We undertook an unannounced focused inspection of Boucherne Limited on 23 March 2018.This inspection was done to check that improvements to meet the legal requirements planned by the provider after our comprehensive inspection on 23 February 2017 had been made.

Boucherne Limited is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of our inspection, there were 21 people living in the service.

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 and 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.

We inspected the service against one of the five questions we ask about services: is the service Safe? This was because the service was not meeting a legal requirement. No risks, concerns or significant improvement were identified in the remaining questions through our on-going monitoring or during our inspection activity so we did not inspect them.

At the last inspection, we found that the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider did not have in place a system for the safe administration and management of medicines.

We asked the provider to complete an action plan to show what they would do and by when to improve the safety of the service. The provider complied with this request and told us what they were going to do to improve.

At this inspection, we found that improvements had been made to the administration of medicines and the provider was no longer in breach of this Regulation. The key question of Safe has now been rated as 'Good'. There was no change to the overall rating.

The inspection took place on 23 February 2017 and it was unannounced.

Boucherne Limited provides accommodation and personal care for up to 24 older people. On the day of our inspection there were 21 people living in the service.

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 and 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.

Improvements were needed to the services provided by Boucherne. We found that the administration and management of medicines were not safe. Medicines were not stored or administered appropriately or securely.

We recommend that the service look at current best practice in relation to helping to protect people’s best interests when assessing their capacity to make decisions.

A quality assurance system was in place. Audits were undertaken to ensure the service was safe and well managed but some record keeping needed attention. We recommend that the service look at current best practice in relation to the recording of information about the service.

People told us they felt safe and staff told us they carried out regular checks on people to make sure they remained safe. Care staff knew how to protect people against the risk of abuse and had completed training in safeguarding people so they knew how to recognise abuse and poor practice.

Our observations during the inspection confirmed that staffing levels in the home were appropriate to meet people's needs. Staff members did not start to work at the home until satisfactory employment checks had been completed.

People we spoke with told us they enjoyed living at Boucherne and were very complimentary about the staff who supported them. They told us they enjoyed the food and received good support with their health needs.

People had the freedom to make their own choices and decide how they wanted to live their life. People were relaxed in the company of staff. Staff interactions were friendly, respectful and caring.

There was clear leadership within the service. Effective communication existed between the management and staff and this showed in the atmosphere and the environment. People were confident to raise anything that concerned them and were satisfied that they would be listened to.

You can see what action we told the provider to take at the back of the full version of the report.

Boucherne is a 24 bedded care home which provides care and support for older people. The service is spacious and set over two floors, on the day of our inspection 22 people were living at the service.

There is 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.

People were cared for by staff that been recruited appropriately and employed after appropriate checks were completed.

Records were regularly updated and staff were provided with the information they needed to meet people’s needs. People's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were policies, procedures and information available in relation to the MCA and DoLS to ensure that people who could not make decisions for themselves were protected.

Staff were attentive to people's needs. Staff knew people well and treated people with dignity and respect.

People who used the service were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs and included activities in the community.

The service worked well with other professionals to ensure that people's health needs were met.

The manager carried out a number of quality monitoring audits to ensure the service was running effectively.

People and relatives we spoke with at Boucherne all had positive comments to make about the care they received and the standard of accommodation. One person told us the staff were: ”Extremely kind and caring.” Another person said: “I love it here.”

During our visit we saw that care had been well planned and was person centred. A relative told us: “He could continue with his own lifestyle, and eat at what time he wanted.” We saw people were relaxed and staff and people enjoyed each other’s company.

People who lived at Boucherne were provided a comfortable and well maintained environment.

There were systems in place that ensured people’s comments and complaints were listened to and acted on appropriately.

Food was well presented and people told us: ”The food was lovely.”

There were recruitment processes in place which ensured people were qualified and were suitable to fulfil their role.

We found records were comprehensive and appropriately stored, which ensured confidentiality was maintained.

We did not visit the home as part of this follow up inspection. We carried out a desk top review based upon information submitted to us by the provider.

We found that the provider had taken steps to ensure that the staff team had up to date training in place and that they were appropriately supervised and supported in their day to day work.

People living at the home felt informed about their care and healthcare and told us that their consent was always sought and that they were involved in decision making. People we spoke with felt comfortable raising any concerns and told us that the manager and the provider were available to talk to.

We spoke to people living at the home and they told us that the standard of care was "Very good." One person said that the care was "First class."

Whilst staff felt well supported and trained, we found that a significant number of staff at the home did not have up to date training in place for key subjects such as safe manual handling, adult protection and fire safety.

People living at the service told us that their care needs are met and that they have choice in their day to day lives. They said that they are encouraged to maintain their independence and that they feel safe. They said that the staff are cheerful and respectful.