On the day of our inspection, no-one was using the service. We spoke with one person over the telephone. They told us everything was always explained to them, so they did not have any outstanding questions or concerns. The person we spoke with said they were always treated with respect. They had complained about their treatment and were “very satisfied” with the provider’s response. We found the provider had effective systems for dealing with complaints.

We found that people were not protected from the risk of abuse because the staff were not trained and did not have access to information about how to identify and report abuse.

When we inspected in February 2013, we asked the provider to take action to improve their medicines management. Although they had taken some action, at this inspection, we found systems for management of medicines did not protect staff, people using the service and others from risks associated with medicines.

We found staff felt well supported but the provider did not have effective systems to ensure staff had access to adequate relevant training and support.

There was only one person using the service on the day of our inspection. They were very satisfied with the service and commented the service was: “Really professional. Make you feel at ease.” By checking records and talking to staff, we found that people were treated safely. The person using the service told us they had been given enough information about the risks and benefits of treatment before giving their consent. They were aware they could withdraw their consent at any time and their questions had been answered so they felt confident giving their consent. They felt confident that staff treating them were qualified and experienced to do their job.

The person using the service was aware that records about their care were kept. They had seen these were kept securely. We found the provider had arrangements for retaining records for an appropriate time.

The person using the service had not been given any medicines by the provider. We checked arrangements for management of medicines. We found the provider was not meeting standards for medicines management because they had not assessed the risks associated with obtaining and storing medicines.

During the inspections we did not see anyone using the service

We completed our inspection by reviewing documents supplied by the provider and by talking with the provider and staff.

We completed this inspection to check what action the provider had taken following our previous inspections in February and October 2013.

We ask five key questions of services we inspect. Are they safe, are they effective, are

they responsive, are they caring, are they well-led? This inspection focused on two of those five questions; are they safe and are they effective?

Is the service safe?

We found that people were protected from the risk of abuse because the staff were

trained and were aware of how to identify and report abuse.

When we inspected in February and October 2013, we asked the provider to take action to improve

their medicines management. Although they had taken some action, at this inspection, we

found systems for management of medicines did not protect staff, people using the service

and others from risks associated with medicines.

Is the service effective?

We found that staff felt well supported. Staff told us the registered provider was very approachable and supportive. The provider had an induction programme for staff who were new to the service and staff received training relevant to their role when they requested it. We noted there was no formal training plan for staff currently in place.

We found staff had not attended first aid training and the registered provider had not completed basic life support training since 2006.