This inspection took place on 22 and 23 August 2017 and was unannounced on the first day. We returned the following day to complete this and we gave the provider notice of this.

Fridhem Rest Home provides accommodation and personal care for up to 25 older people, some of whom may be living with dementia. There were 21 people living at the home when we visited.

There was a registered manager working at the 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 legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the home is run. Two managers run the service, who are also owners of the business, one of them is the registered manager. The registered manager was not available on the first day of the inspection, however, the other home manager was. We met with the registered manager on the second day of the inspection.

We last inspected the service in June 2016 and found some shortfalls in the service provided. The provider was not meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At that inspection, we also found that the systems in place to monitor or assess the quality and safety of the service provided were not effective. Accidents and incidents were logged, but analysis of this information was not completed which could identify any emerging themes or trends.

We asked the provider to provide an action plan to explain how they were going to make improvements to the home. At this inspection, we found that improvements had been made.

Staff knew how to keep people safe from abuse. Staff were confident that if they had any concerns they would be addressed quickly by the registered manager. Risks to people had been assessed and regularly reviewed. Actions had been taken to mitigate these where necessary. Checks had been made on the environment to ensure the service was safe. Equipment to support people with their mobility, such as hoists had been checked to ensure people were safe.

There were enough staff to ensure people were safe and had their needs met in a timely way. Medicines were stored safely, people received their medicines when they needed them

Staff received training to make sure they had the skills and knowledge to carry out their roles. Specialist training such as diabetes and supporting people living with dementia had been completed.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Staff understood their responsibilities under MCA, people’s capacity had been assessed and when required best interests meetings had been held and recorded. Staff encouraged people to make decisions about their day-to-day care and remain as independent as possible.

People told us that they enjoyed the food. People had a choice of meals and were supported to maintain a healthy diet in line with their choices, preferences and any healthcare needs. People’s health was assessed and monitored. Staff took prompt action when they noticed any changes or decline in health. Staff worked closely with health professionals and followed guidance given to them to ensure people received safe and effective care.

People’s dignity and privacy was maintained by staff. People told us staff were kind and caring. Staff spent time with people and were genuinely interested in them and what they wanted t

This inspection took place on 27, 28 and 29 June 2016 and was unannounced. Fridhem Rest Home is a residential care home providing personal care and support for up to 25 older people, some of whom live with dementia. On the day of our visit 23 people were living at the service.

The home has had the current registered manager in post since before October 2010. 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.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service was not meeting the requirements of DoLS. The registered manager had not acted on the requirements of the safeguards to ensure that people were protected.

You can see what action we told the provider to take at the back of the full version of the report.

People felt safe living at the home. Staff were aware of safeguarding people from the risk of abuse but they did not know how to report concerns to the relevant agencies. Individual risks to people were assessed by staff and reduced or removed. There were adequate servicing and maintenance checks to equipment and systems in the home to ensure people’s safety.

There were enough staff available to meet people’s needs and additional staff were available if required.

Medicines were safely stored and administered, and staff members who administered medicines had been trained to do so. Staff members received other training, which provided them with the skills to carry out their roles, although training updates were not always available and this meant that staff knowledge was not always up to date.

People enjoyed their meals and were able to choose what they ate and drank. Staff members worked together with health professionals in the community to ensure suitable health provision was in place for people.

Staff were caring, kind, respectful and courteous. Staff members knew people well, what they liked and how they wanted to be treated. People’s needs were responded to well and support was always available. Care plans contained information about how staff should support individual people with their needs. Staff members understood the MCA and presumed people had the capacity to make decisions. Where someone lacked capacity, best interest decisions had been made.

A complaints procedure was available and people were happy that they did not need to make a complaint. The registered manager was supportive and approachable, and people or other staff members could speak with her at any time.

The home did not effectively monitor care records and other systems to assess the risks to people and the quality of the service provided.

People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members. People told us that staff members were always available, approachable and that they helped people with their care needs.

A risk assessment had been completed to ensure people could safely access the garden area. Checks were also completed to ensure hot water was safe to use.

The service had a policy and procedure to guide people in how to make a complaint and there was clear information about taking complaints further.

During our inspection of 11 December 2012 people told us they enjoyed living at Fridhem Rest Home. One person we spoke with told us, "There is so much to do here, I really do feel at home". People also told us that staff members were understanding of their personal care needs and that they spoke to them in a kind and respectful way.

We saw that people's individual care needs were identified and that staff members were given clear guidance on how to assist people with their personal care.

People lived in a bright, clean and spacious home. However, the provider did not regularly undertake appropriate checks and, where necessary, assess potential risks to ensure people were not placed at risk of harm.

Staff we spoke with told us they felt supported in their work and that they were well trained to be able to provide care and support to people living at Fridhem Rest Home.

We saw that people were not made aware of how to make a complaint if they wanted to. Complaints policy's and procedures were out of date and did not contain accurate information to advise people who to speak with should they feel they wanted to make a complaint.

People we spoke with told us they think Fridhem is a good home and that they are ‘lucky to be here.’

People continually said that staff are very good and always available when needed. We observed staff undertaking their duties with due consideration for choice and dignity. People were laughing and chatting with staff throughout our visit and one visitor said there are staff about whenever they visit and their relative is ‘doing very well with good help from staff.’

We were told by one person living at Fridhem that staff could not do any more than they do and they were happy living in the home.

Everyone said they know who to talk to about any problems or worries, particularly if they feel unwell, staff will always listen and help.

When asked about the food people told us they have plenty, meals are very tasty, they choose what they wish and can ask for a drink or snack at any time.