Clayton House 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. The service provides person care to a maximum of 19 older people some of whom are living with a dementia. At the time of the inspection there were 14 people who used the service.

This inspection took place on13 February 2018. The inspection was unannounced, which meant that the staff and provider did not know we would be visiting. The service has not previously been formally rated. Clayton House is and established service that had a change of legal entity in 2016. This is the first inspection since the change in legal entity. At this inspection we rated the service as Good.

The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received a mixed response when we asked people and relatives if there were sufficient activities and outings for people to take part in. Some people were happy with the range and amount of activities; however, others were not and told us they needed more stimulation. We pointed this out to the registered manager at the time of the inspection who told us they would speak with people and review the activities on offer.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place.

Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. However, we did find some risk assessments to be generic and did not identify the individual risks to the person. We pointed this out to the registered manager at the time of the inspection who told us they would review people’s risk assessments.

Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

People and their relatives told us there were suitable numbers of staff on duty to ensure people’s needs were met.

Pre-employment checks were made to reduce the likelihood of employing people who were unsuitable to work with people.

The registered manager had systems in place for reporting, recording, and monitoring significant events, incidents and accidents. The registered manager told us that lessons were learnt when they reviewed all accidents and incidents to determine any themes or trends.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.

People were supported with eating and drinking and feedback about the quality of meals was positive. Special diets were catered for, and alternative choices were offered to people if they did not like any of the menu choices. Nutritional assessments were carried out and action was taken if people were at risk of malnutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, further work was needed to ensure decision specific Mental Capacity Assessments and best interest’s decisions were in place when people lacked capacity.

The premises were clean and tidy and people and their relatives told us they liked the homely atmosphere. However, some areas were in need of redecoration and replacement floor