We carried out an unannounced inspection of Lakelands Residential Care Home on 22 and 25 June 2018. This was the first inspection of Lakelands Care Home since it had been re-registered with the Care Quality Commission in November 2017. The re-registration had taken place as part of a restructure within the company.

The first day of the inspection was unannounced. This meant the provider did not know we would be visiting the home on this day. The second day was announced.

Lakelands is a ‘care home’. People in care homes receive accommodation and or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided; both were looked at during this inspection.

Lakelands is a purpose built, two-storey building in its own grounds. It offers accommodation for up to 4o older people. Communal rooms and dining areas are situated on both floors offering people a choice of areas to relax. There is a passenger lift between the floors.

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 told us they felt safe and were cared for in a safe way. Safeguarding policies and procedures were in place to ensure people, staff and visitors were aware how to raise concerns and what abusive practice looked like. All staff had received training in this area.

Safe recruitment procedures were followed and new staff received a period of induction before being assessed as competent in their new role. Character checks were completed and each staff member had been referred to the disclosure and barring (DBS) service to ensure any previous criminal convictions were identified prior to being successful at interview.

Risk assessments were evident in people’s care files. These helped identify and manage risks associated with daily living activities, such as, accessing the community alone, medicines and mobility. These assessments recognised and promoted individual risk taking.

Environmental risk assessments were also completed for both internal and external areas. Appropriate checks were done by registered external tradespersons on areas such as gas appliances, fire equipment, electrical appliances, hoists and lifts. The service also employed a maintenance team who monitored the service daily. The registered manager also audited service provision in these areas.

Business continuity plans were in place to offer information and guidance in the case of adverse weather or any other unforeseen circumstances which could affect the day to day running of the service. People had personal evacuation plans and fire audits were completed by both external agencies and internally by the maintenance person.

Medicines practice was carried out in line with current guidance from the National Institute for Health and Care Excellence (NICE) and policies were in place to manage as required medicines. Medicines were stored securely and appropriate oversight given to controlled medicines.

People’s care files were person centred and written in a way which reflected the individual and their personal life experiences. People’s human rights and diverse needs were reflected within each plan and we received positive feedback during the inspection which evidenced people were being treated fairly and in line with their personal preferences.

People were supported in line with the Mental Capacity Act 2005 (MCA). 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 support this practice. DoLS applications had been submitted and oversight was maintained by the registered mana