Russell Green Care Home 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. The home is registered to provide accommodation for up to 18 people, including older people and people living with dementia. The registered provider also offers day care support in the same building as the care home although this type of service is not regulated by the Care Quality Commission (CQC).

The service is also registered as a domiciliary care agency (homecare service) providing personal care to people living independently in their own home.

We inspected the service on 7, 14 and 15 November 2017. The first day of our inspection was unannounced. On the first day of our inspection there were 17 people living in the care home and 18 people receiving personal care from the homecare service.

The service had a registered manager in post. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’) 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.

We last inspected the service in May 2016 when we rated it as Requires Improvement. In August 2016 we re-registered the service to reflect a change in ownership. This was our first inspection of the re-registered service and we were pleased to find that service quality had improved under the new owner and the rating is now Good.

There were sufficient staff to keep people safe and meet their care and support needs without rushing. Staff worked well together in a mutually supportive way and communicated effectively, internally and externally. Training and supervision systems were in place to provide staff with the knowledge and skills they required to meet people’s needs effectively. Staff provided end of life care in a sensitive and person-centred way.

Staff were kind and attentive in their approach. People were provided with food and drink of good quality that met their individual needs and preferences. The physical environment and facilities in the care home reflected people’s requirements. People were provided with physical and mental stimulation appropriate to their needs.

People’s medicines were managed safely and staff worked closely with local healthcare services to ensure people had access to any specialist support they required. Systems were in place to ensure effective infection prevention and control.

The registered manager and her senior team were well known to everyone connected to the service. A range of audits was in place to monitor the quality and safety of service provision. People’s individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm. There was evidence of organisational learning from significant incidents and events. Formal complaints were rare and any informal concerns were handled effectively.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection, three people living in the care home were subject to a DoLS authorisation and the provider was waiting for a further four applications to be assessed by the local authority. Staff understood the principles of the MCA and demonstrated their awareness of the need to obtain consent before providing care or support to people. Decisions that senior staff had been made as bein