This inspection took place on 5 December 2016 and was unannounced. At the last inspection on 8 October 2015 we found breaches of the HSCA 2008 (Regulated Activities) Regulations 2014, in Regulation 12, Safe care and management and Regulation 15, Premises and equipment. At this inspection we found that improvements had been made in all areas to meet the relevant requirements.

Shandon House is a care home providing accommodation and personal care for up to 20 older people. It is a converted house with gardens and seating areas at the side and front of the building. There is a ramp at the main entrance to assist people with limited mobility. Bedrooms, bathrooms and lounges are situated on the ground and upper floors. Some bedrooms have ensuite facilities. There were 17 people living in the home at the time of our 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 2008 and associated Regulations about how the service is run.

Medicines were managed safely in the home.

Risk assessments had been undertaken to support people safely and in accordance with their individual needs.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.

Safety checks of the environment and equipment were completed regularly.

There were enough staff on duty to provide care and support to people living in the home.

The provider had robust recruitment procedures in place to ensure staff were suitable to work with vulnerable adults.

Staff worked in partnership with health and social care professionals to make sure people received the care and support they needed.

Staff were trained to ensure that they had the appropriate skills and knowledge to meet people’s needs. They were well supported by the registered manager.

Staff sought the consent of people before providing care and support. The home followed the principles of the Mental Capacity Act (2005) for people who lacked mental capacity to make their own decisions.

People told us they liked the food and were able to choose what they wanted to eat.

People told us the staff had a good understanding of their care needs and people’s individual needs and preferences were respected by staff.

People at the home told us they were listened to and their views were taken into account when deciding how to spend their day.

Care plans provided information to inform staff about people's support needs, routines and preferences.

People told us staff were kind, polite and maintained their privacy and dignity. We observed positive interaction between the staff and people they supported.

A programme of activities was available for people living at the home to participate in.

A process for managing complaints was in place. People we spoke with knew how to raise a concern or make a complaint.

Feedback we received from people, relatives and staff was complimentary regarding the registered manager’s leadership and management of the home.

Staff told us there was an open and transparent culture in the home.

Systems and processes were in place to assess, monitor and improve the safety and quality of the service.

People living in the home and relatives told us they were able to share their views and were able to provide feedback about the service.

We spoke with eight people about the service that they received. They told us they were happy with the way staff supported them and said the quality of the care was good.

Those we spoke with said the staff knew what support they required and did everything that was needed for them. One person told us, “The care is very good. There’s enough staff around when I need them.” Another person said, ‘’I’ve seen my GP a few times. The staff arrange things for me.’’

People were very relaxed around staff and said they were listened to, so any concerns could be addressed. People were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening

We spoke with staff. They told us they felt supported in their job. They told us there was good communication between different levels of staff. They felt there was always enough staff on duty to carry out the care needed. We asked people who used the service about the skills of the support workers. They told us the staff worked very hard and knew how to do their job. They felt staff were competent.

We looked at the system to manage complaints in the home. We found the complaints procedure was available to people. There were no complaints recorded for the service since our last inspection.

We looked at various records. These included care records and staff records. We found the records were up to date and held securely.

We observed part of the lunchtime medicines round and saw that patient support was offered where people needed help with taking their medicines. People choosing to self-administer medicines were supported to do so. One person we spoke with confirmed that they had everything they needed to safely manage their own medicines. Other medicines were administered by care workers who had completed certificated training in medicines handling. Regular medicines audits (checks) were completed by the manager but we noted that these were quite narrow and did not consider all aspects of medicines handling.

We spoke with people about the service that they received. They

told us they were happy with the way staff supported them and the way they were cared for.

Those we spoke with said the staff knew what support they required and did everything that was needed for them. One person told us, ‘’It’s OK here. The care is very good and that’s the main thing.’’

We spoke with three care staff. They told us they had received relevant training and they felt supported in their job and received supervision from their manager. We asked people who used the service about the skills of the care staff. They told us the staff worked very hard and knew how to do their job. They said staff were competent.

We spoke to people about the service they received with regards to their involvement in monitoring the quality of the service. They told us they had attended a recent meeting so that their views could be known. They said they were able to contact the manager if they ever had a problem with the service.

We looked at how medicines were managed and found that some improvements were needed to ensure these were monitored effectively.

Shandon House is a care home providing personal care. It can accommodate 20 older people. The home is owned by SBS Care Homes Ltd.

This was an unannounced inspection which took place over two days on 8 &12 October 2015.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found the service was not always safe. There were some good monitoring / checking systems in place to ensure the home was maintained safely but we found that people had unnecessarily been exposed to a risk because some environmental hazards had not been effectively monitored. These were with respect to monitoring of infection control and fire safety in the home.

Medicines were administered safely. Medication administration records [MARs] were completed in line with the home’s policies and good practice guidance. We recommended some review of the medication policy and development of a medication audit tool.

Staff understood what abuse meant and knew the correct procedure to follow if they thought someone was being abused. People we spoke with told us they felt safe living at Shandon House and they were well supported.

There were enough staff on duty at all times to help ensure people were cared for in a safe manner. Staff had been checked when they were recruited to ensure they were suitable to work with vulnerable adults.

We looked at whether the home was working within the legal framework of the Mental Capacity Act (2005) [MCA]. This is legislation to protect and empower people who may not be able to make their own decisions. We found examples of good practice in supporting people with decisions in their ‘best interest’. We discussed the need to extend the use of current good practice to more key decisions for people. The manager said this would be developed with further staff training.

People told us the meals were good and well presented. We observed and spoke with people enjoying lunch. We were told that there was choice available with meals.

We asked people if staff were polite, respectful and protected their privacy and dignity. We received positive responses. Our observations of care supported good practice.

There was some information available in the home for people. We discussed some key information such as the complaints process. We were sent an updated copy of the homes ‘Statement of Purpose’ which provided accessible information; for example, regarding the complaints procedure.

We found people and their relatives were involved in planning their care to help ensure it was more personalised and reflected their personal choices, preferences, likes and dislikes. We looked at the care record files for people who lived at the home. We found that care plans and records recorded of this information.

We found people were provided with social activities and were encouraged to participate in the daily life of the home.

We saw a complaints procedure was in place and people, including relatives, we spoke with were aware of how they could complain. We saw an example of one complaint that had been received and dealt with. This had been responded to appropriately.

The manager was able to evidence a series of quality assurance processes and audits carried out internally. We found some of these were not currently developed to ensure the most effective monitoring.

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