Kirby House is a residential care home that provides care and support for up to 40 older people. At the time of our inspection 40 people were using the service and some people were living with dementia.

At the last inspection on 11 December 2015 the service was rated Good. However, we rated the well-led domain as requiring improvements. This was because they did not have a registered manager in post at the time of the inspection. We asked the provider to make the necessary improvements. At this inspection we found that the required improvements had been made and the service was rated Good overall.

There was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

People felt safe. Staff understood their responsibilities to keep people safe from avoidable harm. There were a suitable number of staff deployed and the provider had followed safe recruitment practices. Where risks were identified for people while they were receiving support these had been assessed and control measures put in place. People received their medicines in line with their prescription.

Staff had access to the support, supervision and training that they required to work effectively in their roles. Where agency staff were used, induction was provided to make sure that they were able to meet people's needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People had enough to eat and drink to maintain good health and nutrition. People were supported to access health professionals when required.

People were treated with kindness and compassion. Dignity and respect for people was promoted.

People had care plans in place that focused on them as individuals. This enabled staff to provide consistent care in line with people's personal preferences.

The service had a positive ethos and an open culture. The providers and registered manager provided positive leadership to all staff.

The provider had sought feedback from people and their relatives about the service they received.

The provider's complaints procedure had been followed when a concern had been raised and people felt able to make a complaint if they needed to.

The provider had quality assurance systems to review the quality of the service to help drive improvement.

We carried out an unannounced inspection of the service on 14 December 2015.

Kirby House is a residential care home for up to 40 people. It provides services to people with dementia, mental health conditions, physical disabilities and sensory impairments.

It is a condition of registration that Kirby House has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of our inspection, Kirby House had been without a registered manager for six months. The service was being managed by a manager who intended to apply to be a registered manager within a few weeks of our inspection.

People using the service were protected from abuse and avoidable harm. Staff understood and practised their responsibilities to keep people safe without restricting their independence. People’s care plans included risk assessments of routines associated with their personal care and support. The care plans included guidance for staff about how to safely support people without restricting their independence.

The provider had recruitment procedures that aimed to ensure that only staff suitable to work at the service were employed. Enough staff were deployed to meet the needs of the people using the service.

People were supported to receive their medicine at the right times. Only staff trained in medicines management supported people with their medicines. Medicines were securely stored and there were safe arrangements for the disposal of medicines that were no longer required.

People were supported by staff who had the relevant training to understand their needs. Staff were supported through induction, training and supervision.

The manager had a working knowledge of the Mental Capacity Act 2005. Staff had awareness of the Act. They understood that care and support could only be provided if a person gave their consent, unless a person lacked mental capacity in which case decisions were made in a person’s best interests.

People were supported with their nutritional needs. They had a choice of nutritious meals. People with special nutritional requirements were appropriately supported. People were supported to access health services when they needed them.

Staff developed caring and understanding relationships with people using the service. People or their relatives were involved in decisions about their care. Staff supported people’s privacy and dignity.

People or their relatives contributed to the assessments of their needs. People’s needs were regularly reviewed. People were supported to maintain their hobbies and interests and had access to a range of stimulating and meaningful activities.

People’s care and support was based on their individual needs. Their preferences, likes and dislikes were taken into account.

People and their relatives knew how they could raise concerns. They were confident that any concerns they raised would be acted upon.

People using the service, their relatives and staff had opportunities to be involved in developing the service. Their feedback was acted upon. People and their relatives knew who the manager was and they told us the manager was approachable.

The manager regularly monitored the quality of the service. An area manager also carried out monitoring activity and supported the manager at Kirby House. Monitoring activity, which included seeking people’s feedback, was used to identify areas where the service could be improved.

We spoke with seven people who used the service, two visitors to the home, and six members of staff. We also reviewed five care records.

We observed good interaction between staff and the people using the service and saw choices being given to people and verbal agreement gained before carrying out care.

We also spoke with seven people who used the service and asked them their views in relation to the care they received. All spoke with high regard for the quality of care and professionalism displayed by the staff. One person told us:” The staff always ensure I am safe and getting the care I should”.

We observed a member of staff carrying out the medication round. They were observed administering medication carefully and at a pace that suited the individual.

One person told us:” Although the staff have lots of demands on them. They never leave us unattended and always answer my bell in a timely manner”.

A member of staff explained to us a two hourly walk round of the premises was conducted by a senior member of staff. The walk round consisted of observational checks on personal care, staff interaction, activities, general atmosphere and the environment.