Cloyda Care Home is a residential care home that provides personal care and support for up to 35 older people, some of whom had dementia. There were 29 people using the service at the time of our inspection.

The bedrooms are based on two floors and each floor has shared bathroom facilities. Eight bedrooms had their own toilet and all bedrooms had a small sink for washing. There are two lounges, one attached to a dining area and a small lounge, both overlooking a large garden. There are kitchen and laundry facilities on the ground floor. The home is close to local amenities including shops, cafes, and churches and had good transport links to the local towns and London.

At our inspection in November 2015 we rated the service as Good overall and Well-Led as Requires Improvement, with one breach of regulations because the provider did not have effective systems to assess, monitor, and improve the quality of the services provided.

We inspected against this breach of regulation in March 2016 and although the provider had met the breach we did not change the rating for Well-Led because to do so would require consistent good practice.

At this inspection we found the service remained Good and we changed the rating of Well-Led from Requires Improvement to Good. The service demonstrated they continued to meet the regulations and fundamental standards.

People remained safe at the home. People had suitable risk assessments in place. The provider managed risks associated with the premises and equipment well. There were enough staff at the home to meet people’s needs. Recruitment practices remained safe. Medicines continued to be administered safely. The checks we made confirmed that people were receiving their medicines as prescribed by staff qualified to administer medicines.

People continued to be supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people’s needs. We saw that staff encouraged people to make their own decisions and gave them the encouragement, time and support to do so. Staff were providing support in line with the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their needs. People had access to a range of healthcare professionals.

The staff were caring. The atmosphere in the home was calm and friendly. Staff took their time and gave people encouragement whilst supporting them. Throughout the inspection we saw that people had the privacy they needed and were treated with dignity and respect by staff.

People’s needs were assessed before they stayed at the home and support was planned and delivered in response to their needs. People could choose the activities they liked to do. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

We observed during our visit that management were approachable and responsive to staff and people’s needs. Systems were in place to monitor and improve the quality of the service. Audits of the premises helped ensure the premises and people were kept safe.

We carried out an unannounced comprehensive inspection of this service on 17 November 2015 and a breach of legal requirement was found. This was because the provider did not have effective systems to assess, monitor and improve the quality and safety of several aspects of the service provided to people. This was with particular reference to medicines as there was a risk they may have not been stored safely at the appropriate temperature. Secondly, the provider had not identified an infection control lead to regularly audit the service, which could compromise the welfare of people. Thirdly, police checks to ensure only suitable staff were employed by the service were not updated regularly. Finally, many of the provider’s policies and procedures were out of date; this was with particular reference to the complaints and safeguarding adults at risk policies.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach of regulation.

We undertook a focused inspection on the 31 March 2016 to check that they had followed their action plan and to confirm that they now met legal requirements. This inspection was unannounced.

This report only covers our findings in relation to these requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cloyda Care Home on our website at www.cqc.org.uk

Cloyda Care Home provides accommodation and personal care for up to 35 older people, many of whom are living with dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

During our focused inspection we found the provider had followed their action plan. We saw legal requirements had been met as the provider now had systems in place to assess and monitor the quality of the service. New policies and procedures had been written and the provider was taking action to ensure they were being effectively followed.

Although sufficient action has been taken to meet the legal requirements made at the last inspection, we have not changed the ratings for ‘well-led’ from ‘requires improvement’ to ‘good’ as we need to see changes made have been consistently embedded by the provider over time. The overall rating for the service remains as ‘good’.

The inspection took place on the 17 November 2015 and was unannounced. The last inspection of this service was on the 9 December 2013. At that inspection we found the service was meeting all the regulations we assessed.

Cloyda Care Home provides personal care for older people many of whom are living with dementia. It can provide accommodation for up to 35 people over two floors. At the time of our inspection 29 people were living at the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

The service had a number of measures in place to monitor the quality of the service. However, these measures were ineffective in some areas. This included the storage of medicines, infection control and the continued suitability of people employed by the service.

This is a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of this report.

People and their relatives were positive about the care and support they received at Cloyda. We saw staff were knowledgeable about people and knew how to meet their diverse needs. We saw genuine warmth from staff towards people who used the service. Levels of staffing were sufficient to ensure people’s needs were met.

We observed people were routinely asked for their consent before care was provided. If people were unable to give informed consent, the provider worked within the framework of the Mental Capacity Act 2005. The Act aims to protect people who may not be able to make some decisions for themselves and to make sure their rights are protected.

There were a range of social activities people could chose to participate in if they wished to. Relatives were encouraged to visit the home and to maintain contact with their family members.

People’s care needs were well documented. They reflected individual needs and preferences, and were reviewed regularly so they were up to date in order to meet people’s current needs. People had access to professionals that would enable them to stay as healthy as possible.

Staff were knowledgeable about people they cared for. Care plans outlined clearly how care should be provided and these plans were regularly updated. Staff received regular training and support to ensure the care they provided remained in line with current good practice.

The registered manager was open and inclusive. They encouraged people to share their views of the service, and they had put a number of mechanisms in place so people could respond in a different ways. People felt their views and concerns would be listened to and acted upon.

People were encouraged to maintain good health. They had access to healthcare professionals. People’s nutritional needs were assessed and monitored and people received a variety of meals according to their needs and choice. People received their medicines as they were prescribed by their GP.

During our visit we spoke with the manager, people who used the service and staff.

The aim of the visit was to see if improvements had been made in relation to the level of care provided and staffing numbers following our inspection in April 2013.

We saw through observation that there was an increased level of staff during the morning and over lunch. A member of staff was based in the lounge/dining room area to provide support if required. The manager would also provide additional support during lunch and other busy times.

Since our previous visit staff had received good practice guidance on personal hygiene, dignity, respect and communication. This information was also displayed around the home.

Staff we spoke with said "The staffing levels are OK as before we were a bit pushed", "There is definitely enough support from the managers" and "I really look forward to coming to work every day".

People we spoke with said they felt safe and they thought the staff were very nice. One person said "The staff are always smiling and happy to help you".

During our visit to Cloyda Care Home we spoke with people who use the service, relatives and members of staff.

The people who use the service that we spoke with all thought the staff were very nice and happy. One person commented that the staff had a laugh with the residents. The relatives we spoke with felt the staff were welcoming, helpful and kind.

The staff we spoke with felt there were not enough people on duty to provide the care and support required by the people using the service. They did comment that they thought the training they had received was good and if they could ask for additional training if they felt they needed it.

People said the home was very clean and one relative explained that they visited at different times of the day and there were always high levels of cleanliness. The people we spoke to told us the food was nice and nutritious with one person who used the service saying 'I get to eat ice cream for every pudding".

A relative commented that "What matters is not how posh the home is, it's the people who work there that is important".

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was lead by a CQC inspector joined by an Expert by Experience, people who have experience of using services and who can provide that perspective.

People said they enjoyed living in the home and the staff were very supportive. They said that they felt the food was of a very high quality and that they were given a selection of meals to eat. We were told that staff were supportive and that there was a very warm family atmosphere in the home. One person said, “the carers are lovely and we are very lucky to live here”. Another person told us, “I’m very happy here.”

People who live in this service told us "it's very nice here”, I’m quite happy”, “I like living here” and staff are all very kind”

*The people that we spoke with, who like to be known as residents, told us “the home is a nice place to live in”, “I have a lovely room”, “its always nice and clean” and “I enjoy the meals here”. They also told us that staff “are very kind” and “they do all that they can to help you”.

All the residents looked happy and well cared for and the atmosphere within the home was very cheerful with lots of interaction between them and the staff.