About the service:

Chaplin Lodge is a residential care home that provides personal and nursing care to for up to 66 people aged 65 and over. At the time of the inspection there were 36 people living at the service.

People’s experience of using this service:

Suitable control measures were not put in place to mitigate risks or potential risk of harm for people using the service, as not all risks to people had been identified and assessed.

People were at risk of having their safety compromised. This was because equipment such as people’s call alarms to enable people to summon staff assistance was either not accessible or not working. The arrangements for notifying relevant staff and managing equipment-related risk was not robust.

Staff did not have sufficient time to give people the care and support they needed. The provider did not regularly review its staffing levels or ensure there were sufficient numbers of staff at all times available to meet people’s needs.

Staff regularly felt under pressure and this meant care provided by staff was not ‘person-centred’ care and support. Staff did not sit and talk with people for a meaningful length of time and people’s distress or discomfort was not always responded to promptly or consistently.

The provider did not have effective systems in place to monitor the quality of the service they provided or to drive improvements where needed. The lack of managerial oversight had impacted on people, staff and the quality of care provided. Improvements were not always made when things went wrong.

People did not always receive their medicines as prescribed and accurate medicines records were not maintained.

Staff training was not up-to-date. Not all staff had completed a comprehensive induction and staff supervision and support was inconsistent.

Care planning arrangements did not ensure all of a person’s care needs were recorded. Staff were aware of people’s end of life care needs but these were not recorded.

Recruitment arrangements were robust to ensure the right staff were recruited.

People were protected by the provider’s prevention and control of infection procedures.

Sufficient food and drink was available to people throughout the day. Regular monitoring and review was carried out for people at nutritional risk to ensure their dietary needs could be met.

People experienced positive outcomes regarding their health and wellbeing and had access to healthcare services. The service worked collaboratively with other services and agencies.

People’s capacity to make day-to-day decisions had been considered and assessed and the provider was working within the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People enjoyed the activities provided but stated there were occasions when they were bored and there was nothing for them to do.

Rating at last inspection:

The rating of the service was ‘Requires Improvement’ (Last report published 9 November 2017)

Why we inspected:

This was a planned inspection based on the rating at the last inspection of ‘Requires Improvement’.

Enforcement:

Full information about CQC’s regulatory response to the more serious concerns found during this inspection is added to reports after any representations and appeals have been concluded.

Follow up:

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.

At our previous comprehensive inspection to the service on 27 October 2016 and 16 and 18 November 2016 and four breaches of regulatory requirements were made in relation to Regulation 9, Regulation 12, Regulation 17 and Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. As a result of our concerns the Care Quality Commission took action in response to our findings by placing the service into ‘Special Measures’ and amending the provider’s conditions of registration. This meant the provider had to send the Care Quality Commission a detailed written report each month as to how the necessary improvements were to be achieved. At this inspection considerable progress had been made to meet regulatory requirements, however some further improvements were still required.

Chaplin Lodge provides accommodation and personal care for up to 66 older people. Some people also have dementia related needs.

This inspection was completed on 2 and 3 August 2017 and there were 34 people living at the service when we inspected.

A registered manager was in post but on maternity leave at the time of this inspection. The service was being managed by a peripatetic manager to cover the registered manager’s maternity leave and to address the shortfalls identified at the last 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.

Quality assurance checks and audits carried out by the provider and the management team of the service were in place and had been completed at regular intervals in line with the provider’s schedule of completion. The provider and management team of the service were able to demonstrate a better understanding and awareness of the importance of having good quality assurance processes in place. This was a significant improvement and this had resulted in better outcomes for people using the service. Feedback from people using the service, those acting on their behalf and staff were positive and spoke of the improvements made by the provider and management team following our last inspection in November 2016. This referred specifically to better visible management presence within the service and there now being confidence that the provider and management team were doing their best to make the required improvements to the service. Nonetheless, some improvements were still required to ensure that where issues were highlighted as part of the management teams auditing arrangements, information was available to show actions required had been addressed. Additionally not all areas of concern found at this inspection, namely induction processes for newly employed staff, infection control practices and improvements to the premises had been identified.

People told us the service was a safe place to live and that their safety was maintained. Staff understood the risks and signs of potential abuse; however improvements were required to ensure staff followed relevant safeguarding processes by alerting the management team at the earliest opportunity where concerns were highlighted.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed to ensure their safety. Although environmental risks were highlighted, where actions were required, not all of these had been addressed in a timely manner. This referred specifically to the service’s Legionella risk. Additionally improvements were needed in respect of some aspects relating to infection control practices and procedures at the service and ensuring the premises were suitable for people using the service. The latter referred specifically to improvements required to Parkview Unit so as to make it suitable for people living with dementia

We carried out an unannounced comprehensive inspection of this service on 19, 25 and 26 August 2016 and found breaches with regulatory requirements. As a result of concerns relating to medicines management and staff failing to follow their individual responsibility to identify and report abuse at the earliest opportunity and to safeguard people from restraint, warning notices were served on 8 September 2016. The date for compliance to be achieved was 1 and 8 October 2016 respectively. The provider shared with us their action plan on 20 September 2016. This provided detail on their progress to meet regulatory requirements. On 27 October 2016 we found that the provider had not made all of the improvements they told us they would make and had only initially achieved compliance with one warning notice and this related to safeguarding. Following an internal management review meeting it was agreed that a full comprehensive inspection would be undertaken to Chaplin Lodge.

The inspection was completed on 27 October 2016, 16 and 18 November 2016 and was unannounced. There were 56 people living at the service when we inspected. Chaplin Lodge provides accommodation and personal care for up to 66 older people. Some people also have dementia related needs.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by the Care Quality Commission. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action.

A registered manager was 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 lack of provider and managerial oversight of the service. Quality assurance checks and audits carried out by the registered manager were not robust as they did not identify the issues we identified during our inspection and had not identified where people were placed at risk of harm or where their health and wellbeing was compromised.

Suitable control measures were not put in place to mitigate risks or potential risk of harm for people using the service as steps to ensure people and others health and safety were not always considered and risk assessments had not been developed for all areas of identified risk.

People did not think that there were sufficient numbers of staff available to meet their needs. Staff did not always have time to spend with the people they supported to meet their needs and the majority of interactions by staff were routine and task orientated.

Suitable arrangements were needed to ensure that staff received regular formal supervision and an annual appraisal of their overall performance. Improvements were required to ensure that where subjects and topics were raised by staff, this

Chaplin Lodge provides accommodation and personal care for up to 66 older people. Some people also have dementia related needs. A new provider took over the ownership of Chaplin Lodge on 21 January 2016.

The inspection was completed on 19 August 2016, 25 August 2016 and 26 August 2016 and was unannounced. There were 56 people living at the service when we inspected.

A registered manager was 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 lack of provider and managerial oversight of the service. Quality assurance checks and audits carried out by the registered manager were not robust as they did not identify the issues we identified during our inspection and had not identified where people were placed at risk of harm or where their health and wellbeing was compromised.

Arrangements were not in place to make sure that peoples medication records were completed to a good standard or that they received their prescribed medication as they should.

Suitable control measures were not put in place to mitigate risks or potential risk of harm for people using the service as steps to ensure people and others health and safety were not always considered. Risk assessments had not been developed for all areas of identified risk and bedrail assessments had not always been completed to determine that these were suitable for the individual person so that any risks identified were balanced against the anticipated benefits.

People did not think that there were sufficient numbers of staff available to meet their needs. Staff did not always have time to spend with the people they supported to meet their needs and the majority of interactions by staff were routine and task orientated. This had a significant impact on the delivery of care to people using the service.

Improvements were required to ensure that all staffs training were up-to-date and staff received a robust induction so that they had the skills and confidence to carry out their role and responsibilities effectively. Not all staff understood the relevant requirements of the Mental Capacity Act [MCA] 2005. Additionally, suitable arrangements were needed to ensure that staff received regular formal supervision and an annual appraisal of their overall performance. Improvements were required to ensure that where subjects and topics were raised by staff, this was followed up and there was a clear audit trail to demonstrate actions taken.

Not all of a person’s care and support needs has been identified and documented. Improvements were required to ensure that the care plans for people who could be anxious or distressed, considered the reasons for people becoming anxious and the steps staff should take to comfort and reassure them. Improvements were needed in the way the service and staff supported people to lead meaningful lives and to participate in social activities of their choice and ability, particularly for people living with dementia.

Although there was a complaints system in place, not all complaints evidenced fully how conclusions had been reached and actions followed up.

The dining experience was positive and people were supported to have enough to eat and drink. Consideration by staff was evident to demonstrate that the dining experience was an important part of people’s daily life and treated as a social occasion. People were supported to maintain good health and have access to healthcare services as and when required.

Suitable arrangements were in place to ensure that the right staff were employed at the service.

Where appropriate people were enabled and supported to be independent. People were also treated with dignity and respect. Staff knew the care needs

Chaplin Lodge provides accommodation, personal care and nursing care for up to 66 older people. Some people have dementia related needs.

The inspection was completed on 9 December 2014 and there were 56 people living at the service at the time.

A registered manager was 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.

The last inspection on 25 April 2014 found that the provider was not meeting the requirements of the law in relation to consent to care and treatment and supporting workers. An action plan was provided to us by the registered manager on 24 September 2014. This told us of the steps taken and the dates the provider said they would meet the relevant legal requirements. During this inspection we looked to see if these improvements had been made.

People and their relatives told us the service was a safe place to live. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and other’s safety.

Staffing levels to meet the needs of people who used the service were appropriate to meet people’s needs.

The management of medicines was suitable and people received their medication safely.

People’s healthcare needs were well managed and we found that the service engaged proactively with health and social care professionals.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. Where people lacked capacity to make day-to-day decisions about their care and support, we saw that decisions had been made in their best interests. The registered manager was up-to-date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were being protected.

People and their relatives told us that if they had any concerns they would discuss these with staff on duty. People told us that they were confident that their complaints or concerns were listened to, taken seriously and acted upon.

Not all people had been involved in the development of their care plan. People’s care plans were not fully reflective of their care needs as some of the information was not up-to-date.

Risks to people’s health and wellbeing were assessed but generic in content.

Staff felt supported and valued. Staff received regular training opportunities. However, staff did not receive a robust induction, supervision and appraisal.

Comments about the quality of the meals provided were variable across the service. Although the dining experience for people was positive, choices of food and drink were not always readily available.

We found that an effective system was in place to regularly assess and monitor the quality of the service provided. The registered manager was able to demonstrate how they measured and analysed the care provided to people who used the service and how this ensured that the service was operating safely. However, the provider’s quality assurance system had not picked up that people’s comments about the quality of meals was not favourable and people had not always had a choice of snacks and drinks available. In addition, it had failed to pick up and address that not all newly employed staff had received a formal induction, regular supervision and appraisal in line with the provider’s policy and procedure.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the care and welfare of people who use the service and suitable arrangements not in place for people in relation to their dignity, consideration and respect. You can see what action we told the provider to take at the back of the full version of the report.

As part of our inspection, we spoke with five of the 44 people who used the service and three relative's. We also spoke with five staff member's, the manager and deputy manager. We looked at six people's care records. We also looked at the provider's arrangements for obtaining, and acting in accordance with, the consent to care and treatment for people who used the service. In addition we looked at medication practices and procedures, the provider's arrangements to safeguard people from abuse, staff recruitment procedures, staff training, supervision and appraisal records and; the provider's arrangements to monitor the quality of the service provided. Records relating to complaints management was also viewed. Observation of staff practices throughout the day of our inspection was undertaken to ensure that people who used the service were treated with respect and dignity.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service a member of staff checked our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

People told us they felt safe living in the service. They also told us that they would feel able to speak up if they had concerns or worries and felt that they would be listened to.

Since our last inspection to the service in September 2013, we found that there had been eight safeguarding concerns. Records showed that the outcome of three safeguarding concerns was known and remaining outcomes had yet to be provided to the manager by the local authority. We saw that all staff had received training in safeguarding of vulnerable adults from abuse. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

We found that people who used the service were protected against the risks associated with the unsafe use and management of medicines.

We found that people who used the service lived in premises that promoted their safety and wellbeing. Many areas of the home environment had been re-decorated since our last inspection to the service. In line with regulatory requirements the manager had forwarded to us two statutory notifications advising of events which stop the provider from running the service as well as they should. This referred specifically to the service's boiler and passenger lift.

The provider was able to demonstrate that they had an effective recruitment procedure in place.

Is the service effective?

Our observations and discussions with the manager demonstrated that people who used the service received regular support and access from a variety of health and social care services and professionals as their conditions and circumstances required.

Records showed that no member's of staff had received Mental Capacity Act [MCA] 2005 and Deprivation of Liberty Safeguards [DoLS] training. Staff spoken with were able to demonstrate a basic understanding and awareness of MCA and DoLS. We found that people who used the service had not had their capacity to make day-to-day decisions formally assessed. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having suitable arrangements in place for the consent to care and treatment and; in line with the Mental Capacity Act 2005.

We found that the majority of staff working at the service required core and specialist training for the needs of older people, formal supervision and appraisal. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having suitable arrangements in place for staff employed to receive appropriate training, supervision and appraisal.

Is the service caring?

People told us that they received the care they needed. People living in the service told us that they were happy living there. Our observations showed that care and support was provided in a timely manner.

People who used the service had a care plan in place detailing their specific care needs and the support to be provided by staff.

Our observations showed that people who used the service were respected and treated with dignity by staff.

Is the service responsive?

People's preferences and diverse needs had been recorded in accordance with people's wishes.

Our observations during the inspection showed that visiting times were flexible.

We found that there were appropriate arrangements in place pertaining to complaints management.

Is the service well-led?

The provider was able to demonstrate that there were systems in place to assess and monitor the quality of the service provided. The views of the people who used the service and staff had been sought. People's views about the service were noted to be positive.

Prior to this inspection concerns were raised that people's care and support needs were not always met and staffing levels were not always maintained.

As part of this inspection we spoke with the manager, deputy manager and four members of staff.

We found that appropriate systems were in place to ensure that documentation relating to people's manual handling needs were clearly documented and provided sufficient guidance to staff on how this should be carried out. There was no evidence to indicate that people's mobility needs were not being met and/or that poor manual handling practices were being carried out by staff.

Records showed that appropriate arrangements were in place to ensure that an adequate supply of incontinence pads were available for people's use throughout the day and night.

We found that staffing levels at Chaplin Lodge were determined by the assessment of people's dependency levels and completion of a 'staffing level calculator'. Records showed that appropriate staffing levels were maintained at the service each day. Where staffing levels were reduced as a result of unforeseen circumstances additional measures were put in place to staff the service.

The purpose of this inspection was to review compliance with three warning notices issued in July 2013.

Our findings found that the atmosphere within Chaplin Lodge was observed to be calm and relaxed. Staff working within the service were seen to be responsive to people's individual support needs and assistance was provided in a timely manner. Comments from people who used the service and visitors was noted to be very positive and included, "The staff look after my relative very well", "I'm very happy with everything. The best thing is the atmosphere", "The staff are very kind. Sometimes they are (staff) a bit short but are usually good at responding in a timely manner" and "Staff are friendly. Just ask them and they'll do it."

Whilst improvements were noted in relation to the care and welfare of people who use the service, the management of medicines and quality assurance, further improvements are required to ensure the provider attains compliance.

This inspection was carried out in response to concerns raised.

Concerns raised related to people's nutritional needs not being met; poor staff practices in relation to manual handling procedures and poor medication practices. We found no evidence to suggest at this inspection that people who use the service were placed at risk as a result of poor manual handling practices by staff. However we found that records relating to people's food and hydration needs required significant improvement. Shortfalls were identified with medication practices and this related specifically to discrepancies with records and not having appropriate arrangements in place for ensuring that some people received their prescribed medication. We found during the inspection that some people's dignity was compromised.

Whilst we acknowledge that some improvements to people's individual records had been made since our last inspection to Chaplin Lodge in September 2012, further improvements were required at this inspection and included ensuring that people's care records were up to date and accurate; and that an effective quality assurance system was in place to identify non-compliance and/or risk of non-compliance.

We spoke with people who use the service but their feedback did not relate to this standard.

We found that people were protected against the risks associated with medicines as appropriate arrangements were in place to manage medicines, however improvements were needed in the way that medicines that were prescribed in variable doses were recorded.

On the day of our visit one relative told us that they had found a small white tablet on the floor in their relative's bedroom. The tablet was shown to both inspectors. The relative stated that this happens regularly and that they cannot be assured that their relative always receives their prescribed medication. The relative reported a further example whereby they had found their relative's tablets in a plastic cup with some water on the window sill.

There were variable comments made in relation to people who use the service feeling that they were treated with respect and dignity. Three people spoken with told us that staff were respectful and polite. Other comments were gathered from our observations and from comments recorded within recent satisfaction surveys and the minutes of resident meetings held at the home. Comments included “I get very upset when they (staff) are seeing to my personal care and they forget something like going to get a hoist and they leave me with just a towel or blanket over me with the door open. I feel very embarrassed in case someone sees me. It doesn’t happen all the time but it’s not nice” and “Day staff always knock but night staff usually just walk in.”

Four people spoken with during our inspection told us that they were happy living at Chaplin Lodge and they found the staff to be nice and caring. Positive comments included “Staff are lovely”, “The girls are very nice and they work very hard”, “They do their best” and “The staff are lovely, some more than others but all are OK.” Other comments about the quality of care were gathered from our observations and from comments recorded within recent satisfaction surveys and the minutes of resident meetings held at the home. Positive and negative comments included “Staff work hard and are always kind”, “Carers seem to have attitude when I ask for assistance i.e. you’re not the only one here. Feels like I’m in the army.”

One relative told us that they were always kept informed if their relative became unwell and/or required healthcare input. They confirmed that they found staff working at the home to be pleasant and polite. Two relatives spoken with told us that there were occasions whereby they could be kept waiting at the main front door for between five to 15 minutes before being let in.

People’s comments about the quality of food and meals provided were generally positive. Comments were gathered during our inspection from talking with people, our observations and from comments recorded within recent satisfaction surveys and the minutes of resident meetings held at the home. Positive comments included “The food is very nice”, “I can’t complain I always eat all my food” and “Yes I eat everything it’s very nice.” The only negative comments recorded stated, “The food isn’t very nice, meat is hard to chew and potatoes are lumpy, I never eat vegetables” and “Sometimes carers come into my room, ask if I’m OK I say yes, so they put breakfast down and walk away and then there is no way I can get to the food until someone else comes along.”

Three people we asked suggested that they felt safe and that, if they had any concerns or worries, they would discuss them with a member of staff.

People with whom we spoke were happy with the care they received at Chaplin Lodge. Each person had an individual personalised care plan, which identified their care needs and choices. People spoken with stated that the staff provided any care they needed. Staff were observed speaking with residents with dignity and respect and involving them in their care. People appeared relaxed with staff and were viewed making choices on how they wanted their care provided.

Some people with whom we spoke were happy with the cleanliness and decoration of the home, but others felt that the home needed some decoration.

The home had systems in place to consult with people who use the service, relatives and visitors on the quality of the service provided by the home. One compliment the home had received included 'There is only one word for your staff and that is brilliant’ and 'Its home from home, you get bed, board and friends.’

There are systems in place for people to use if they have a concern or are not happy with the service being provided to them. People with whom we spoke said they were happy with the care they received from the staff and knew how to raise any concerns they may have.

Chaplin Lodge provides accommodation and personal care for up to 66 older people. Some people also have dementia related needs.

The inspection was completed on 26 and 27 August 2015. There were 53 people living at the service when we inspected.

A registered manager was 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.

At our inspection on 9 December 2014 we found that the provider was not always meeting the requirements in relation to providing people with choice, ensuring that staff’s training was up-to-date and staff received appropriate opportunities for supervision and appraisal. Improvements were also required in relation to care planning. An action plan was provided in May 2015 and this confirmed the actions to be taken by the provider to achieve compliance. Our observations at this inspection showed that the improvements had been made in relation to providing choice for people who used the service and ensuring that staff were appropriately trained, received an induction, supervision and appraisal. However, improvements were required to ensure that care plans contained all information about a person’s care and support needs.

Improvements were required in relation to medicines management to ensure that this was safe and people received their prescribed medication.

Improvements were required as the arrangements for the prevention and control of infection were poor and required improvement.

Although records were not always available to guide staff on how to meet all aspects of a person’s assessed care needs, actual care and support provided by staff was observed to be appropriate.

The provider’s systems to check on the quality and safety of the service provided were not always effective in identifying areas for improvement.

Robust procedures and processes to protect people’s rights and prevent people from being abused were in place. Staff had attended training on safeguarding people and were knowledgeable about identifying abuse and how to report it.

Staff were available in sufficient numbers to meet people's care needs and staff deployment was observed to be appropriate.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff felt well supported in their role and received regular supervision and appraisal.

Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and others’ safety. People received proper support to have their social care needs met. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected.

The dining experience for people was positive and people were complimentary about the quality of meals provided. People who used the service and their relatives were involved in making decisions about their care and support and told us that their healthcare needs were well managed.

People and their relatives told us that if they had any concern they would discuss these with the manager or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

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