed atmosphere. Relatives made positive comments about the staff including: “The staff are all very caring.” Someone living in the home who preferred to maintain their independence said: “Staff offer help when I ask. They do not interfere.”

The home was well managed and relatives commented on this in the quality monitoring surveys. Comments included: “I feel that the manager is doing a great job”, “We feel that the manager has gone out of her way to be really helpful and we are very grateful” and “The home is improving a lot since the new manager has taken over.”