About the service: Honister is a care home without nursing registered to provide accommodation and personal care in one adapted building for up to 19 older people some of who may live with dementia. At the time of the inspection there were 17 people living there.

People’s experience of using this service:

People’s medicines were not always managed safely. Staff did not always administer people’s medicines in accordance with good practice, medicines were not always stored securely when staff were not present. Staff had received training in infection control however, we noted repeated instances where a staff member did not demonstrate good infection control practice.

There were limited activities on offer and people were not supported to go out and about on trips as they had previously. The deputy manager was looking at how they could develop this area further and encouraged staff to explore things of interest to individuals.

People were not always treated with respect and dignity. Staff did not always consider people’s opinions and individual rights in relation to their home environment.

People’s relatives told us that they thought the management team were responsive and they dealt with any concerns promptly. However, some relatives said they were unsure who to raise a concern to as they were unaware who the current manager or owners were.

The provider had failed to achieve improvements identified during the previous inspection in August 2018.

Relatives praised the staff for promoting people’s safety and wellbeing and said there were enough staff available to meet people’s needs. People appeared relaxed and comfortable with staff and management. People’s relatives said they felt people were safe living at Honister.

People enjoyed the meals and their dietary needs had been catered for. People’s care plans were being developed to provide more personalised information about people and their care needs. The provider had undertaken significant refurbishment work in the home creating a brighter environment however, further consideration was needed to support the needs of people living with dementia. There was no signage to support people to orientate the building and encourage their independence.

The deputy manager had a visual presence in the home and staff felt supported by them. Staff had received training to support their role and received ongoing supervision to continue this support. People had good health care support from external professionals. Staff identified when people were unwell and raised this with relevant health professionals.

Relatives told us the staff team were pleasant, kind and caring and took good care of people.

The provider had made the latest inspection report and rating available at the home albeit inside a folder in the communal entrance hall. The provider does not have a website. When required notifications had been completed to inform us of events and incidents, this helped us the monitor the action the provider had taken.

More information is in the detailed findings below.

Rating at last inspection:

At the previous inspection in August 2018 the service was rated as Requires Improvement with Well-led rated as Inadequate. The provider had failed to support or encourage staff to undertake the training they needed to care for people safely. Quality monitoring had been inconsistent and the provider had failed to act on advice given by external health and social care professionals. Risk assessments did not help mitigate risks to people’s safety and the environment was not always appropriate to promote people’s safety or dignity. Shortfalls with medicines management meant we could not be confident that people’s medicines had been administered in line with prescriber’s instructions and people’s records were not always maintained in a manner that promoted confidentiality. Care plans were not sufficiently detailed to guide staff to provide their individual care needs or end of life wishes. Peop

This inspection was undertaken on 13 August 2018 and was unannounced. This inspection was undertaken in response to concerns the Care Quality Commission (CQC) had received from local authority monitoring and commissioning teams.

At our previous inspection of this service undertaken in March 2016 we found the service was meeting the required standards under the previous provider. This was the first inspection under the new registration with the new provider, C & K Healthcare Limited. At this inspection we found that there were serious failings from the provider and management to ensure people received care and support in a safe and effective way.

Honister 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.

Honister is a care home without nursing registered to provide accommodation and personal care in one adapted building for up to 19 older people some of who may live with dementia. At the time of the inspection there were 19 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

The provider had not supported the newly appointed registered manager with mentoring or supervision in their new role. The registered manager did not have any autonomy to manage the service in the best interests of the people who used it which had a negative impact on safety and people’s dignity.

The provider had failed to support or encourage staff to undertake the training they needed in order to care for people safely. The management team did not have protected management time to undertake routine safety audits. Quality monitoring was inconsistent, had not identified risks to people and had not served to mitigate risk to people`s health and wellbeing. The provider had failed to undertake quality checks of the service to satisfy themselves that the service they provided was safe, effective, caring responsive and well-led.

The provider did not have a clear overview of the service provided or actions that were necessary to improve the quality of the service. The provider had failed to act on advice given by external health and social care professionals. Relatives of people who used the service knew the registered manager by name and felt that they were approachable with any problems.

Accidents or incidents were not always managed robustly and not always used as learning to improve the safety of the service. Risk assessments were not always detailed and did not clearly describe the controls in place to help mitigate risks to people’s safety and well-being. The environment was not always appropriate to promote people’s safety. The staff team was not sufficiently knowledgeable to promote people’s safety in the event of a fire. People were supported to take their medicines by trained staff however, we found some shortfalls which meant we could not be confident that medicines had always been administered in line with prescriber’s instructions.

Some of the staff team demonstrated a lack of understanding of infection control matters and some areas of the home required more in depth cleaning. We received mixed feedback about the staffing levels in the home. People told us that they felt safe living at Honister and relatives had no concerns about people’s safety at the home. Staff had been trained in how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. Safe and effective recruitment practices were followed to help make sure that all staff were