Market Lavington Care Home 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.

Market Lavington accommodates up to 87 people across two separate buildings, each of which have separate adapted facilities. The residential building is known as Vicarage Gardens and was named by the people who live there. At the time of our inspection 67 people were living in Market Lavington Care Home.

The inspection took place on 22, 23 and 26 March 2018 and was unannounced on the first day.

At the last inspection there was a breach of the legal requirements in the area of risk. During this inspection we found that improvements had been made.

A registered manager was 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. The registered manager has worked at the home for many years and was present on day two of the inspection. The deputy manager and the unit manager were available on days one, two and three.

The ordering storage and disposal of medicines was managed safely. We observed the lunchtime medicines round and saw that medicines were given in a safe and caring way. Medicine administration records (MARs) were completed correctly. There were appropriate systems and records in place for ordering and disposing of medicines. However, we found some out of date medicines and missing protocols for ‘as required’ medicines from the records. We have made a recommendation about the management of some medicines.

Staff sought people’s consent before carrying out any support and they had knowledge of the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards (DoLS). However there were many locked doors in the residential part of the home which restricted access to some areas. We have made a recommendation about best practice for people living with dementia.

People told us they felt safe. Staff knew and understood their responsibilities for safeguarding people against potential risk or harm, and were able to tell us how and when they would report any concerns. Staffing levels were appropriate to meet people’s needs and staff recruitment practices were conducted correctly.

People were supported by staff who had access to training to equip them with the skills and knowledge they needed. Staff benefited from regular one to one supervision sessions to discuss their needs and development.

People and their relatives told us the staff were caring. We observed and heard many kind and compassionate interactions between staff and the people they were supporting. However, some interactions and information lacked dignity. We have made a recommendation about the practise of person centred care methods.

Care and support plans were individualised and contained information on people’s likes, dislikes and preferred routines. People were supported to have maximum choice and control of their lives and staff supported people to make decisions.

There were systems in place to monitor and improve the quality and safety of the service provided. People, their relatives and staff were encouraged to share their views on the quality of the service people received. Where actions to improve had been identified these had been acted upon.

The home had a new provider and the registered manager was effectively supporting people, their relatives and the whole staff team with the changes.