This inspection took place on 07 August 2017. This inspection was unannounced, which meant the service did not know in advance we were coming.

Haylands Residential Home for Gentlemen is a care home providing accommodation and personal care for up to 24 people some of whom are living with dementia. It is a spacious, three storey building located in Urmston and situated near local amenities such as shops, a library and public transport links. There is a chair lift in place and communal facilities for cooking, dining, personal care, relaxing and leisure. The home has two lounges and one dining room. At the time of this inspection there were 22 people living in the home with care provided on the ground and first floor.

Our last inspection took place on 25 and 26 July 2016 when we gave an overall rating of the service as 'Requires Improvement'. We found two breaches of the legal requirements in relation to safe care and treatment and good governance. At this inspection we found that the service was now meeting these regulations.

At the time of the inspection there was a registered manager at Haylands Residential Home for Gentlemen. A registered manager is a person who has registered with the Care Quality Commission to manage 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We noted improvements in medicines management from the last inspection in July 2016 and some examples of good practice. Medicines were ordered, stored, administered and disposed of safely.

Staffing levels were structured to meet the needs of the people who used the service. There were sufficient numbers of staff on duty to meet people's needs.

At the last inspection we made recommendation for the provider to access the best practice guidance to promote the health and wellbeing of people who are living with dementia. At this inspection we found the provider had made a number of positive changes within the environment of the home to make it more dementia friendly.

Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and they demonstrated a good understanding of the act and its application. Where people did not have the capacity to make decisions about their care, meetings were held with people, their relatives, and health and social care professionals to help ensure that any decisions were made in the best interests of people using the service.

The registered provider had policies and systems in place to manage risks and safeguard people from abuse. Staff were aware of the whistle blowing policy and they told us they would use it if required. Staff told us they were able to speak with the managers if they had a concern.

People had a choice of nutritious food and their weight was monitored, with

appropriate referrals made to other healthcare professionals when concerns were identified. However, we received varied opinions on the quality of food on offer.

Care plans were complete and regularly reviewed. We saw any changes to care plans were reflected in handover documents to help ensure all staff were aware. Information on preferences, social history and interests were recorded.

The involvement of people and their relatives in care planning had improved since our last inspection and a regular quality assurance meeting was now held with people and their relatives. Care workers knew people well as individuals and we saw warm and friendly interactions between people and care workers.

We found accident records at the home were comprehensive and evidence showed people were monitored effectively following an accident.

Some senior care staff at the home had received advanced training in end of life care

This inspection was unannounced and took place on the on 25 and 26 July 2016. The first day was unannounced.

The service was previously inspected 4 February 2014 when it was found to be meeting all the regulatory requirements which were inspected at that time.

Haylands Residential Home for Gentlemen is a care home providing accommodation and personal care for up to 24 people living with dementia. It is a spacious, three storey building located in Urmston and situated near local amenities such as shops, a library and public transport links. There is a chair lift in place and communal facilities for cooking, dining, personal care, relaxing and leisure. The home has two lounges and one dining room.

At the time of the inspection there was a registered manager at Haylands Residential Home for Gentlemen. A registered manager is a person who has registered with the Care Quality Commission to manage 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection visit we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to safe care and treatment and ineffective quality assurance and auditing systems. You can see what action we told the registered provider to take at the back of the full version of the report.

The manager was present during our inspection and engaged positively in the inspection process.

The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors. During the inspection we found Haylands Residential Home for Gentlemen to have a warm and relaxed atmosphere and overall people living in the home appeared happy and content.

Feedback received from people using the service we spoke with was generally complimentary about the standard of care provided. People living at Haylands Residential Home for Gentlemen told us the manager was approachable and supportive.

People were not always protected against the risks associated with the unsafe use and management of medicines. Appropriate systems were not in place for the recording, safe keeping and disposal of medicines.

The service lacked governance systems to assess the quality of the service. For example, effective systems to monitor medicines were not in place and auditing systems were not robust.

Some staff and people told us that activities could be limited at times. A part time activities co-ordinator was responsible for activities, however no activities were organised when they were not at work. This meant at times people lacked social stimulation.

We found that the home was properly maintained and ensured people's safety was not compromised. However, we felt the stair lift at the home required a safety guard in place to minimise any potential trip hazards.

Staff were supported through induction, regular on-going training, supervision and appraisal. A training plan was in place to support staff learning. There were however, gaps in some topics in particular food hygiene and health and safety training.

Consent to care and treatment was sought in line with legislation and guidance. Capacity assessments had been completed appropriately for people and were in their care records. Staff we spoke with understood the principles of the Mental Capacity Act 2005 which meant staff understood the importance of ensuring people's rights were protected.

People felt safe living at the home and their relatives were confident they were well cared for. If they had any concerns, they felt able to raise them with the staff and management team.

Risks to people's health and wellbeing were assessed and managed. There were sufficient suitably re

Twenty four people were using services at Haylands when we visited.

We spoke to four people using the service. They were able to talk to us about their experiences at the home, although not in detail. They were positive about the home and the staff; comments included ‘The nurses are very good’, ‘They work hard’ and ‘The staff are nice’.

We spoke with three members of staff and we observed and heard staff interacting with people and assisting them. They were knowledgeable and understood the needs of the people using the service.

The atmosphere was relaxed and homely; we observed staff interacting with people and engaging in conversations. The staff clearly understood their needs and had good relationships with all of them.

The home had well-kept garden areas with a small memorial area, seating and parking. There was an accessible ramped entrance and a stair lift. Accommodation was provided on two floors and we saw that rooms were clean and personalised with people’s belongings. There were two lounge areas and a separate dining area with a bar.

A variety of information was displayed in the foyer, such as complaints information, health and safety and fire information, a dignity in care policy and a philosophy of care which included a commitment to dignity. A Dignity in Care award had been made by the local authority.

We also saw photographs of activities, poems, 100th birthday telegrams and paintings by people living at Haylands displayed around the home.

Four people living in the home told us that staff respected their rights to privacy, dignity and decision making. They said that they received the right amount of care and support and that this was provided in a safe manner.

Robust assessments of need had been undertaken for people living in the home and care plans contained detailed information about the care and support each person was receiving. Care plans also provided evidence that people were receiving their care and support in a manner that suited their preferences.

Hayland's had a suitable policy and procedures for keeping people using the service safe from abuse. Staff knew what they must do to keep people safe from harm. One of the four people we spoke with said, "The staff know what they are doing and I am confident that they care about my safety."

Staff working in the home had received the appropriate training to safely meet the needs of the people they cared for. Staff had been consulted on a regular basis and were encouraged to participate in decisions about the day to day management of the home.

We saw evidence that Haylands had implemented a robust system to monitor and review the quality of the service being provided. People using the service, their representatives and staff working in the home had participated in this process and their views and suggestions had been used to make continual improvements to the way the service was provided.