This inspection was carried out on 15 June 2017 and was unannounced.

Hagley Place provides accommodation and personal care for up to 60 people. At the time of our inspection there were 41 people living at the home.

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 and associated regulations about how the service is run.

People were treated with dignity and respect. Care was person centred with people having good relationships with staff.

Staff had training and support to enable them to effectively meet the needs of the people living at the home. There were sufficient numbers of experienced and well trained staff to ensure people were supported safely and people’s health needs responded to quickly. Medicines were managed safely and people received their medicines in line with their prescription.

People knew the registered manager and the provider. People felt that if they had any concerns they were able to speak with the registered manager or staff. The registered manager and provider welcomed people's views and opinions and acted upon them.

People felt safe and knew how to raise concerns. Staff felt comfortable to raise any concerns about people’s safety and understood about how to keep people safe.

People enjoyed the food and had the support they needed to enjoy their food and drinks safely. People were able to make choices about the food and drink they wanted. There was a choice of freshly prepared nutritious food.

People's health needs were monitored and changes were made to people's care in response to any changes in their needs. People had access to other health professionals and were referred to them by the registered manager if there were any concerns about their health needs.

There were a range of checks to make sure that good standards of care and support were maintained. Feedback from the people and relatives was gathered on a regular basis and where any actions were identified these were actioned quickly.

Hagley Place is a care home that provides personal and nursing care for up to 60 people. Care and support is provided to people with dementia, nursing and personal care needs. At the time of our inspection 41 people lived there.

There was a registered manager who provided good leadership and supported the staff. During our inspection the registered manager took time to check that staff were alright and that people’s needs were met.

The environment was comfortable, clean and hygienic. We saw staff wash their hands and wear protective clothing when they completed different care tasks.

All the people that we spoke with were happy living at the home and praised staff for the care they received. People gave us their views about the way staff treated them and told us, "Nothing is too much trouble" and staff were, "Nice" and treated them well. Staff were confident to recognise and report abuse, so that people were as safe as possible from harm. We saw that staff had received training on the protection of vulnerable adults and were confident to speak out if they observed poor or abusive practice.

We saw that staff were kind and caring. Staff were respectful in the way they spoke with people and showed how they supported people to do things that interested them. Staff had a good knowledge of the people they cared for. They knew how to support people to meet their needs and referred people to other health professionals when appropriate.

We found that risk factors for people’s safety and wellbeing were identified and explored, so that they were as safe as far as possible from injuries or harm. For example, during our inspection we saw that staff provided people with support and equipment which included walking frames and specialised equipment that was right for them to meet their needs and safety.

Staff told us they were provided with good training opportunities to keep people safe and that met their individual needs and ensured they had the right knowledge and skills to support people effectively. The training for staff included the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no application have needed to be submitted proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

The registered manager showed us the quality assurance audits they had completed to check that the care and support people received met their needs and safety. The registered manager also held meetings with people and their relatives so that they could share future plans and seek what was important to people. This showed that the leadership of the home ensured improvements were sought so that people received care and support that met their needs, and assisted people to do the things that they were interested in.

Not all the people we met were able to speak with us about the care they received and their experience of living in the home. Therefore we observed how staff interacted and supported people. This helped us to make a judgement on how their needs were being met.

Everyone we spoke with told us they were satisfied with their care. People who used the service and their representatives were able to contribute to their care plans. These reflected their personal preferences. There was evidence that the home worked well with other community health professionals and clinical specialists outside the home. This helped to ensure the best care was made available to individuals. People told us that they enjoyed the food and drink provided within the home. They were able to choose what they wanted to eat from the menu.

We found that people who used the service were protected from the risk of abuse. This was because the provider had taken reasonable steps to identify potential abuse and acted appropriately.

There was an effective recruitment and selection procedure in place.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We found that the provider had completed nearly all of the action points contained in the action plan created after our last inspection.

We found that admission assessments and care plans had now been agreed by people using the service or their representatives. A system was in place to obtain consent on behalf of people who were deemed to lack the capacity to give it themselves. However, there was still no routine assessment to identify who might lack decision making capacity in advance of a decision needing to be made.

We found that there had been significant improvements in the training and supervision of staff. Induction programmes for new staff were properly supervised and completed. We saw that regular meaningful supervision meetings were being held for all staff.

Staff told us that training courses were now much more readily available and that they felt better supported by the management.

People told us that they were happy in the home. One person said, "everything's nice". Another person told us that there were "very good staff here". People were appropriately dressed and well groomed. We saw staff treating people with respect and kindness and in ways that respected their dignity.

We found that care plans were up to date and that appropriate risk assessments had been carried out to ensure that people were kept safe. However, none of the people had indicated on their admission assessments or care plans that they agreed to the care and treatment being offered. We also found that advanced directives were not properly completed.

The home had an interim manager in place at the time of the visit. Staff told us that they had not received any formal supervision since the home opened four months ago. We also found that probation and training records were incomplete. Most of the staff had not been asked to provide evidence of qualifications they had obtained in previous jobs.

The inspection took place on 9 and 13 November 2015 and was unannounced.

Hagley Place is registered to provide accommodation with nursing care for up to 60 people. There were 42 people living at the home on the day of our inspection. People were cared for in four units over two floors. The Mountford and Smethurst suites were situated on the ground floor and provided support for people with physical health needs. On the first floor there were the Bottomley and Piggott Suites which provided support for people living with dementia.

There was a registered manager who was present during the 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.

Staff did not have a full understanding about the Mental Capacity Act (MCA) and we could not be assured that decisions that had been made on people’s behalf were made in their best interest.

People we spoke with felt safe living at the home. Staff were aware of how to recognise signs of abuse. They knew who to report concerns to if they became aware or witnessed any abuse taking place. Where concerns had been raised we saw that these had been investigated and appropriate action taken.

Staff were aware of people’s needs and associated risks. They knew how to support people safely in order to reduce further risk of harm or injury. Where people were at risk of falls we saw that equipment was used to alert staff when people may be at risk. We saw that accident and incidents were appropriately reported and recorded. The registered manager analysed the forms to identify if there were any trends or signs of deterioration in a person’s health and took action to reduce the risk of re occurrence.

Staff told us they had access to training that ensured they had the skills to care for people. We saw that staff knew people well and were able to respond quickly to changes in people’s needs

People enjoyed the food and had a choice of menus to choose from. Where required people were given support to eat and drink. People’s nutritional needs were assessed monitored and reviewed on a regular basis. We saw that dieticians and speech and language therapists were approached for advice and guidance where required. The catering staff were aware of people’s dietary needs and provided suitable diets in line with people’s needs. People were referred to health care professionals as and when required to make sure their health needs were met.

People felt staff treated them with kindness and consideration and involved them in their own care. Staff promoted people’s dignity and supported them to remain as independent as possible.

People were able to choose how they spent their time. They were supported to maintain contact with people who were important to them and in activities of their interest. People told us staff were responsive and that they received their care when they needed and were not left waiting.

People told us they would tell staff if they had any issues or complaints. However, one visiting relative told us they did not know how to share their concerns with the provider.

There was a positive working culture at the home where staff worked together as a team to meet people’s needs and create a warm and welcoming atmosphere. Throughout our visit we saw that staff spoke to people with respect and genuine concern for their well-being.

People and relatives were encouraged to provide feedback through meetings held at the home and through individual discussions with care staff and the activities coordinator. The registered manager told us they used this feedback to develop the service.