This inspection took place on 26 April 2018 and was unannounced. This was our first inspection of this service since its registration on 23 January 2017.

Homestead Care Home name is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates a maximum of 33 people in one adapted building.

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. There was a new manager who had recently joined and was present during our inspection. At the time of our inspection they had started their application to become registered manager and this was accepted on 9 May 2018.

People and relatives consistently told us the service was safe. The registered manager was driving necessary improvements to the safety of the service, such as recruitment processes, moving and handling support and medicines management. Although staffing levels had recently increased, staff were, still not always available to safely meet all people’s needs. We also found some approaches to risk management did not promote people’s freedom as far as possible.

Systems did not ensure people were always supported as needed with their meals and drinks to remain well, although we also received some positive feedback about this aspect of people’s care. Staff were not supported to develop the skills and knowledge needed for their roles which we saw impacted on how people were supported to make choices, and how people were supported to live with dementia and with behaviours that may challenge. Improvements were ongoing in this area. Staff reported improved support from the new registered manager who was addressing training and support needs. Overall people and relatives expressed satisfaction with the support provided and spoke positively about staff. People were supported to access healthcare support. Home developments were underway to enhance people’s comfort and experience.

We received consistent feedback about the caring approach of staff and there were genuine and positive relationships between people, relatives and staff. People were supported to express their views and choices about their care. We observed a respectful approach from staff and people were treated kindly. However, people did not receive a consistently caring service. The care and support provided did not always meet people’s needs and therefore ensure people were always treated with respect and to have their independence promoted as far as possible. Staff were also not always available to spend time with people and to reassure them if issues arose.

Relatives and staff told us group activities of interest were usually offered, however we did not find that people had good access to their interests and activities of choice. Continued improvements were required and ongoing to people’s care plans so these would reflect people’s current needs and wishes. People and relatives were involved in care planning processes and expressed satisfaction with the support provided. People and relatives felt comfortable making complaints and could be confident they would be addressed.

The provider’s systems to assess, monitor and improve the service were not always effective. Systems did not ensure incidents were always learned from and investigated, and that relevant partner agencies were always informed of safeguarding concerns when necessary. This was in breach of two regulations and we are deciding our regulatory response to this. We will publish a supplementary report once this decision is finalised.

We identified another breach of the regula