This inspection took place on 1 June 2017 and was unannounced. Onny Cottage care home is registered to provide accommodation with personal care for up to a maximum of 7 people. There were six people accommodated at the home on the day of our inspection.

At the last inspection on 14 December 2016 we identified that improvements were needed regarding four out of the five key questions. We identified breaches of Regulations 12, 15 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider sent us an action plan telling us what they would do to make improvements and meet legal requirements in relation to the law. We found at this inspection the provider had taken the necessary measures to ensure the quality of care people experienced had improved.

The provider had addressed advice from the Fire and Rescue Service. The premises and equipment were appropriate to meet people’s individual needs. However, people were not enabled to have easy access to the outdoor spaces due to large loose chippings.

The manager had started to do more regular quality checks of the service. They engaged more with people and their families and encouraged feedback from people in order to improve the service. People felt confident they were listened to and their views were valued. The manager had sustained improvement of the record keeping and embedded management practice consistently.

A registered manager is not required for this provider as Mrs Elizabeth Owen is registered as an individual. There is a new manager in post for day to day management of the service. The provider and manager were not present at this inspection.

People received support with their medicines from staff who were trained to safely administer them. Medicines were locked away safely and in accordance with their individual risk assessments.

People were safe as staff had been trained and understood how to support people in a way that protected them from harm and abuse. People's records had individual assessments of risk associated with their care. Staff knew what to do in order to minimise the potential for harm.

People were supported by enough staff to safely meet their needs. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work. The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

People received care from staff that had the skills and knowledge to meet their needs. New staff received an introduction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to the people they supported and any additional training needed to meet people's requirements was provided.

People's rights were protected by staff who were aware of current guidance and legislation directing their work. People were involved in decisions about their care and had information they needed in a way they understood.

Staff received support and guidance from a manager who they found approachable. People and staff felt able to express their views and felt their opinions mattered. People had good relationships with the staff who supported them. People's likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by those supporting them. People had access to healthcare when needed and staff responded to any changes in need promptly. People were supported to eat and drink sufficient amounts to maintain optimum health.

Onny Cottage is a care home which provides residential care for up to seven people. At the time of the inspection there were five people living at the home.

This was an unannounced inspection that took place on 14 December 2016. The home has a registered manager who was present during the inspection but had recently applied to cancel their registration. 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 and associated Regulations about how the service is run.

The provider delivered care and support in a grade 2 listed domestic building. As such permission to carry out certain works to meet the fundamental standards had been difficult to achieve. We identified hazards with the premises and appliances that could be a risk to people’s safety. We contacted other regulators to ascertain their views on safety in the home.

The provider had policies and procedures to ensure that people who could not make decisions for themselves were protected. People’s human rights were protected because staff understood the policies and legislation and how to apply them. Staff were aware of their responsibilities to report any incidents of abuse or suspected abuse immediately

People felt the staff had the right skills and experience to look after them. The provider had omitted to provide staff with the mandatory updates of some training. Regular supervision and appraisals had not taken place. Not all staff had received certificated training in keeping people safe.

People believed staff would do everything necessary to keep them safe. One person shared a concern about how they would get out if there was a fire. Accidents and incidents were monitored on an individual basis to identify any trends or concerns. People were assessed against a range of potential risks such as poor nutrition, falls, skin damage and mobility according to their current need.

The registered manager assessed people’s needs and this information was used to determine the minimum staff number needed to run the home. In addition to this system they monitored people’s changing needs and staff feedback on the number of staff needed.

Suitable recruitment procedures and checks were in place to ensure staff had the right skills to support people at the home.

Medicines were stored securely but not always handled safely.

People were happy with the standard and range of food and drink provided at the home. People did not know what they were having in advance of their meal.

Staff were able to tell us about people’s particular needs and how best to support them. People’s health and wellbeing was monitored and staff regularly referred

people to GPs and district nurses as required.

People and their families were encouraged to express their views through surveys and day to day contact. The registered manager made time to speak with people directly.

People could speak to the registered manager or staff if they were concerned about anything. A complaint procedure was in place but not sufficient enough in its detail.

The registered manager had organised external activities in the community and visiting entertainers in the home. There was little opportunity for social stimulation in the home on a daily basis. People had, through provider surveys, expressed a wish for this to be improved but the provider had not acted on it.

The provider had quality monitoring processes which included audits and checks on medicines management, care records and staff practices. However, these were not always carried out and so were not effective in identifying where improvements were required to ensure the regulations were met. Feedback from people and their relatives was sought but comments not always acted upon. This meant opportunities to identify where improvement wa