The inspection took place on 8 December 2016 and it was unannounced. The last inspection of this service took place on 1 October 2015, no breaches of regulation were found but the service was rated ‘requires improvement’ overall at that time.

College View is registered with the Care Quality Commission [CQC] to provide accommodation for up to twelve people who may be living with dementia. Accommodation is provided over two floors. There is a secure garden at the rear of the service and a car park for visitors to use.

The service had a registered manger in place, who is the registered provider. 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.

Staff understood they had a duty to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

We observed that the staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff were aware of the risks to people’s health and wellbeing, they knew what action to take to minimise those risks.

Staff were provided with training in a variety of subjects to develop and maintain their skills. Staff received regular supervision and appraisals took place to help to monitor their performance.

People’s nutritional needs were assessed and monitored; people’s special dietary needs were catered for. Staff prompted and assisted people to eat and drink. People’s nutritional needs were met.

Staff supported people to make decisions for themselves, they reworded questions or information to help people, especially those living with dementia to enable them to understand what was being said. People chose how to spend their time. People were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when people lacked capacity and important decisions needed to be made.

Signage was in place to help people find their way to the toilets and bathrooms. People had their names and pictures on their bedroom door to help them find their room. The communal areas of the service were on the ground floor. General maintenance occurred and service contracts were in place to maintain equipment to ensure it remained safe for staff to use.

A complaints procedure was in place. People’s views were asked for informally by staff and through the use of questionnaires. Feedback received was acted upon to ensure people remained satisfied with the service.

A variety of audits were undertaken to monitor the quality of service provided. This helped to maintain or improve the service provided to people.

This inspection was undertaken on 01 October 2015, and was unannounced. The service was last inspected on 9 April 2014 the service was compliant with the regulations that we looked at.

College View is registered with the Care Quality Commission [CQC] to provide accommodation for up to twelve people who may be living with dementia. Accommodation is provided over two floors. There is a secure garden at the rear of the service and a car park for visitors to use.

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

Staff understood they had a duty to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission [CQC]. This helped to protect people.

We observed that the staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff were aware of the risks to people’s wellbeing and what action to take to minimise those risks. Staff had undertaken training in a variety of subjects to develop and maintain their skills, this was updated, as required.

People’s nutritional needs were assessed and monitored; their preferences and special dietary needs were known and were catered for. Staff encouraged and assisted people to eat and drink, where necessary. Advice from relevant health care professionals was sought to ensure that people’s nutritional needs were met.

Staff supported people to make decisions for themselves they reworded questions or information to help people living with dementia understand what was being said. People chose how to spend their time.

We found when inspecting people’s care records that there was no record of an incident where a person had been unwell and that medical advice had not been sought. During our inspection some fire doors were held open by inappropriate means and some storage of some cleaning chemicals and slug pellets had to be addressed. Window restrictors were not in use in two areas and a person required a bed rail bumper to be replaced. These issues were dealt with at the time of our inspection.

People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

There was signage in place to help people find their way to the toilets and bathrooms. People had their names and pictures on their bedroom door to help people find their room. Staff helped to guide people to where they wished to go. The communal areas were located on the ground floor. General maintenance occurred and service contracts were in place to maintain equipment so it remained safe to use.

A complaints procedure was in place. This was explained to people living with dementia or to their relations so that they were informed. People’s views were asked for informally by staff and through surveys. Feedback received was acted upon to help people remain satisfied with the service they received.

The registered manager undertook a variety of audits to help them monitor the quality of the service. However, the issues we found at the time of our inspection had not been identified by this process.

The inspection took place on 8 December 2016 and it was unannounced. The last inspection of this service took place on 1 October 2015, no breaches of regulation were found but the service was rated ‘requires improvement’ overall at that time.

College View is registered with the Care Quality Commission [CQC] to provide accommodation for up to twelve people who may be living with dementia. Accommodation is provided over two floors. There is a secure garden at the rear of the service and a car park for visitors to use.

The service had a registered manger in place, who is the registered provider. 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.

Staff understood they had a duty to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

We observed that the staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff were aware of the risks to people’s health and wellbeing, they knew what action to take to minimise those risks.

Staff were provided with training in a variety of subjects to develop and maintain their skills. Staff received regular supervision and appraisals took place to help to monitor their performance.

People’s nutritional needs were assessed and monitored; people’s special dietary needs were catered for. Staff prompted and assisted people to eat and drink. People’s nutritional needs were met.

Staff supported people to make decisions for themselves, they reworded questions or information to help people, especially those living with dementia to enable them to understand what was being said. People chose how to spend their time. People were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when people lacked capacity and important decisions needed to be made.

Signage was in place to help people find their way to the toilets and bathrooms. People had their names and pictures on their bedroom door to help them find their room. The communal areas of the service were on the ground floor. General maintenance occurred and service contracts were in place to maintain equipment to ensure it remained safe for staff to use.

A complaints procedure was in place. People’s views were asked for informally by staff and through the use of questionnaires. Feedback received was acted upon to ensure people remained satisfied with the service.

A variety of audits were undertaken to monitor the quality of service provided. This helped to maintain or improve the service provided to people.

The inspection was carried out by a pharmacist inspector. We set out to answer one of our five questions; Is the service safe?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with the staff and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the service was safe because people were protected against the risks associated with the unsafe use and management of medicines.

We saw that medicines were stored safely. People were given their medicines as prescribed. The records about the management of medicines showed that medicines were handled safely.

During our inspection on 17 September 2013 we found that staff were not employed in sufficient numbers in order to meet the needs of the people who used the service. At our inspection on13 January 2014 we found that appropriate levels of staff were deployed. The home operates with three care staff including one senior through the day and two carers through during the night. Other ancillary staff are also employed including domestic and kitchen staff. The manager was supernumerary to staffing levels.

During our inspection on 17 September 2013 the provider was failing to ensure people who used the service received their medicines safely. It was judged that this had a minor impact on the people who used the service. A pharmacist inspector from the Care Quality Commission revisited the service on 13 January 2014 to check whether improvements had been made and maintained. We found that people were still not protected against the risks associated with the unsafe use and management of medicines.

During our inspection we looked at five care plans. People who used the service had signed a number of consent forms agreeing to the home recording information, photographing wounds, completing physical examinations and producing care plans.

A number of detailed care plans had been developed covering subjects including communication, medication, tissue viability and continence care. It was evident that care plans and risk assessments were assessed and updated on a monthly basis.

We looked at medication records and the administration of medication. We found there were some concerns about medicines or the records relating to medicines.

We looked at a number of staff rotas and saw that staffing levels within the home had not increased since our last inspection in June 2013. Staffing levels have not increased to reflect the higher number of people who now use the service.

Staff received appropriate training and professional development as they commenced employment with the home. We saw that a comprehensive induction programme mapped the development of new starters.

The provider had an extensive audit schedule for 2013. Audits were completed for care plans, activities, staff supervision, medication, complaints and organisational policies. We saw evidence that when shortfalls had been identified and action plans had been produced to address underperformance.

We looked at the controlled drugs book and saw issues in relation to dual signatures not always being completed and other episodes of poor recording. Failing to keep accurate records could lead to medication errors resulting in poor episodes of care for service users.

People told us their privacy, dignity and confidentiality were respected. One person said, “The care is all right. I get looked after. I have input from the GP and district nurse after I had a fall. The staff help me when I want to go anywhere. They are all right here and I am quite happy being here. It’s a nice place.” A relative said, “This is just like coming into a home and I feel relief as they treat everybody the same. There is a lot of love and kindness here.” Another relative told us, “They do treat all of the residents here with the utmost respect.” Another relative said, “The care is fantastic. They are so kind and considerate and people are so well looked after.”

People we spoke with said they felt safe in the service. Relatives said they felt people were safe from the risk of abuse. One relative told us, “There are no safeguarding issues.” Another relative said, “I think safeguarding is well taken care of. You don’t hear anybody shout. They handle the people very well.”

People who used the service spoke with us positively about the staff that worked in College View. One person said, “The staff are supported, yes. The staff are all right.” We also spoke with relatives about the staff. One relative told us, “The staff all get on and they just do the job.” Another relative said, “A lot of the staff have worked here for a long time. A couple of staff are on apprenticeship. Without exception they are all caring staff and very friendly. You can ask any of them anything at any point.”

We spoke with people who used the service about how they would progress any concerns they had with the provider. People explained that they were listened to and their concerns were acted on. One person told us, “I would go to the residents’ and relatives’ meeting if I was asked. I have not completed any questionnaires. I have no complaints I am quite happy being here.”

We have not spoken directly to people who use the service in assessing the outcome areas for this review. But we did take into consideration the views of people we interviewed at the last inspection in September 2009, we have also taken into consideration the views of people from their consultation with the provider.

People told us at our inspections and more recently through surveys and meetings with the provider that they were happy with the care they were receiving, their privacy and dignity was respected and that staff supported them in the way they wanted. They considered the staff were very friendly and helpful.

They told us that they were happy with the environment and the home was kept very clean and tidy.

They said they were generally very happy with the meals but some felt the menu choices could be changed more frequently.

People said they knew who to talk to if they had any concerns, they were consulted about how the home was run and felt involved in decisions about their care and treatment.