About the service: Hinckley House Care Home is a residential care home providing personal care and accommodation for up to 60 people, some of whom have dementia. There were 54 people living at the service at the time of our inspection.

People’s experience of using this service:

• People felt safe living at Hinckley House Care Home and with the staff team who supported them. The staff team were aware of their responsibilities for keeping people safe and had received the relevant safeguarding training.

• People felt that, overall, there were enough staff on duty to meet their care and support needs. Appropriate checks had been carried out on new members of staff through employment history had not always been explored. The staff team felt supported by the management team and involved in how the service was run.

• The risks associated with people’s care and support had been appropriately assessed and managed. Checks had been carried out on the environment and equipment to ensure it was safe and fit for purpose.

• Plans of care had been developed and the staff team knew the people they were supporting well. People spoke highly of the staff team and told us they were treated with dignity and respect.

• People were supported to access healthcare services when needed, and they were supported to eat and drink well. Recommended fluids levels had not always been recorded as a target for staff to aim for. People were involved in making decisions about their care and support and their consent was always obtained.

• People were supported with their medicines in a safe way and as prescribed by their GP.

• 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.

• People were provided with a clean and comfortable place to live and the staff team adhered to the providers infection control policy.

• People’s personal preferences within daily living had been identified and they were supported to attend a wide range of activities.

• People were involved in how the service was run through meetings, the use of surveys and day to day conversations with the registered manager and staff team.

• There were comprehensive systems in place to monitor the quality and safety of the service being provided. A complaints process was in place and people knew who to talk to if they had any concerns.

• The registered manager worked in partnership with others to ensure people received safe care and support.

More information can be found in the detailed findings below.

Rating at last inspection: Good (report published 24June 2016) all the key questions were rated Good and the service was rated as Good overall. This rating has not changed and the service remains Good.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out an unannounced inspection of the service on 3 May 2016.

The service provides accommodation for up to 60 older people. The service is located in a residential area of Hinckley. Hinckley House is a modern purpose built residential care home. Accommodation is on three self-contained floors. Each has a dining room, lounges and communal areas. The home has landscaped gardens. At the time of our inspection 46 people were using the service.

At our last inspection on 12 May 2015 we asked the provider to take action to improve how they deployed suitably qualified, competent, skilled and experienced staff to meet people’s care and treatment needs; and how they ensured that people’s consent was sought or where people lacked capacity to give consent that the service acted in accordance with the Mental Capacity Act 2005. At this inspection we found that the provider had made the required improvements.

At our last inspection the service did not have a registered manager. Interim management arrangements were in place pending the appointment of a newly recruited registered manager. A registered manager was in place from 8 February 2016. 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. A registered manager left the service in February 2015.

There were procedures to protect people from abuse. Staff understood their responsibilities to identify and report any sign of concerns using the provider’s safeguarding procedures. People were protected from avoidable harm through risk assessments. These included information for staff about how to support people safely and without undue restrictions.

Since our last inspection provider had recruited enough staff to be able to reduce reliance on agency staff. Improvements were made to how staff were deployed at busy periods to ensure that people’s needs were met. People received their medicines at the right time. The provider had effective arrangements for the safe management of medicines.

The provider’s arrangements for the storage of medicines were safe. Only staff that successfully completed training in management of medicines supported people with their medicines.

People using the service were supported by staff with the relevant skills and knowledge. Staff were supported through effective training and supervision. Staff understood and practised their responsibilities under the Mental Capacity Act 2005. They sought people‘s consent before they provided care and support. No person had restrictions on their liberty unless they had been authorised under the Deprivation of Liberty Safeguards.

People were supported with their nutritional needs. They had a choice of nutritious food and were protected from the risks of malnutrition and dehydration. People were supported to access health services when they needed. The service had experienced problems with the lift which at times had impacted on the quality of meals and access to health services for people with accommodation on the first and second floors, but this risk was being addressed.

Staff developed caring relationships with people using the service. They were able to do this because they understood people’s needs and their life stories. Staff were attentive to people’s needs and supported them to be comfortable.

People using the service and their relatives had opportunities to be involved in decisions about their care and support. They had access to information about the service and their individual care plans.

Staff treated people with dignity and respect. People were able to spend their time the way they wanted and their choices were respected. People were able to spend private time alone or with relatives in their rooms.

People received car

We carried out our inspection on 12 May 2015. The inspection was unannounced.

The service provides accommodation for up to 60 older people. The service is located in a residential area of Hinckley. Hinckley House is a modern purpose built residential care home. Accommodation is on three self-contained floors. Each has a dining room, lounges and communal areas. The home has landscaped gardens. At the time of our inspection 50 people were using 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 and associated Regulations about how the service is run. A registered manager left the service in March 2015. Interim management arrangements were in place pending the appointment of a newly recruited registered manager.

Staff understood and put into practice the provider’s procedures for safeguarding people from abuse and avoidable harm. People using the service knew how to raise concerns. The provider was recruiting staff in order fill vacancies and address issues caused by under-staffing by permanent staff. People usually received their medicines at the right time. The provider had effective arrangements for the safe management of medicines.

People using the service were supported by staff who had received relevant and appropriate training. Staff felt supported through effective training but they had not had regular supervision. Senior staff understood the relevance to their work of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, but care workers we spoke with had only a basic awareness of the legislation.

Staff supported people with their nutritional needs. However, as a consequence of a lift being out of order, people on the second and third floors were not provided with the same quality of meals as people on the ground floor during a two week period.

People were supported with their healthcare needs and could access healthcare services when they needed them. However, during the period the lift was out of use two people’s hospital appointments were cancelled because staff believed it was unsafe to attempt to transfer people to the ground floor. One of those cancellations was unnecessary.

People using the service told us that staff were considerate and caring. People were able to enjoy a variety of meaningful activities that reflected their hobbies and interests. People were usually supported by care workers who understood their needs, but we saw agency care workers who were not fully attentive to people’s needs. People were involved in the assessments of their needs and in reviews of their plan of care. People were provided with information about their care and support options and were involved in decisions about their care and support. Care worker’s respected people’s privacy and dignity but we saw an instance of an agency care worker who hadn’t done so.

People’s plans of care were centred on their specific needs. Those plans had agreed aims and objectives which care workers helped people to achieve. People knew how to raise concerns if they needed to. People we spoke with were very pleased with the care and support they had experienced.

The provider had effective procedures for monitoring and assessing the quality of service that promoted continuous improvement. The provider had managed the impact of the lift being out of use and scale of disruption to service was less than it might otherwise have been. However, the absence of continuous and consistent management had been felt by staff. The management team were not fully aware of some decisions care workers and other staff had taken, for example cancellation of a person’s hospital appointment and that people on the upper floors were served improvised meals.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.