The inspection was unannounced and took place on 6 and 9 December 2016. The home is registered to provide accommodation and personal care for a maximum of 15 people. There were 15 people living at the home on the day of the inspection.

There was a registered manager in place. 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 felt safe and well cared. Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People were cared for by staff that demonstrated knowledge of the different types of potential abuse to people and how to respond to actual or suspected abuse.

People got the assistance they asked for and staff ensured they were available to help people when needed. People told us they enjoyed meals times and were positive about the choice of food they received. People were supported by staff to have their medicines when they needed them and staff recorded when they had received them.

Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them. There were good links with healthcare professionals and staff sought and acted upon advice received, so people’s needs were met.

People said staff were caring and their privacy and dignity was maintained and we made observations that supported this. People and relatives valued the positive relationships they had with staff. Relatives told us there were no restrictions on when they could visit and they were always made welcome by staff.

People received care that met their individual needs. People were encouraged to express their views and said staff listened to them and they felt confident they could raise any issues should the need arise. People chose how they spent their day and said staff respected their choices.

Staff spoke positively of the registered manager and felt supported and listen to. Staff said teamwork was good and the staff team supported each other. The quality of service provision and care was monitored by the provider and actions taken where required.

Since our last inspection on 2 and 8 April 2015, the provider had made improvements to the home. A new lounge area had been added to the home and new furniture purchased. People, relatives and staff all told us the changes had improved the daily lives of people living in the home.

People were positive about the care and support they received, the management of the home and the service as a whole.

An adult social care inspector carried out this inspection. As part of the inspection we spoke with three people who used the service, and the family member of one other. We also spoke to the registered manager and two members of staff. We reviewed the records relating to the management of the home. This included care five records, three staff personnel records, policies and procedures, and minutes of meetings.

College House is registered to provide accommodation for 13 people. At the time of our visit there were 11 people using the service. One of the registered managers named on the front of this report was not in post and not managing the regulatory activities at this location at the time of the inspection.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

People told us that they felt safe. Individual risk assessments were well completed and actions to minimise the risks identified were reflected in care plans.

Appropriate systems and processes were followed with regard to the Mental Capacity Act 2005. Staff had received training and were clear about their role and responsibilities.

The provider had effective medicines management processes and procedures that were applied in practice.

People were cared for in clean premises. Staff had received infection prevention and control training and were clear about their roles and responsibilities. Appropriate measures had been taken to ensure the security of the premises. A key code entry system prevented the risk of unauthorised access.

The building was in urgent need of refurbishment and repair. Bathroom facilities were inadequate. Progress with building work had been delayed. There were no risk or impact assessments relating to the building work or lack of suitable bathrooms. A recent fire safety inspection by the Local Authority had highlighted a number of areas requiring attention with regard to fire safety systems and procedures. We asked the provider to provide us with an action plan of work planned and when it would be completed.

Is the service effective?

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People's needs were assessed and care plans developed. People told us that they had been involved in developing their care plan. Care plans were not always updated when people’s needs changed.

Staff had access to a range of relevant training to meet the needs of the people they cared for.

Is the service caring?

People told us that the care they received was very good. One person told us, “People here look after me very well.” We observed staff speaking to people in a friendly and caring manner.

People told us that the staff supported them to undertake the activities of their choice.

Is the service responsive?

People told us that the service was very responsive. People felt able to raise any issue and were confident that it would be acted upon. However people were frustrated about the lack of progress and information about the refurbishment programme. People were able to express their views about their care through satisfaction surveys and resident meetings.

People who used the service and staff were clear about the complaints process. None we spoke to had ever had the occasion to raise a complaint. However people were confident that if they did it would be acted upon.

Is the service well-led?

Staff told us that they felt supported by the registered manager. Staff meetings were held regularly. The proprietor was not regularly visiting the home which meant that the manager was not always adequately supported.

Systems to monitor and manage the risks to people who used the service were not effective. Environmental audits had failed to identify the risks relating to the incomplete building work and inadequate bathing facilities. We have asked the provider to take action to improve systems to identify and monitor the risks to people who used the service.

We spoke with three people who use the service. We found people had been involved in making decisions about their care and treatment.

People expressed their views on how they wanted to maintain their independence. Care workers we spoke with told us how they supported people in their choice.

People were complimentary about the care and support they received. One person told us: “You feel like you belong”. Another person said: “I enjoy being here”.

The provider had a system in place to make sure care workers recruited had the required documents and checks in place to protect people.

People told us that they felt safe when care workers provided care and support. Care workers had received training on how to recognise signs of abuse and knew how to raise concerns.

People who used the service were supported by care workers who were suitably trained and qualified to meet people’s needs.

The provider made sure care workers were trained to an appropriate standard to meet people’s needs. They also encouraged care workers to participate in team meetings and supervisions.

The provider had systems in place to regularly assess and monitor the quality of service that people received.

We inspected compliance against five of the essential standards at the service.

We spoke with people who used the service. One person told us that changes had been discussed and made to their room since moving to live at the service. This person said the service had "made me comfortable". They told us that many activities took place at the service and that they liked to take part. The person told us that they did not have to wait long if they had pressed the call bell as they required assistance. One person said that they were supported to maintain their appearance how they wanted to and that their clothes were well looked after. This person said the staff were "very good".

We found that there were enough suitable and trained staff to meet people's care needs. We observed a meal time and saw that people received drinks and meals when required and that those that needed support at meal times were given that support. We also saw that people were offered healthy options including fruit for pudding.

We found that people's preferences were considered and their independence was supported. We heard that staff addressed people differently depending on what they preferred to be called. Some people were called by their Christian name and others were addressed using their title.

The service had systems in place to monitor and where necessary improve care quality. The environment was clean and well maintained.

We focused our visit on observing how the staffing arrangements impacted on outcomes for people who used the service.

When we arrived at the home we became aware that there were two members of care staff on duty for 12 people and that the Acting Manager was one of those care staff. Our planned inspection had to be put on hold as there would have been an unacceptable risk of harm to people who use the service if we had spent any meaningful time with the Acting Manager who was providing care.

College house provides accommodation and personal care for a maximum of 16 older people. On the day of our inspection there were 11 people living at the home.

The inspection took place on the 2 and 8 April 2015 and was unannounced. At our last inspection in August 2014 we found the provider was not meeting the regulations in relation to the suitability of the premises and in the assessing and monitoring the quality of service provision. Following that inspection the provider sent us an action plan telling us about the improvements they were going to make. During this inspection we found most of these improvements had been made. However work on improving the lounge facilities still need to be completed.

There was a registered manager in post when we inspected. 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 who lived at the home and their relatives said they felt safe and staff treated them well. Relatives told us staff were kind and caring and thoughtful towards people. Staff we spoke with understood they had responsibility to take action to reduce the risk of harm for people. They demonstrated awareness and recognition of abuse and systems were in place to guide them in reporting these.

People who lived at the home were supported by staff with up to date knowledge and training. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. People were protected against the risks associated with medicines because the registered manager had appropriate arrangements in place to manage medicines. People’s preferences were taken into account and respected. We saw staff treated people with dignity and respect whilst supporting their needs.

The registered manager had followed the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards when assessing people’s ability to make specific decisions. Applications had been submitted to the supervisory body so the decision to restrict somebody’s liberty was only made by people who had suitable authority to do so.

People had food and drink to maintain a healthy diet. We saw at mealtimes there was a relaxed atmosphere and people and their relatives told us they enjoyed the food. People were supported to eat and drink well and had access to health professionals in a timely manner.

All the visitors we spoke with told us they were made welcome by the staff in the home. People were able to see their friends and relatives as they wanted. There were no restrictions on when people could visit the home.

Relatives knew how to raise complaints and the registered manager had arrangements in place so that people were listened to and action taken to make any necessary improvements.

The registered manager promoted a positive approach to including people’s views about their care and service development. People who lived at the home and staff were encouraged to be involved in regular meetings to share their thoughts and concerns about the quality of the service.

The registered manager had systems were in place to monitor and improve the quality of the service, however these systems required further involvement of the provider to complete the improvements and suggestions and for future monitoring of the service.