Our inspection was unannounced and took place on 11 May 2017. Boars Tye Farm Residential Home provides personal care and accommodation for up to 27 older people, many of whom are living with dementia. At the time of the inspection there were 21 people living at the service. The service is spread across two floors, with communal lounge and dining areas located on the ground floor. Some bedrooms were located on the ground floor but a majority were situated on the upper floor and accessed via stairs or a passenger lift. The service had two double rooms, both of which were occupied by two people at the time of the inspection.

The service had 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.

During our previous inspection on 10 February 2016, we found several breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008. We found that the service was not consistently working within the principles of the Mental Capacity Act (MCA) 2005 and improvements were required in the management’s oversight of the service. We also identified improvements were required with regard to the monitoring of the safety of the environment and ensuring that people had their medicines administered safely. We gave the home an overall rating of requires improvement. The provider sent us an action plan, setting out the actions they planned to take to improve the quality of the service. At this inspection, we looked to see whether they had implemented the action plan. We found that since our previous inspection the provider had made the required improvements to improve the standard of care and they were no longer in breach of the regulations.

Records showed that there had been an improvement in the frequency and effectiveness of quality assurance checks. This meant that the management team had a clear oversight of the service and were able to effectively monitor and manage the service and drive improvement.

Improvements had also been made to the storage and management of medication. Effective systems were in place to safely manage and administer people's medicines. Some people had been prescribed 'as required' medicines, information relating to why and when these should be given was clearly documented in people's care plans.

The service was consistently working within the principles of the MCA. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The management team understood their responsibility to comply with the requirements to comply with the MCA and this was reflected within people’s care plans. People were supported to make choices and no unnecessarily restrictive practices were in place.

The service kept people safe from harm. Staff had completed safeguarding training. They understood their responsibilities to protect people from harm and were confident about how to raise concerns in line with the provider's safeguarding and whistleblowing policies.

Risks to people’s daily lives had been assessed and measures were taken to prevent avoidable harm and to help ensure that people’s freedom was supported and respected.

The service had a process in place for recording, monitoring and analysing accidents and incidents and action had been taken to mitigate the risk of reoccurrence.

Robust recruitment and selection procedures were in place and the management ensured that appropriate checks had been undertaken before staff began work. New members of staff were introduced to the service through an induction programme and were required to complete a probation period to ensure that they had acquired the necess

The inspection took place on the 10th February 2016 and was unannounced. Boars Tye Farm Residential Home provides residential accommodation and personal care for up to 27 older people, including people living with dementia. On the day of the inspection there were 23 people living at the service. The accommodation was arranged over two floors. Two of the bedrooms were shared rooms. The ground floor had communal dining and lounge areas and there was an extensive, well maintained garden area.

We previously inspected the service on the 24th June 2013.

The service 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. The service also had two care managers who were responsible for managing the service in the absence of the registered manager.

People, including family members, told us that they felt safe living at Boars Tye Farm Residential Home. Staff who were responsible for administering medicines had been trained to do so. However, there were not effective procedures in place to monitor the safety of the environment and to ensure that people had their medicines safely. This meant that people were not kept safe from potential harm.

The staff described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported. Training records confirmed staff had undertaken safeguarding training.

The service was not consistently working within the principles of the Mental Capacity Act (MCA) 2005. The MCA and Deprivation of Liberty Safeguard (DoLS) ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. Where people’s liberty needs to be restricted for their own safety, this must done in accordance with legal requirements.

We found staffing levels were sufficient to meet people’s needs and that staff were recruited safely and trained appropriately. There was a thorough induction process for new members of staff.

A caring environment was evident. Staff knew about people’s life history and their likes and dislikes. We saw that staff were kind and caring in their approach and there was a warm and friendly atmosphere in the home. The people that we spoke with said they were happy living there and both they and their relatives spoke about the care staff positively.

People's dignity and privacy were respected. The registered manager held regular meetings with staff, people who lived at the home and their relatives and felt that their views and opinions were taken into consideration and acted upon.

People were supported to eat and drink at meal times. During lunchtime people received the help they needed to eat their lunch.

Relatives told us that staff were caring towards their relative and treated them with respect. Care plans and risk assessments were in place and reviewed. We saw that staff supported people to maintain regular contact with health professionals such as doctors and community health teams.

Relatives knew how to raise concerns or make a complaint and were confident that they would be responded to appropriately.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We were able to speak with four people using the service, two relatives and a visiting health professional about the service. People told us that they liked living at Boars Tye and that staff were supportive of their needs and were kind and caring. We found the service had improved and increased the range of activities offered to people and their families. We found that people’s privacy and dignity were respected and staff assisted the promotion of people’s independence.

We found that care was provided according to people's assessed needs and people were asked for their views about the service. People were provided with support when needed to help with eating and drinking. People’s care was provided in accordance with their care plan. People who use the service and their families were included in the development of their care plans.

We saw there were good arrangements to protect people from abuse. People told us they felt safe living at Boars Tye, one person said, “The staff are lovely."

We found that the provider had an effective quality assurance and monitoring system in place to ensure the safety of people who use the service. The provider had effective systems to deal with complaints.