The inspection took place on 11 May 2017 and was unannounced.

Marrams provides accommodation, care and support for up to three older people who require support with personal care and their meals cooked. At the time of this inspection there were three people living in the home. The residential care home is situated on the ground floor of a large semi-detached house, which has its own private grounds. The provider lives in the upstairs part of the building and both environments have independent entrances.

As the service is operated by an independent sole provider, who oversees the running of the service on a daily basis, there is no requirement for a separate registered manager to be in post. The registered provider is therefore the ‘registered person’. 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.

There were enough staff working in the home to help ensure people's safety. Staff worked well together to ensure people's needs were met safely and appropriately. Proper checks were carried out when new staff were recruited, which helped ensure only staff who were suitable to work in care services were employed. Staff knew how to recognise different kinds of possible abuse and understood the importance of reporting any concerns or suspicions that people were at risk of harm appropriately. The provider also understood their role in addressing any issues.

Risks to people's safety were identified, recorded and reviewed on a regular basis. There was also written guidance for staff to know how to support people to manage these risks. Staff worked closely with healthcare professionals to promote people's welfare and safety. Staff also took prompt action to seek professional advice, and acted upon it, where there were concerns about people's mental or physical health and wellbeing.

People's medicines were stored and managed safely and administered as the prescriber intended. Staff were appropriately trained and competent to support people with their medicines, although some people managed and administered their own medicines.

People enjoyed their meals and were provided with sufficient quantities of food and drink. People were also able to choose what they had. If people were identified as possibly being at risk of not eating or drinking enough, staff would follow guidance to help promote people's welfare and input would be sought from relevant healthcare professionals.

Staff were trained well and were competent in meeting people's needs. Staff understood people's backgrounds and preferences and supported people effectively. New staff completed an induction and all staff had frequent one-to-one time with the provider, during which supervisions and appraisals of their work were undertaken.

Staff understood the importance of helping people to make their own choices regarding their care and support and consistently obtained people’s consent before providing support. All three people had full capacity to make all their own decisions at the time of this inspection. However, staff understood how to act in people’s best interests, to protect their human rights, should this situation change.

Staff had developed respectful, trusting and caring relationships with the people they supported and consistently promoted people’s dignity and privacy. People were able to choose what they wanted to do and when. People were also supported to maintain relationships with their friends and families. People engaged in activities of their choosing and were supported to maintain and enhance their independence as much as possible.

The service was well run and communication between the provider, staff, people living in the home and visitors was frequent and effective. People and their families and friends were able to voice their concerns or make a complaint if needed and were listened to with appropriate responses and action taken