The inspection took place on the 19 February2018 and was unannounced. The inspection continued on the 20 February 2018 and was announced. This was the services first inspection since registration on 10 February 2017.

The home had a registered manager who had been in post four months at the time of our inspection. 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.

St Ives Country House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 care for up to 60 people. The service had been registered for providing nursing care in the care home and personal care to people living in their own homes but had not commenced these activities so were not included in our inspection. At the time of our inspection there were 31 people in the home some of whom were living with a dementia. The home provides accommodation over two floors. Rooms have en suite shower facilities. Communal facilities include specialist bathrooms, lounges, dining rooms, quiet social areas and an accessible garden.

People and their families described the care as safe. Staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. Staff had completed equality and diversity training and respected people’s individuality. People had their risks assessed and actions put in place to minimise avoidable harm whilst respecting people’s rights to freedom and choice.

Medicines were ordered, stored, administered and recorded safely. Protocols were in place for medicines prescribed for as and when needed but required more detail to meet best practice guidance. Staff understood the actions needed to protect people from avoidable infections.

People were supported by enough staff that had been recruited safely including checks to ensure they were suitable to work with vulnerable adults. Accidents and incidents were reviewed and where necessary actions taken to reduce further risk. Processes were in place to ensure lessons are learnt when things go wrong both in the home and across the wider organisation.

People were supported by staff that had completed an induction and on going training that gave them the skills to carry out their roles effectively. Pre-assessments had been completed with people and their families which provided information about peoples care needs and life histories.

Care and support plans detailed how people liked to be supported and recognised their individuality. Working relationships with other professionals such as district nurses provided effective outcomes for people. Staff understood their roles in supporting people whilst respecting a person’s right to privacy, dignity, independence and life style choices. People and their families were involved in end of life plans which included cultural requirements.

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.

Staff were described by people and their families as caring, kind and patient. Relationships between staff and people were warm and positive and demonstrated that staff were knowledgeable about people, their likes, dislikes and things that were important to them. People’s communication needs were understood which meant people could be involved in decisions about their day to day lives. A complaints process was in place which people and their families felt if they used they would