The inspection took place on 10 December 2018 and was announced. We last inspected the service on 2 and 6 October 2017. We found the provider had breached the regulations relating to safe care and treatment, person-centred care, need for consent and good governance. We rated the home as requires improvement.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service safe, effective, caring, responsive and well-led, to at least good.

During this inspection we noted improvements had been made and the provider was now meeting the requirements of the regulations. For example, improvements had been made to medicines management and risk assessments contained more information than previously. However, we noted risk assessments would benefit from more detailed information about the measures required to mitigate risks. The provider had implemented systems to support staff when making Mental Capacity Act (MCA) assessments. We have made a recommendation about this as, although staff followed the correct process, the decisions considered were not always relevant. Improvements had also been made to the quality assurance processes.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone using Haddington Vale receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

People said they were very well cared for and told us the staff were kind, considerate and caring. Care records provided staff with a summary of people’s preferences.

People and staff told us Haddington Vale was a safe place to live.

Staff had a good understanding of both safeguarding and the provider’s whistle blowing procedure. They told us they hadn't needed to use the procedure but wouldn't hesitate to do so if required.

Staffing levels were sufficient to meet people’s needs. People told us staff were very reliable and responded to their needs well.

There were robust recruitment procedures to ensure new staff were suitable to work at the service.

Incidents and accidents had been logged, with details recorded of the action taken to keep people safe. These were monitored to identify any trends.

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.

Current care plan audits were infrequent which presented as risk issues would not be addressed quickly.

Staff were well supported and received the training they needed. Records confirmed supervisions, appraisals and training were up to date. The provider made resources available for the training and development of staff.

People were supported to meet their nutritional needs as required. Where necessary, staff supported people to attend healthcare appointments.

The service user guide provided details of important information, such as the availability of advocacy services and the provider’s c

This inspection took place on 2 and 6 October 2017 and was unannounced. Haddington Vale Extra Care Scheme is a domiciliary care provider registered to provide personal care for people living in an extra care scheme. At the time of this inspection 46 people were using the service. This is the first time the service has been inspected.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone using Haddington Vale Extra Care Scheme receives the regulated activity of personal care; CQC only inspects the service being received by people provided with ‘personal care’; such as help with tasks related to washing, dressing and eating for example.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 found the service had breached a number of regulations. The provider failed to identify, assess and manage risks to the health and safety of people of using the service. Medicines were not managed safely. Care plans were not specific and lacked detail. We also found that the provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure that people received appropriate care and support.

The service ensured trained staff were deployed to support people. The provider had a robust recruitment process in place, with staff being fully checked before starting working with people.

There were enough staff employed to carry out all the visits that were required. People told us they were regularly supported by the same team of care workers.

People were supported to maintain good health and access to healthcare professionals.

People were happy with the care and support they received and spoke positively about the staff. People told us they were treated with respect and dignity with staff being kind and caring.

Processes and procedures were in place to ensure people were protected from abuse and harm. Staff spoke confidently about the actions they would take if they thought a person was at risk of harm.

People were involved in the decision making about their care and treatment. Feedback was regularly sought from people using the service and staff.

People were not always supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and the policies and systems in the service support this practice.

Staff said they felt supported by the branch and assistant manager. Staff we spoke with confirmed they could raise issues with the management and said they were “approachable”.

Following this inspection, we invited the provider to meet with us to discuss our findings and to seek assurances about how they planned to improve the service.