The inspection took place on 2 and 3 January 2019 and was unannounced.

Clifftop Care Home 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.

Clifftop Care Home is registered to accommodate 32 older people. The home is split over three floors with all floors having access via stairs, lift or a stairlift. On the ground floor there is a large lounge leading into a conservatory and a separate dining room. There was level access to the outside patio areas of the home. There were 24 people living at the home at the time of inspection.

Medicines were not always managed safely. Assessments had not been carried out to assess the competency of staff who gave medicines. The correct procedures for medicines were not always followed and some medicines were not stored securely. The registered manager took action during and following the inspection to address this.

We have made a recommendation about the management of medicines.

Accidents and incidents were recorded and action carried out. However, the registered manager had not analysed them to identify trends, learning or reduce the likelihood of reoccurrence.

Audits were not always completed in full. Shortfalls had not been identified. Quality assurance systems were not in place to enable the home to monitor the standard of care they provided. Feedback received from people had not been addressed. The registered manager had a number of improvements planned but it was unclear what their priorities were.

Staff had received an induction and continual learning that enabled them to carry out their role effectively. Staff received supervision and felt supported, appreciated and confident in their work. People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with professionals such as doctors, nurses and social workers.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse. Staff told us who they would report this to both internally and externally. Staffing levels were sufficient to provide safe care and recruitment checks had ensured staff were suitable to work with vulnerable adults. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

Staff were clear on their responsibilities with regards to infection prevention and control and this contributed to keeping people safe.

People had their eating and drinking needs understood and met. People told us they enjoyed the food and thought the variety and quantity was good.

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.

People, their relatives and professionals described the staff as caring, kind and approachable. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs. Their life histories were detailed and relatives had been consulted. The home had a complaints process and people were aware of it and knew how to make a complaint. Activities were provided and these included staff, people and their relatives. Individual activities were provided for those that preferred them.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone. Leadership was visible within the home. Staff spoke positively about the management team and felt supported. The registered manager actively sought to work in partnership with other organisat

An adult social care inspector carried out this unannounced inspection of Clifftop care home on 7 September 2016. The service was previously inspected on the 21 February 2013 when it was fully compliant with the regulations.

The service is registered to provide care and accommodation for up to 32 people. On the day of our inspection there were 25 people living at the service. There was a registered manager in post at the time of this 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.

People told us they were safe and well cared for and appeared relaxed and comfortable throughout our inspection. People’s comments included, “I am quite happy, it is very good here”, “To be quite honest I think I am very lucky to have ended up here” and “I would certainly highly recommend this place to anyone.”

Staff said, “As far as I know everyone is perfectly safe here” and “People are definitely safe here. It is the best home I have worked in.” Health and social care professionals told us, “People are definitely safe here” and “I would like to come here myself when I am older.”

On the day of our inspection the service was fully staffed and the service had sufficient staff available to meet people’s care needs. People and relatives told us there were enough staff available and staff said, “There are enough staff” and “They have used agency staff in the past but we are fully staffed at the moment.” There was a stable staff team at the service and recruitment practices were safe and robust. The registered manager told us, “I can be quite choosy with who I employ.”

People’s care plans included risk assessments and staff had been provided with detailed guidance on how to protect people from each identified area of increased risk. Where accidents or incidents had occurred these had been documented, fully investigated and regularly audited to identify any areas of increased risk within the service.

All new staff completed formal induction training before there were permitted to provided care within the service. The registered manager told us, “They have to do all the training in the first 12 weeks, it’s a big ask but they have to do it so they know how to look after people.” While a recently recruited staff member said, “I shadowed for about four weeks so I did feel confident when I started on my own. There is a lot to remember here.” Records showed staff training was regularly updated and that managers provided appropriate supervision. Staff told us, “We get one [an online training course] to do every month”, “I don’t think I have ever had as much training as here” and “The manager does supervision every two months.”

The service used a digital care planning system and we found that people’s care plans were accurate and sufficiently detailed to enable staff to meet people’s care needs. Staff told us, “I love the computer system, there is a support team there if you need them” and “The assessment asks you questions, you answer them and that feeds into the care plan. It reminds you when updates are due, of people’s birthdays and appointments. I am happy with it.”

Staff knew people well and provided calm and compassionate support throughout our inspection. People told us, “I do get on well with them” and “The staff are excellent, kind, loving and caring.” Professionals said, “The staff are lovely” and “staff know people very well”. We saw that people requested support from staff without hesitation and that staff responded promptly to people’s requests.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA). The service had made appropriate applications for the authorisation of potentially restrictive ca