Cross Lane House is a residential care home offering personal care and accommodation to older people and those living with dementia. The service is registered to accommodate a maximum of 18 people. The service does not provide nursing care. There were 11 people using the service at the time of the inspection. The registered manager told us that they had capacity within their registered numbers to accommodate couples in two double rooms. These bedrooms were used as single rooms at other times.

This inspection was carried out on 30 November 2016 and was unannounced.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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. People were protected by staff that understood how to recognise and respond to signs of abuse. Risks to people’s wellbeing were assessed and staff knew what action they needed to take to keep people safe. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. The premises were safe, clean and hygienic. People had individual evacuation plans outlining the support and equipment they would need to safely evacuate the building; however some of these needed review to ensure they contained clear information about how to evacuate the first floor without using the lift. We made a recommendation about this. Staff understood how to reduce the risk of infection spreading in the service and they followed safe practice.

There was a sufficient number of staff on duty at all times to meet people’s needs in a safe way. We saw that staff had time to chat with people and support them with social activities in addition to meeting their health and care needs. The registered provider had systems in place to check the suitability of staff before they began working in the service. People and their relatives could be assured that staff were of good character and fit to carry out their duties. Staff had completed training and qualifications relevant to their role. The registered manager monitored staff training needs to ensure that staff were skilled and competent to meet people’s needs.

Staff identified and met people’s health needs. Where people’s needs changed they sought advice from healthcare professionals and reviewed their care plan. Records relating to the care of people using the service were accurate and complete to allow the registered manager to monitor their needs. People had enough to eat and drink and were supported to make choices about their meals. Staff knew about and provided for people’s dietary preferences and restrictions. Medicines were stored, administered, recorded and disposed of safely and correctly. Where people were prescribed medicines to be given ‘as required’ there was no written guidance in place to describe the circumstances in which these should be given. We have made a recommendation about this.

Staff communicated effectively with people and treated them with kindness and respect. People’s right to privacy was maintained. They promoted people’s independence and encouraged people to do as much as possible for themselves. Personalised care and support was provided at an appropriate pace for each person so that they did not feel rushed. Staff were responsive to people’s needs and requests. Where people’s assessment documentation recorded that they had particular interests, favourite TV programmes or hobbies this had not always been included in care plan for their social needs to ensure staff knew how to support them to continue with these. We have made a recommendation about this.

Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necess