This inspection took place on 19 November 2018 and was unannounced.

Frampton House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Frampton House Residential Care Home is registered to accommodate 30 older people, some of whom are living with dementia. At the time of our inspection there were 24 people living in the home.

At our last inspection in May 2016 we rated the service good overall, but we found improvements were required in the implementation of the Mental Capacity Act 2005. At this inspection we found those improvements had been made and the evidence continued to support the overall rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager 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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Good staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and friendly interactions between staff and people.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

This was an unannounced inspection carried out on 9 May 2016.

Frampton House Residential Care Home can provide accommodation and personal care for 30 older people and for people who live with dementia. There were 26 people living in the service at the time of our inspection. The accommodation was a two storey detached house situated in a rural location.

There was registered manager 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse including financial mistreatment. People had been helped to avoid the risk of accidents and medicines were managed safely. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to support people in the right way. People had been assisted to eat and drink enough and they had been supported to receive all of the healthcare assistance they needed.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. However, the Care Quality Commission is also required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had not promptly taken all of the necessary steps to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the support they wanted to receive and they had been given all of the assistance they needed including people who could become distressed. People had been helped to enjoy a range of interests and hobbies and there was a system for resolving complaints.

Most of the necessary quality checks had been completed to ensure that people benefited from the facilities and services they needed. Good team work was promoted and staff were supported to speak out if they had any concerns because the service was run in an open and inclusive way. People had benefited from staff acting upon good practice guidance.

We carried out an unannounced comprehensive inspection of this service on 15 October 2014 and found that there was a breach of legal requirements. The service was not consistently well led because the registered persons did not operate reliable systems to monitor the quality of the service provided. This is necessary so that shortfalls can quickly be corrected.

We completed an unannounced focused inspection carried out on 7 July 2015. This inspection was undertaken to make sure that improvements had been made and that the breach of legal requirements had been addressed.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Frampton House Residential Care Home on our website at www.cqc.org.uk.

There was a registered manager. 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.

Frampton House Residential Care Home provides accommodation for up to 30 people who need personal care. The service provides care for older people some of whom live with dementia.

There were 28 people living in the service at the time of our inspection.

At this inspection we found that the registered persons had followed their action plan that they had told us would be completed by the 1 May 2015. This action plan had enabled the registered persons to meet legal requirements.

We found that the registered persons had regularly completed robust quality checks. These checks helped to ensure people reliably and safely received all of the care they needed. This included making sure that people had enough to eat and drink in order to promote their good health. In addition, checks had been completed to ensure that staff received relevant training and that new staff could demonstrate their previous good conduct before being appointed. Quality checks had also ensured that fire safety equipment and procedures provided people with a high level of protection.

Frampton House Residential Care Home provides accommodation for up to 30 people who need support with their personal care. The service mainly provides care for older people and people who are living with dementia. The service is a large, converted period property. Accommodation is arranged over two floors and there is a passenger lift to assist people to get to the upper floor. The service has 28 single bedrooms and two double rooms, which two people can choose to share.

There were 23 people living at the home at the time of our inspection.

This was an unannounced inspection carried out on 15 October 2014. There was a registered manager. 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.

We last inspected Frampton House Residential Care Home in January 2014. At that inspection we found the service was meeting all the essential standards that we assessed.

The service did not have a robust system to make sure that people who were at risk of not eating and drinking enough always received the extra care they needed. Some staff had not received all of the training which the provider said that they needed. The recruitment system had not ensured that full background checks were completed before new staff were employed. Some fire safety checks had not been completed.

The systems used to assess the quality of the service had not identified the issues that we found during the inspection. This meant the quality monitoring processes were not effective as they had not ensured that people consistently received safe care that met their needs.

People were helped to stay safe. Staff knew how to recognise and report any concerns and how to keep people safe from harm. Staff had helped people to avoid having accidents. There were reliable systems for managing medicines.

People who lived in the service and their families had been included in planning and agreeing to the care provided. People had an individual care plan, detailing the assistance they needed and how they wanted this to be provided.

Staff knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives. People had received a wide range of personal care such as help with washing and dressing and moving about safely.

People were treated with kindness, compassion and respect. The staff in the service took time to speak with the people they were supporting. People enjoyed talking with the staff in the service. Staff knew how to support people who lived with dementia.

People were provided with a choice of meals.

People were offered the opportunity to pursue their interests and hobbies.

On the day of inspection there were 23 people living at Frampton House.

We spoke with three people who lived at the home and two visitors. We were not able to speak with some of the other people due to their communication needs. One person said to us, "The staff are very nice; they work very hard." Two people described a variety of Christmas activities they had recently enjoyed. One person said, "It was a lovely Christmas lunch." We observed the care and attention people received from staff. All of the interactions we saw were appropriate, respectful and friendly.

The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained. Risks to people living in the home had been assessed. The home was warm, clean and was personalised to the people who lived there.

We saw that people's support plans and risk assessments reflected their needs and were up to date. Staff we spoke with were aware of the contents of the care plans, which enabled them to deliver safe care in line with those plans. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines.

Staff recruitment systems were robust. The provider ensured staff were supported and trained to care for the people safely.

We spoke with three members of staff who told us how they would recognise signs of abuse and how they would escalate their concerns to the relevant bodies. One member of staff said, “I would go straight to the manager or the team leader.”

We spoke to people who told us they felt safe and well looked after. One person said, “We’re all fine here. No problems.”

On this visit we saw the manager now had a robust recruitment process. Staff were not appointed until they had received Criminal Record Bureau clearance and two references.

We spoke with one person who told us, “The staff all know what they are doing.”

On this visit we saw all care files were stored in a locked office. People who lived in the home and visitors to the home did not have access to the office.

As part of our inspection we spoke with several people who used the service, visiting healthcare professionals and a selection of staff members. There were no visiting family or friends on the day of our visit.

During our visit to Frampton House Residential Care Home on 24 September 2012 people told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. One person told us, “The staff are nice and they look after me well.” Another person said, “It’s home, it’s family and I’m well looked after.”

People told us they were happy living there. They told us they felt safe and care staff understood their needs. One person said, “They [staff] keep me safe.” Another person said, “I feel safe and secure. It’s alright.”

Some of the people living in the home were unable to talk with us about their experience of living in the home. We have used a Short Observational Framework for Inspection (SOFI 2). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.

There were 19 people living in the home on the day of our visit. The manager told us many people living in the home had a diagnosis of dementia.

We did not get peoples' views directly from them. However their experiences were captured through records, other information we received from the staff, and from other people they have contact with.

People felt that they were able to have a say in how their care was delivered and spent their time where they wanted. One person said, “We are able to be ourselves and can do what we want.” People said they felt safe in the home and treated with respect. They also told us they enjoyed having a laugh with staff, and spoke highly of them. One person said, “I haven’t come across anyone who I thought didn’t know what they were doing.”