About the service: Gedling Village Care Home is a care home that provides personal care for up to 60 people across three floors, in one adapted building. It is registered to provide a service to older people who may be living with dementia or physical disability. At the time of the inspection 51 people lived at the home.

People’s experience of using this service: Risks associated with people’s care and support were not always managed safely. People were placed at risk of harm as medicines were not managed safely. There had been a failure to learn from incidents. There were not always enough, adequately trained staff available to meet people’s needs. Action was underway to protect people from improper treatment and abuse. Overall, the home was clean and well maintained and safe recruitment practices were followed.

Further work was needed to ensure people’s rights under the Mental Capacity Act 2005 were protected. Mealtimes were not always positive experiences and improvements were needed to ensure risks associated with eating and drinking were managed safely. People had access to a range of health care professionals, but care plans required more information about people’s health to ensure consistent support. Overall, the home was adapted to meet people’s needs. Staff had training and told us they felt supported, however, formal supervisions was inconsistent.

Staff were not consistently kind and caring. People were supported to be as independent as possible. People had access to advocacy services if they required this.

People did not consistently receive personalised care that met their needs. People were at risk of receiving inconsistent support as care plans were confusing, contradictory and not up to date. People were provided with some opportunity for meaningful activity. There were systems in place to respond to complaints.

Systems to ensure the safety and quality of the service were not fully effective. Where issues had been identified, improvements had not always been made or sustained. This failure to identify and address issues had a negative impact on the quality of the service provided at Gedling Village Care Home. The management team were responsive to feedback and took swift action to address issues identified in this inspection. People living at the home, their families and staff were positive about the management team and were consulted about the running of the home.

The service met the characteristics of Requires Improvement in all areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: Good (report published on 5 May 2017)

Why we inspected: This inspection was conducted due to concerns we received about the safety and quality of the service provided at Gedling Village Care Home.

Enforcement: You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: During our inspection we requested evidence of action planned in relation to staffing, medicines management and risk assessment. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This unannounced inspection was carried out on 03 April 2017. Gedling Village Care Home provides accommodation and personal care for up to 60 older people. On the day of our inspection visit there were 49 people who were using the service.

The service had a registered manager in place 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.

People were supported by staff who understood the risks they could face and knew how to keep them safe. Risks to people’s health and safety were identified and action was taken when needed to reduce these. There were sufficient staff employed to meet people’s needs. People received their medicines as prescribed and these were managed safely.

People were supported by staff who received appropriate training and supervision and had an understanding of people’s care needs. People were supported to make choices and decisions for themselves. People who might lack capacity to make certain decisions were assessed to see if they did, and if needed decisions were made in their best interests.

People were provided with a nutritious diet which met their needs and were provided with any support they needed to ensure they had enough to eat and drink. Staff understood people’s healthcare needs and their role in supporting them with these.

People were cared for and supported by staff who respected them as individuals. Staff had caring relationships with people and respected their privacy and dignity. People were involved in planning and reviewing their own care and some people were supported by relatives in doing so.

People received individualised care and they were able to participate in meaningful interaction and activities. People knew how to raise any complaints or concerns they had and felt confident that these would be dealt with.

Some systems for auditing and monitoring the service were not being used effectively. Staff worked well as a team and were supported with their work by the registered and deputy managers.

This inspection took place on 06 January 2015 and was unannounced. Gedling Village Care Home opened as a new service in November 2013 and provides residential care for up to 60 older people, including people with dementia. There were 23 beds for use by people who are using an intermediate care service, which provides people who are ready to leave hospital but not ready to live independently with extra support to help them regain their independence and return home. There were also 37 beds for people who require long term care. On the day of our inspection 50 people were using the service.

The service had a registered manager in place 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 and associated Regulations about how the service is run.

Staff knew how to keep people safe and to raise any concerns if they suspected someone was at risk of harm or abuse. Staff understood the risks people could face through everyday living and how they needed to ensure their safety.

There were sufficient staff on duty to meet people’s needs. There were bank staff employed to cover any absences from work so people’s needs would be met in the event of someone not being able to work at short notice.

Staff received training and supervision to ensure they had the knowledge and skills to provide people with safe and appropriate care. People’s right to make decisions when they were able to were not protected because the legislation for this had not been correctly implemented.

People were encouraged to eat and drink sufficient to maintain their health and well-being. People were supported with their healthcare needs. We observed people were treated with dignity and respect. People felt staff were always kind and respectful to them.

People’s care plans provided staff with the information they needed to support people appropriately. People felt they could raise concerns and we saw these were acted on. Concerns were not recorded to enable the RM to identify trends.

People who used the service, relatives and staff were able to express their views on how the service was run. There were systems in place to monitor the quality of the service and identify what was working well, and if any improvements were needed.