We inspected Olive House on 2 March 2017. This was an unannounced inspection. Olive House is registered to provide accommodation and personal care for 45 older people, some living with dementia. There were 40 people living in the home when we inspected.

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.

The service was safe; staff understood their responsibilities to protect people from harm or abuse and had received training. People received their medicines as prescribed. Safe recruitment processes were in place which contributed to protecting people from harm.

There were enough staff to keep people safe, and the service had recently recruited more staff so that there would be less use of agency staff and improve consistency for people living in the home.

There were effective processes in place to minimise risks to people. Assessments had taken place regarding people’s individual risks and clear guidance was in place for staff to follow in order to reduce them. However, improvements were needed to the consistent recording of supporting people to change position when they were at risk of pressure ulcers.

Staff knew the people they cared for and understood how to meet their needs. People planned their care with staff and relatives, and a variety of activities were carried out in line with people’s preferences. There were close links with the local community to encourage people to participate in events which were carried out with the local church or school.

Staff understood the importance of gaining people’s consent to the care they were providing to enable people to be cared for in the way they wished. Staff were able to explain how they promoted choice where people had variable capacity. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported to access healthcare wherever necessary and in a timely manner, with prompt action taken in response to changes to a person’s health needs. People’s hydration needs were met by the service. Drinks were available throughout the day.

We inspected Olive House on 7 March 2016, and we found that the quality of the food required improvement. People’s nutrition needs were met in line with recommendations such as speech and language therapy, however the food was not always to everybody’s taste and adequate choice was not always available. It had not been improved significantly.

Staff were kind and they had meaningful interactions with people. Feedback from people and their relatives about the care they received was complimentary. Staff respected people’s privacy and dignity.

The quality assurance systems in place had identified shortfalls and the registered manager was working with the management team and quality monitoring staff from the organisation to improve these areas.

We inspected Olive House on 7 March 2016. This was an unannounced inspection. Olive House is registered to provide accommodation and personal care for 43 older people, some living with dementia. There were 43 people living in the home when we inspected

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. The registered manager was absent on the day of our inspection.

The service was safe; staff understood their responsibilities to protect people from harm or abuse and had received appropriate training. Staff were confident in reporting incidents and accidents should they occur.

Staff understood the importance of providing a high standard of care to the people living in the service. Staff felt that there was good teamwork within the service, although at times felt that they were rushed as staffing levels were variable.

There were effective processes in place to minimise risk. Assessments had taken place regarding people’s individual risks and clear guidance was in place for staff to follow in order to reduce the risks.

Staff had good knowledge about the people they cared for and understood how to meet their needs. People planned their care with staff and relatives, and activities were carried out in line with people’s preferences.

Robust recruitment processes were in place to ensure that staff employed in the service were suitable for the role. People were safely supported with medicines administration by senior staff.

Staff understood the importance of gaining people’s consent to the care they were providing to enable people to be cared for in the way they wished. Some people had applications in for the lawful deprivation of their liberty (Deprivation of Liberty Safeguards (DoLS)) and staff were able to explain how they promoted choice where people had variable capacity. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported to access healthcare wherever necessary and in a timely manner, with prompt action taken in response to changes to a person’s health needs. People’s nutrition needs were met in line with recommendations made by professionals such as speech and language therapists, however people told us that the food was of poor quality. Whilst there were quality assurance systems in place, they had not picked up the problems we found with the food.

Staff were kind and they had meaningful interactions with people. Feedback from people and their relatives about the care they received was complimentary. Staff respected people’s privacy and dignity.

The purpose of this inspection was to check that improvements had been made following our last inspection 27 December 2012. We found that there had been improvements made in people’s care records.

We spoke with five people who used the service. People we spoke with were complimentary about the care and support they received. One person told us, “There are good facilities here and staff are caring and supportive”.

We spoke with three staff who expressed confidence in the newly appointed homes manager and told us they were optimistic for the future. They felt there had been a noticeable difference with positive changes made to improve the quality of care provided to people who used the service.

We spoke with seven people who used the service. One person told us, "Staff are kind and helpful." Another person told us, "The food is very good here, there is lots of it." We observed the tea time meal and saw staff treating people with respect and offering people choice.

People told us that staff listened to what they had to say. One person told us, "I had a few complaints and when I spoke to the manager he sorted things out straight away."

We found care records were not being audited and reviewed and did not contain accurate up to date information. This meant that people were at risk of receiving care and treatment that was inappropriate or unsafe.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of an inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

To help us understand people's experiences we used the Short Observational

Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us

understand the experiences of people who could not talk with us.

The inspection team was led by a CQC inspector joined by an ‘expert by experience’ who has had experience of using services and who can provide that perspective.

We spoke with ten people who told us that they were happy with the service they received. They told us that the staff were polite, treated them well and with dignity and respect. One person commented, “Staff are always ready to help and respond to requests”. One person described how one of the senior staff had not hesitated to go to collect a new oxygen cylinder for them at short notice. They told us that this “Hands-on” approach created a very good atmosphere at Olive House. This was supported by several people and a relative, who commented, “Staff really do treat people as individuals”.

People told us that they had been “Very impressed with the service” and that they were “Very happy, living in Olive House”. One person commented that, “This is as good as it gets and I couldn’t be in a better place”. People also told us that staff treated them in a friendly and professional way. One person said that they found the staff to be, “Very approachable”.

It was clear from our discussions with people using the service and our observations that Olive House had a group of staff who enjoyed their work and wanted to do their best for the people living there. One person commented “The staff are happy and that rubs off on the residents”. One person said “I can honestly say I love it here, I’m happy, the food is good and I am well treated”. One person told us that they were, “Delighted with the food” and always, “Had enough to eat”.

A relative told us that they were, “Very happy with the service”, and that the family had no concerns.