The inspection was completed on the 16 and 17 April 2018 and was unannounced. At the time of this inspection there were 32 people living at Memory House.

Memory House 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. The care home accommodates up to 39 older people and people living with dementia in one adapted building.

Memory House is a large detached building situated in a quiet residential area in Leigh on Sea and close to all amenities. The premises is set out on two floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service.

At the last inspection on the 9 and 10 March 2017, the service was rated ‘Requires Improvement ’. No breaches of regulatory requirements were served. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of ‘Safe’, ‘Effective’, ‘Responsive’ and ‘Well-Led’ to at least good. At this inspection, we found the service had improved their rating to ‘Good’.

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 dining experience for people was not as positive as it should be and improvements were required to ensure people were appropriately supported by staff to eat their meal. Though newly appointed staff received an induction, improvements were needed to ensure a robust induction was in place for staff with no previous care experience. Improvements were also needed to ensure where people required their food and fluid intake to be monitored, records provided sufficient detail to determine if the person’s diet was satisfactory or not.

Quality assurance arrangements were in place and completed at regular intervals in line with the registered provider’s schedule of completion. The registered provider and the registered manager were able to demonstrate an understanding and awareness of the importance of having good effective quality assurance processes in place. Feedback from people using the service, those acting on their behalf and staff were positive about the care and support provided.

People told us the service was a safe place to live and there were sufficient staff available to meet their care and support needs. Appropriate arrangements were in place to recruit staff safely. Although staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow, improvements were required to ensure all matters of concern were reported to the Care Quality Commission. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed to ensure their safety.

Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs to ensure theirs’ and others’ safety. Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines. This meant people received their prescribed medicines as they should and in a safe way.

Staff received opportunities for training and this ensured staff employed at the service had the right skills and competencies to meet people’s needs. Where training updates were required, the registered manager made arrangements to source this training as soon as possible. Staff felt supported and received appropriate formal supervision at regular intervals and an appraisal of their overall performance. Staff demonst

The inspection was completed on 9 and 10 March 2017 and there were 34 people living at the service when we inspected. The previous inspection to the service was on 5 and 8 June 2015 and the overall rating of the service was judged as ‘Good’. At this inspection we found that improvements were required in relation to ‘Safe’, ‘Effective’, ‘Responsive’ and ‘Well-Led.’

Memory House provides accommodation and personal care for up to 39 older people. Some people also have dementia related needs.

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.

Quality assurance checks and audits carried out by the provider and the management team of the service were in place and had been completed at regular intervals in line with the provider’s schedule of completion. Nonetheless, some improvements were still required to ensure that where issues were highlighted as part of the provider’s and management teams auditing arrangements, information was available to show actions required had been addressed.

Staff described the registered manager and management team as supportive and approachable. However, suitable arrangements were still needed to ensure that all staff received a formal induction, regular formal supervision and an annual appraisal of their overall performance. Staff told us and records confirmed that a range of training opportunities were available and provided to them.

Staff had a good knowledge of the Deprivation of Liberty Safeguards [DoLS] and the key requirements of the Mental Capacity Act [2005]. Suitable arrangements had been made to ensure that people’s rights and liberties were not restricted. People were asked to give their consent to their care and support and people’s capacity to make day-to-day decisions had been considered and assessed.

Suitable control measures were not always in place to mitigate risks or potential risk of harm for people using the service as steps to ensure people and others health and safety were not always considered and better recording was required to evidence the arrangements in place.

Not all of a person’s care and support needs had been identified, documented or reviewed to ensure these were accurate and up-to-date. Improvements were required to ensure that where people could be anxious or distressed, staff interventions and outcomes were recorded. Improvements were needed in the way the service and staff supported people to lead meaningful lives and to participate in social activities of their choice and ability.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect the people they supported.

People were supported to be able to eat and drink sufficient amounts to meet their needs. The dining experience was positive. People’s healthcare needs were supported and people had access to a range of healthcare services and professionals as required.

People were treated with kindness and respected by staff. Staff understood people’s care and support needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

There was an effective system in place to respond to comments and complaints.

During our inspection we spoke with people who used the service and six relatives.. We spoke with five staff members and the registered manager. We looked at four people's care records. Other records viewed included audits, minutes of meetings, staff training records, health and safety checks, and satisfaction questionnaires. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service the staff asked to see our identification and for us to sign the visitors book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on equipment and on the environment. This told us people lived in a safe environment.

We saw that the staff had been provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff had been provided with the information that they needed to help ensure that people were safeguarded.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treated people with dignity and respect.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. This was demonstrated in minutes we saw, which related to meetings with people who used the service and their relatives. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, optician, chiropodist and district nurse. This told us that the service worked well with other professionals and that people's needs were met.

Is the service well-led

The service had a number of quality assurance measures in place. The manager was proactive in monitoring and looking for ways to improve the service. We saw the quality of the service had been maintained.

As part of this inspection process we spoke with the manager, deputy manager, five members of staff and four people who used the service.

Our observations indicated that people living at the service were very happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them. Comments included, "The staff are very good. They are so kind, caring and considerate. Nothing is ever too much trouble" and, "The care I receive is very good. Staff are very attentive."

In general people's health and personal care needs were assessed and there were detailed care plans in place for care staff to follow. This ensured that people were supported safely and in accordance with people's individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that medication practices and procedures ensured people's safety and wellbeing. We found that the provider's cleanliness and infection control arrangements were appropriate.

People living in Memory House were able to talk to us, but not always able to fully express their views about their care or experiences. We therefore used a number of different methods to help us understand the experiences of people using the service. We observed how people interacted with staff and management and spent time with people using the service.

During our inspection we saw that people received good care and that staff treated them with respect.

We spoke with four people who use the service and three relatives. People who use the service told us that they liked living in the home. One person said that care was “First class”. Relatives told us that the home was “Good”. One relative said, “I’ve been to bad homes before. They should bring people here and show them how it is done”. Another said there is a really nice atmosphere in the home.

We found that the home had systems in place to ensure that the premises were safe and suitable for people using the service. There were various ways that relatives and people using the service could raise any concerns, complaints or compliments they had and staff took appropriate action as required.

People told us that they liked living at Memory House, they were respected, involved in the way their care was provided and felt listened to by the manager and staff.

Relatives who we spoke with were very happy with the care and support given. One relative said "When I have to leave I know that X will be well cared for by lovely staff."

The inspection was completed on 5 and 8 June 2015 and there were 34 people living at the service when we inspected.

Memory House provides accommodation and personal care for up to 39 older people and people living with dementia.

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.

Although risk assessments relating to the premises and equipment were completed, actions to address these remained outstanding.

Care plans accurately reflect people’s care and support needs. People received appropriate support to have their social care needs met.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

People and their relatives told us the service was a safe place to live. There were sufficient staff available to meet their needs. Appropriate arrangements were in place to recruit staff safely. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and others’ safety.

Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

The dining experience for people was positive and people were complimentary about the quality of meals provided. People who used the service and their relatives were involved in making decisions about their care and support. People told us that their healthcare needs were well managed.

Where people lacked capacity to make day-to-day decisions about their care and support, we saw that decisions had been made in their best interests. The manager was up-to-date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were being protected.

People and their relatives told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

There was an effective system in place to regularly assess and monitor the quality of the service provided. The manager was able to demonstrate how they measured and analysed the care provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.