The inspection took place on 15 and 16 November 2016 and was unannounced. The last inspection took place in June 2015 and the home received an overall rating of ‘requires improvement’.

Crossley house provides care and accommodation for people living with dementia. There were 13 people living in the home at the time of our inspection; however two of these were in hospital.

There was a registered manager in place, however they were on leave at the time of our 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 was a deputy manager in charge and also the quality and training manager supported the inspection.

People in the home were protected in line with the Mental Capacity Act 2005 (MCA). This is legislation that protects the rights of people who are unable to make decisions about their own care and treatment. There was evidence of mental capacity assessment relating to various decisions and a best interest decision made. Where people had LPA's in place, information about this was available in their file and they were asked to consent to people's care arrangements.

Medicines were stored and administered safely. However we found that there weren’t clear instructions in place for all PRN (‘as required’) medicines. Clear instructions are important to set out exactly when PRN medicine should be given and what dose should be administered.

People in the home experienced happy and positive relationships with staff. Staff were responsive to people’s needs, offering support and reassurance when people were upset and at other times sharing smiles and laughter. Activities that engaged people and which they clearly enjoyed were provided. Staff spent 1-1 time with people outside of care tasks; for example we saw one person clearly enjoying have their nails painted by staff and being encouraged to participate by choosing the colour of varnish.

Staff were supported in their role with training and supervision. New staff followed the Care Certificate which is a set of standards that all care workers are expected to achieve. Of the staff files we checked not all had received formal 1-1 supervision with their line managers; however staff were positive about their training and support and felt able to approach the registered manager at any time.

The home was well led by the registered manager and supported by other senior staff within the organisation. There were systems in place to monitor the quality of the service provided and this included gathering feedback from people and their relatives.

At the time of our inspection 17 people were living in Crossley House. During our inspection we spoke with people living in the home, staff, relatives and examined the care records for people living in the home.

Not all people were able to verbally tell us about the care they received and if they were happy. Therefore we observed how staff interacted and supported people in the communal areas to enable us to make a judgement on how their needs were being met. People appeared happy and relaxed in the company of the staff and were seen to be engaged in activities and conversations during our inspection.

We looked at people’s personal care files to see if their care assessment documentation met their needs. We spoke with six people who used the service, one relative and five staff during our inspection.

Overall people’s comments were positive about living in the home. Comments included; “I can’t fault it I’m very happy, they can’t do enough for you”, “there is always something going on, it’s very comfortable there are lovely gardens to walk around”.

One relative told us” X is very happy here, we have no complaints but we would know how to make one if we did”.

We spent time with people that lived in the home. The atmosphere was calm, happy and relaxed. People told us that they were very happy living there and that they were looked after by 'super staff'. We saw staff talking to people in a sensitive way and supporting people with their needs.

This inspection was unannounced and took place on 24 and 25 June 2015. A previous inspection on 30 November and 1 December 2014 had found six breaches of regulation. At this inspection we found that action had been taken in response to these breaches; however further improvements were required in two areas relating to audits and record keeping.

The home provides care for older people, some of whom are living with dementia. At the time of our inspection there were 14 people living at Crossley house.

There was a manager in post at the home, although at the time of our inspection they had not yet begun the registration process with the Commission. The previous manager had deregistered with the Commission in May 2015.

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 our previous inspection on 30 November and 1 December 2014, we found six breaches of regulation. These included concerns relating to record keeping and auditing of medicines. Although action had been taken to improve in these areas, further improvements were required.

Errors had been made in stock taking of medicines which meant there was a risk that concerns would not be identified through the audit process. Records relating to food and fluid intake showed significant improvement; however gaps in recording were still found. The manager was aware of the importance of clear record keeping and was taking action to address issues, including providing training for staff.

People in the home benefitted from kind and caring relationships with staff. This was evident in interactions where people shared laughter with staff and received reassurance when it was needed. Friends, relatives and staff alike were positive about the home and the changes that had occurred in recent weeks, since the findings of the previous inspection.

Staffing levels had increased since the last inspection and this meant people’s needs were met effectively. Staff reported that the increased staffing levels allowed them to spend more time with people on care tasks not directly related to their personal care.

Staff understood people as individuals. Their needs were well described in their care plans and we observed staff supporting people in accordance with their plans. Friends and relatives were able to be involved in planning people’s care where appropriate.

Staff reported feeling well supported and felt able to approach senior staff with any concerns or issues. Staff received regular supervision, which provided opportunity to discuss their performance and development needs. An induction programme for new staff had been introduced based on the Care Certificate. The Care Certificate is a nationally recognised set of standards that new staff are expected to meet in order to equip them fully for their role.