The inspection took place on 10 August 2018 and was unannounced. At the last inspection in July 2017 we rated the home overall as ‘Requires Improvement.’ Following the last inspection, we asked the provider to complete an action plan to show how they would make the required improvements. What they would do and by when to improve the key question in ‘Effective’ and ‘Welled’ to at least good At this inspection we saw the required improvements had been made.

Lacemaker Court 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.

The home is purpose built to support people living with dementia. The accommodation is provided over two floors, each floor has communal spaces to provide dinning and relaxation. All the bedrooms have ensuite facilities. On the ground floor there is access to a secure garden and additional communal rooms.

The service was registered to provide accommodation for up to 16 people. At the time of our inspection 14 people were using the service.

Lacemaker Court has 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.

People were supported to be protected from harm. Staff had received training in safeguarding and a range of courses to support their role. Risks had been assessed to reduce the opportunities of accidents or incidents occurring. Where these had happened, we saw risk assessments had been reviewed and measure put in place to reduce the risk of reoccurrence.

There was enough staff to support people’s needs and recruitment practices were in place. This ensured staff were suitable to work with people. Medicine was managed safety and reviewed when necessary.

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. Independence was encouraged and supported. People could choose how they spent their day.

Activities were available and people had been encouraged to be part of the planning. Their views mattered and any comments or suggested improvements had been followed.

The care plans reflected people’s needs. These included those in relation to culture and communication. People had been able to connect with the staff and had established positive relationships.

The registered manager completed a range of audits to reflect on the quality of the care being provided. These had been used to consider trends or to drive improvement. We had received notifications and the provider understood their responsibilities under their registration.

Partnerships had been established with health care professionals and this enabled good communications in promoting people’s health care needs. This included people’s nutritional requirements. These were supported and people were able to make choices in relation to their meals.

The environment was kept clean to reduce the risk of infection. The home was purpose built and provided space for people to socialise with other or to have some private space. People had been encouraged to personalise their own space.

This inspection visit was unannounced and took place on 23 May 2017. This was the first inspection at the service since their registration with us. The service was registered to provide accommodation for up to 16 people. People who used the service were living with dementia. At the time of our inspection 16 people were using the service.

There was a registered manager in post. 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.

People were not always supported to make decisions about their care and when people could not make these decisions for themselves, it was not clear how the decisions had been made in their best interest. Assessments and applications to deprive people of their liberty had not all been completed The provider had not always used effective systems to monitor and improve the quality of the care people received. People received their medicines safety, however audits were not in place to ensure on going checks in relation to storage and as and when required medicines.

People were encouraged to make choices about their food. People had been encouraged to be involved in any changes within the service, however these were not always managed due to the service restrictions

Opportunities to participate in activities were available and staff felt these increased their bond with people and their memories. Staff had developed relationships with people so they knew their likes and dislikes. People were encouraged to make choices about their day and staff ensured people’s dignity was respected. Relatives had been encouraged to be involved in the care being provided and were welcome to visit anytime. They also felt able to raise any concerns, although the home had received no complaints.

Risk assessments had been completed to protect people from harm. The environment was kept safe and secure and relatives felt confident that people using the service were safe.

There were sufficient staff to ensure people’s needs were met and there was additional resource available from the adjoining unit if required. Recruitment processes had been carried out to ensure staff were safe to work with people. Staff received training and an induction that helped them support people and maintain the knowledge they required for their roles.

Staff told us they were supported by the manager and provider. We saw the service had a positive relationship with professionals and referrals were made to health professionals when needed. The manager understood the responsibilities of their registration with us.

We found 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.