Loundsley House 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. Loundsley House accommodates up to eight people in one building. On the day of our inspection there were 6 people living in the service.

We inspected the service on 16 August and 8 September 2018. The inspection visits were unannounced on both days. This was the first inspection of the service.

The service did not have 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. A manager was in post and plans to apply to the Care Quality Commission for registration.

People had not always been kept safe through the use of effective care planning and risk assessment and management. There was not always sufficient trained staff who were given clear directions on how to care for people with complex needs. The provider did not always have systems in place to recognise when they could no longer meet people’s needs.

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Staff were not always deployed in the best interests of people and they worked very long hours without a break. Records did not always reflect what was happening in the service such as staffing levels and staff hours worked. They had not always been supported in a manner that enabled them to learn and flourish as staff members.

Care plans were basic and they did not always give staff clear directions on how to care for people who had complex needs. This impacted on risk assessments as up to date information on risk was not always available. Due to the lack of consistent management communications were not always effective. Staff said they had improved with the appointment of the new manager.

People’s dignity was promoted and staff were caring in their interactions with people. However people's independence was not always promoted as there was not always enough staff to ensure they had an active social life at a time they wanted outside the service.

There was a complaints process in place. There was a quality assurance process in place. However it was not always effective and had not reflected the concerns raised during this inspection process. The new manager reviewed incidents and acted to reduce them.

The service was clean and fresh and there were processes in place to keep the service infection free.

Medicine was stored and administered as prescribed. People's consent to care was sought for daily personal care activities. 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. The provider was working in accordance with the Mental Capacity Act 2005 (MCA), and people had their rights respected in this regard.