About the service: Pelton Grange provides personal care for up to 47 people; nursing care is not provided. At the time of our inspection there were 33 people living at the home, some of whom were living with a dementia.

People’s experience of using this service: Medicines were mostly managed safely. Improvements had been made to the recording of prescribed creams and guidance for staff on ‘when required’ medicines. Flooring had been replaced and other improvements had been made to the environment.

Staff training in key areas was not up to date, although plans were in place to address this. Staff received more regular supervision meetings with their managers.

Checks on the quality and safety of the service had improved. Issues identified through these checks were being addressed at the time of this inspection.

At this focused inspection we found improvements had been made. The provider had followed their plan and legal requirements were now met. While improvements had been made we could not improve the overall rating from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

Rating at last inspection: Requires Improvement (report published 21 July 2018).

Why we inspected: At the previous inspection we found breaches of Regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because: pressure relieving mattresses were not set correctly; records relating to the administration of prescribed creams were not accurate; people's medicine records lacking detailed guidance for staff relating to 'when required' medicines and patches which attach to the skin and contain medicine; staff training and supervisions were not up to date; and the provider did not have effective quality assurance processes to monitor the quality and safety of the service.

Following the previous inspection we asked the provider for an action plan which said what they would do to meet legal requirements in relation to the above issues. We undertook this focused inspection to check they had met legal requirements and to confirm they had followed their action plan and made improvements to the service. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Pelton Grange on our website at www.cqc.org.uk.

Follow up: We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 24 May 2018 and was unannounced. Subsequent days of inspection took place on 29 and 30 May 2018 and were announced.

Pelton Grange is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Pelton Grange provides personal care for up to 47 people. At the time of our inspection there were 35 people living at the home who received personal care, some of whom were living with a dementia.

A registered manager was not in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 previous manager had left the service six weeks earlier. The service was currently being managed by the deputy manager.

This is the first inspection of this service under the management of Hillcare 3 Limited. This service had been taken over by Hillcare 3 Limited since our last inspection in December 2015. Hillcare 3 Limited registered with the Care Quality Commission to manage this service in May 2017.

During this inspection we found breaches of Regulations12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because: pressure relieving mattresses were not set correctly; the administration of topical creams was not recorded accurately; people's medicine records lacking detailed guidance for staff relating to 'when required' medicines and transdermal patches; staff training and supervisions were not up to date; and the provider did not have effective quality assurance processes to monitor the quality and safety of the service.

We have made recommendations about recording decisions made in people's best interests and person-centred care planning.

You can see what action we told the provider to take at the back of the full version of the report.

People and relatives spoke positively about the service and said it was a safe place to live.

Staff knew how to respond to any allegations of abuse. Safeguarding referrals had been made to the local authority appropriately, in line with set protocols. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who used the service.

Accidents and incidents were recorded accurately and analysed regularly. Each person had an up to date personal emergency evacuation plan should they need to be evacuated in the event of an emergency.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Fluid charts had not been completed accurately. People said the food was enjoyable.

People had access to important information about the service, including how to complain and how to access independent advice and assistance such as an advocate.

People and relatives we spoke with knew how to make a complaint. They told us they would speak to a member of staff or the manager if they had any issues.

Staff had a good understanding of people's care preferences but care records did not always contain up to date and relevant information about people's care needs.

People had access to a range of activities which they said they enjoyed.

People, relatives and staff told us the deputy manager (who was currently managing the service) was approachable.