This unannounced inspection took place on 18 and 20 April 2018.

Greenmantle 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.

Greenmantle is a 15-bed care home providing accommodation and care for older people, including people living with dementia. When we visited 12 people were using the service.

The service had 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.

The registered provider of the service recently changed from an individual provider to Greenmantle Care Home Ltd. Whilst this change is technically a new registration it is however just a change in legal entity for a continuing service.

At the last inspection on 23 and 29 August 2017, we found three breaches of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Medicines were not safely managed and there were not enough staff deployed to safely meet people’s needs. The registered person had not adequately monitored, assessed and improved the quality of the services provided. Following the last inspection, the provider completed an action plan to show what they would do to improve the service and meet the requirements.

At this inspection, we found that action had been taken. Staffing levels had been changed and were sufficient to meet people's needs. An additional member of staff was on duty in the afternoons and an extra staff was on duty for an hour at the beginning and end of the day.

Systems to monitor the service provided had been changed and strengthened. External consultants had provided guidance and support and an action plan was in place to address issues found. The registered manager had increased the audits and checks they carried out and had taken action when issues had arisen. Staff felt the registered manager was supportive and gave them clear guidance.

Systems in place supported people to receive their prescribed medicines when they needed them. The registered manager monitored and audited medicines to ensure they were safely managed. The completion of outstanding staff competency checks will make the process more robust.

The provider’s relationship with staff and some relatives was not positive and was not conducive with an open or supportive culture. We have recommended that the provider works with staff and relatives to address any issues and to foster positive professional relationships.

Planned improvements to the environment were still pending and the bathroom and kitchen continued to need refurbishment.

There was a stable staff team who knew people's needs. Further changes had been made to care plans but some more work was needed to ensure they were detailed and person centred.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Accidents and incidents were recorded but not reviewed or analysed to determine if there were any trends or issues that needed to be addressed.

People were supported to receive the healthcare that they needed. They told us they felt safe at Greenmantle and were supported by kind and caring staff.

Staff supported people to make choices about their care and systems were in place to ensure they were not unlawfully deprived of their liberty. Systems were in place to ensure that decisions made in people’s best interest protected their human and legal rights.

Information about complaints and activities was available for people and pictures and larger print formats were used to help those who might find it difficult to read or unders