This inspection took place on 14 June 2018. The inspection was unannounced.

Sovereign house is a care home registered to provide nursing care and accommodation for a maximum of 60 people. People in care homes receive accommodation and 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 accommodation is provided over three floors. The ground floor provides residential accommodation for both younger adults and older people (including those people living with dementia). This floor also has 19 beds known as “pathway 2” beds which are used for short term placements from hospital to help rehabilitate people prior to going back home. The first floor provides accommodation for people requiring nursing care who may also be living with dementia. The second floor has 21 beds to accommodate older people. Seven beds on this floor are referred to as “discharge to assess” beds where people from hospital are again supported with a view to going home once they are well enough.

Sovereign House was previously registered under a different provider. This is the first inspection of Sovereign House under the new provider. However, many of the staff who were at the home prior to the new provider taking over, continued to work at the home.

The service has a registered manager. This is a requirement of the provider's 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 2008 and associated Regulations about how the service is run.

The home was managed by an experienced management team who aimed to provide good standards. The provider and registered manager completed a range of quality monitoring checks to ensure the care and services provided were in accordance with the standards people should expect. However, our inspection process identified some areas needing improvement, this included a breach in the regulation related to person centred care and we also found staffing arrangements were sometimes not effective to ensure people’s needs were met. . This suggested the audit check process was not always effective.

Staff were recruited following a number of checks to ensure they were suitable to work with people.

They received appropriate training and support, understood their roles and responsibilities and had confidence in the management team.

People felt safe and at ease with staff, and staff understood their responsibilities to protect people from the risk of harm and discrimination. We saw staff were caring in their approach to people, but they did not always have time to spend with people or listen to what they had to say. People said sometimes they had to wait for support. People had some opportunities to engage in, and experience, stimulating activities within the home to help support their mental, physical and emotional wellbeing.

Risks related to people’s health were identified in their care plans to help minimise those risks.

People were able to access healthcare professionals when needed to support their healthcare needs. Staff who administered medicines understood what was required to manage these safely, although some medicine records were not accurate.

People's ability to make decisions was assessed in line with the Mental Capacity Act 2005. Staff offered people choice and respected the decisions they made. Where restrictions on people had been identified, Deprivation of Liberty Safeguards authorisations were in place to lawfully deprive people of their liberty for their own safety.

People were encouraged and supported to eat and drink and were mostly positive about the quality and choice of their meals.

The design of the premises meant there was sufficie