At our last inspection on the 10 and 11 May 2017, we found the service required improvement in all of the questions, is the service safe, effective, caring, responsive and well-led. At this inspection we found there had been sufficient improvement to rate this service as an overall good.

The inspection visits took place on the 04 and 05 December 2018. Perry Locks provides accommodation and support for up to 128 adults with nursing care needs. The home comprises of four units, Perry Well House, Calthorpe House, Lawrence House and Brooklyn House. At the time of our inspection visit 110 people were living there. 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.

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 and associated Regulations about how the service is run.

The provider’s quality monitoring processes required some further improvement to ensure potential dangers were identified and requests for repairs were completed in a timely way. Some care plans were not consistently updated following professional visits. There were some gaps in the recording of medicines and administration of topical creams.

People were kept safe. Staff understood how to protect people from risk of harm. People's risks were assessed, monitored and managed to ensure they remained safe. Processes were in place to keep people safe in the event of an emergency such as a fire. People were protected by safe recruitment procedures to ensure suitable staff were recruited. People received their prescribed medicines when required by trained staff. Staff understood their responsibilities in relation to hygiene and infection control.

People told us they received support from staff they felt had the skills required to support them safely. People were supported to have 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. People were encouraged to eat healthily. People had access to healthcare professionals when needed in order to maintain their health and wellbeing.

Staff encouraged people's independence where practicably possible. People received a service that was caring and respected their privacy. People were supported by staff who knew them well.

People received a service that was responsive to their individual needs. Care plans were personalised and contained details about people's preferences and their routines. People were supported to pursue hobbies and activities that interested them and processes were in place to respond to any issues or complaints. Where people’s faith was important to them, they were supported to continue with following their beliefs. This included their end of life (EOL) wishes.

The registered manager understood their role and responsibilities and staff felt supported and listened to. People and staff were encouraged to give feedback and their views were acted on to enhance the quality of the service provided to people. People and staff were complimentary about the leadership and management of the home and said the registered manager was friendly and approachable. The provider worked in conjunction with other agencies to provide people with effective care.

This inspection took place on 10 and 11 May 2017 and was an unannounced inspection. On 10 May 2017 we conducted an unannounced evening inspection to see how care was provided to people at night. We then returned for a full day on 11 May 2017 to complete the inspection.

Perry Locks Care home was registered under the provider name of BUPA Care Homes (CFH Care Limited) up until February 2017. We were notified in December 2016 that the provider intended to simplify its structure and applied for all of its registered locations across the UK, (which at that time were registered across 13 different legal entities) to transfer over to just two legal entities. This meant that Perry Locks Care Home became newly registered under the provider name Bupa Care Homes Limited in February 2017. Therefore, this was the provider’s first inspection at this location since newly registering with us in February 2017. The inspection history for the location under the previous provider was used to inform the planning of this inspection because there had been no other changes at the location; the registered manager and the running of the service had remained consistent.

Our last comprehensive inspection of this location took place in June 2016, when the service was rated as “requires improvement”. As a result of matters found on that occasion, a further inspection was undertaken in January 2017. The reports from both inspections are available in the full history of inspection reports, which can be found in the previous provider’s archived records for this location on our website at www.cqc.org.uk

Some matters outstanding from these two inspections required our further attention during our inspection of 10 and 11 May 2017, and an action plan submitted by the previous provider detailing the way it would improve the care delivered and ensure compliance with relevant legal requirements was used to inform our inspection.

Perry Locks care home provides accommodation for up to 128 people who require nursing and personal care for their physical and/or dementia care needs. The home is purpose built and is separated in to four buildings. Perry Well House is for people living with dementia whilst Lawrence House, Calthorpe House and Brooklyn House provide nursing care for people with general nursing care needs. The location also provides accommodation and nursing care to people on a temporary basis whilst their on-going nursing care needs are being assessed. These are known as Enhanced Assessment Beds (EAB); most of these were situated in Brooklyn House. At the time of our inspection, there were 122 people living at the home.

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.

Staffing levels had improved to a safe level and on the whole, people received the care and support they required in a much timelier way. Medicine management systems and processes within the home had also improved and people received their medicines as prescribed. However, some of the record keeping practices with regards to medicine and risk management meant that people were potentially at risk of not receiving consistently safe care in accordance with their health and care needs.

The provider had not ensured that all staff had received training updates in accordance with their policy and procedures. However, people we spoke with were confident that most of the staff had the knowledge and the skills they required to care for people safely and effectively.

The provider had quality assurance systems and processes in place which supported them to maintain the safety and efficiency of the service. However, some of these systems and processes had not always ide