This inspection took place on 20 April 2017 and was unannounced.

Cloverfields provides accommodation for up to 35 people who require nursing or personal care. At this inspection 29 people were living there.

A manager was in post and present during our inspection. The manager was newly appointed and commenced work at Cloverfields approximately eight weeks before this inspection. We confirmed that they had submitted appropriate applications to become the 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 12 and 16 May 2016, we identified five areas where the provider was not meeting the requirements of the law. There were not enough staff on duty to meet people's needs and this compromised their safety. There was not enough staff available to ensure people ate and drank sufficient amounts. People did not receive support or assistance in a timely manner. The provider did not have sufficient systems in place to resolve people’s concerns. Quality checks were not robust enough to ensure people received a good level of care.

The provider sent us an action plan in September 2016 telling us what they would do to make improvements and meet legal requirements in relation to the law. At this inspection we found the provider had taken the necessary measures to ensure the quality of care people experienced had improved.

People were supported by enough staff to safely meet their needs. People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care. Equipment required to reduce risks to people was provided and was appropriate to people’s individual needs. Staff knew what to do in order to minimise the potential for harm. The provider had systems in place to address any unsafe staff practice which included additional training or disciplinary processes if required.

People received help with their medicines from staff who were trained and assessed as competent to safely support them. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work.

People received care from staff that had the skills and knowledge to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to the people they supported.

People’s rights were maintained by staff members who were aware of current guidance and legislation directing their work. People were involved in decisions about their care and had information they needed in a way they understood. Staff received support and guidance from a management team who they found approachable.

People had positive and caring relationships with the staff members who supported them. People and staff felt able to express their views and felt their opinions mattered. People’s likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by those supporting them. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently.

People were supported to eat and drink sufficient amounts to maintain good health. People’s personal likes and preferences were known by the catering staff who supported them to make decisions regarding their diet.

People were involved in decisions about their day to day care and had care plans which were individual to them. Care plans contained people’s likes, dislikes and personal histories. Staff had a good knowle

This inspection was unannounced and took place on 12 and 16 May 2016.

Cloverfields provides accommodation and nursing care for up to 35 people. On the days of our inspection there were 32 people in residence.

The home had a registered manager who was present for one day of the 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.

There were not enough staff on duty to meet people’s needs and this compromised their safety. However, people felt safe living in the home and staff knew how to protect them from the risk of potential abuse. People were protected from the risks of harm because staff knew about the risk posed to them and action was taken to avoid this from happening. People were supported by staff to take their prescribed medicines and they received them when needed.

People had a choice of meals but staff were not always available to ensure they ate and drank sufficient amounts. People were supported by staff who had access to routine one to one sessions [supervision] and training. People’s human rights were protected because the registered manager was aware of the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards. People were supported by staff to access healthcare services to promote their health.

Staff were aware of people’s care and support needs but people did not always receive support in a timely manner because there wasn’t enough staff on duty. People were encouraged to be actively involved in planning their care and their rights to privacy and dignity was respected.

People were involved in the assessment of their needs and were supported to do the things they liked. People’s views and concerns were listened to by staff and action was taken to address them but this was not always sustained.

People and staff were aware of whom the registered manager was and they were sometimes involved in the running of the home. Checks were carried out to monitor the effectiveness of the service. However, these checks were not entirely robust to ensure people needs were met when required.

This was a scheduled inspection of Cloverfields. However, shortly before our visit we heard various concerns about the home. The concerns were mostly about the numbers of staff in the home and how they were supervised. There were also concerns about how medication was administered in the home. We looked at these concerns as part of our inspection.

On the day of our visit a director and a senior manager from the home’s parent company were working in the home. They told us that they were addressing the concerns that had been raised with them. The home’s manager had left several weeks earlier. An experienced interim manager was running the home.

People we spoke with were mostly happy with the service they received although they were aware of changes in the home. One person told us, “They look after me well.” Another person said, “It’s very good, I have no complaints”.

People did, however, tell us that there had been a lot of agency staff in the home recently who did not understand their needs well. One person told us that they had not been able to go to bed when they wanted to when there had been a shortage of staff. People were very complimentary about the home’s own staff. They told us that the staff were, “Absolutely wonderful”, and “You can’t knock the staff”.

We spoke with relatives of people living in the home. They were generally happy with the service their relatives received.

Most of the staff we spoke to told us that things had begun to improve in the home in recent weeks. One member of staff was not happy with the changes.

We found that there had been a period when staff were under severe pressure and that had not been well supported. The home’s owners were now addressing this. At the time of our inspection, the local authority had just begun an investigation to see if the problems at the home had had any impact on the people living there.

People told us that they were happy in the home. One relative told us about her father, "I travel from Lancashire rather than move him because he loves it so much".

We spent time with people over lunch. We saw staff being sensitive and caring in the way they helped people to eat. The cook came out to speak to people after the meal to ask how they had enjoyed it. One person told us that the staff "would do anything for me". Another person said the staff were "really kind".

People told us that there were lots of activities in the home that they really enjoyed, but some said they would like to go out more.

We found that care plans were detailed and up to date and that they gave the staff the information they needed to support people. The staff told us they felt well supported by the management but would sometimes like an extra staff member on duty.

People told us they felt safe in the home. Staff clearly understood the safeguarding policy and said they would feel comfortable raising any concerns.