Cunningham House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cunningham House accommodates 54 people across two separate areas, each of which has separate adapted facilities. One of the areas specialised in providing care to people living with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People and relatives told us they felt the service was safe. People remained protected from the risk of abuse because staff understood how to identify and report it.

Medicines were stored, administered and managed safely and we saw evidence of recent improvements. The provider regularly checked the premises and equipment were safe for people to use.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Care plans were written in a very person centred style and were regularly reviewed to reflect peoples' individual care and support requirements. People were given safe care because risks had been identified and managed.

Staff were well motivated, proud of the service and felt listened to. Staff had regular opportunities to reflect on their practice and to request any additional support or training.

The provider was actively looking at ways to improve the quality of the food to meet people’s preferences. People were supported to eat and drink enough to maintain a balanced diet and referred to other healthcare professionals when their health needs changed.

People and their relatives were encouraged to share their opinions about the quality of the service, through meetings. Staff were supported in their practice by a manager they liked and respected.

The provider's quality monitoring system included regular reviews of people's care plans, checks on medicines management and staff's practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.

Further information is in the detailed findings below.

When we previously inspected Cunningham House in May 2013 we found that people were not always protected from the risks of unsafe or inappropriate care and treatment because accurate records were not maintained. We required the provider to make improvements.

We inspected the home again on 07 November 2013 to check whether improvements had been made. We found that records relating to food and hydration were accurate and detailed. We found that the provider had begun a review of care plans to ensure that they accurately reflected people's needs, we noted that this area was 'work in progress' at this inspection.

We spoke with two relatives and two people who use the service who told us that people at Cunningham House, including those who have difficulty with verbal communication, were supported in promoting their independence and community involvement where possible. They said that people were treated with dignity and respect and that people were encouraged to express their views and were involved in making decisions about their care and treatment.

People and relatives we spoke with told us that care and treatment was planned and delivered in a way that ensured people’s safety and welfare. One person said “They will listen and get things right” another said “The staff are lovely, I like it here, they care about me.”

People we spoke with said that they were happy that the home manages their medicines on their behalf. One person said "I don't think I could remember them all myself now so it's best they do it for me."

People living at Cunningham House told us that they were treated with dignity and respect and their independence was supported and encouraged. People with whom we spoke told us they were satisfied overall with the care and support they received at the home. This included in relation to healthcare matters.

People using the service told us they felt safe at Cunningham House. One person with whom we spoke told us that they could say if they were unhappy or concerned about anything, they felt safe there and said “I know who people are so that feels better.”

People told us that they were comfortable at the home and were able to bring some of their own possessions to make it more homely and personalised. “I brought my own furniture, my bed, chair and other things, it’s nice.” Another person said “My room is very pleasant and comfortable.”

People were complimentary about the staff working at the home. One person said “The staff are very good, they are polite and friendly and they respond to the buzzer when I call.” Some people said there were enough staff on duty to meet their needs. Other people found that staffing levels did not fully meet their needs at times and they had to wait a long time for a drink in the morning.

People using the service told us that they felt able to express their views and had opportunity to do so at Cunningham House. One person with whom we spoke said “We are very happy but could certainly say if we were not happy with something.” Another person said “The manager is very good, anything you do not like, they will come and shut the door, sit and listen and sort it out.”

A healthcare professional with whom we spoke said that, in their opinion, this is one of the best care homes in the area and that “People are cared for and about.” They also told us that staff are competent and available and report matters promptly to ensure people's wellbeing.

The inspection was completed on 30 November 2015 and 1 December 2015 and there were 48 people living at the service when we inspected.

Cunningham House provides accommodation and personal care for up to 54 older people and people living with dementia.

A registered manager was in post. 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 the time of the inspection we were advised that the registered manager was providing additional support to another service belonging to the registered provider. However, the Head of Care was deputising for them in their absence. Both the registered manager and Head of Care confirmed that they communicated with each other on a daily basis and there was no negative impact on the day-to-day running of Cunningham House.

People told us the service was a safe place to live and that there were sufficient staff available to meet their needs. Appropriate arrangements were in place to recruit staff safely so as to ensure they were the right people. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and others’ safety.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

The dining experience for people was positive and people were complimentary about the quality of meals provided. People who used the service and their relatives were involved in making decisions about their care and support.

Where people lacked capacity to make day-to-day decisions about their care and support, we saw that decisions had been made in their best interests. The manager was up-to-date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were being protected.

Care plans accurately reflect people’s care and support needs. People received appropriate support to have their social care needs met. People told us that their healthcare needs were well managed.

People and their relatives told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

There was an effective system in place to regularly assess and monitor the quality of the service provided. The manager was able to demonstrate how they measured and analysed the care provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.