This inspection took place on 30 January 2017 and was unannounced. St Judes provides care and accommodation for up to 27 older people. At the time of our visit there were 24 people living in the home.

During our last inspection on 5 and 6 May 2015, the provider was not fully meeting the standards required. This applied to the standards related to “Safe” and “Well Led”. We found medicines were not managed safely, and quality monitoring was not effective in identifying areas needing improvement. This meant we allocated an overall rating of “Requires Improvement”. We asked the provider to take action to make the necessary improvements. We found action had been taken to make some of the improvements required, but further action was required to ensure people consistently a high standard of care.

The home has a registered manager. 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.

People told us they felt safe living at St Judes and felt at ease to raise any concerns with staff if they needed to. People were protected from the risk of abuse because staff had attended training in safeguarding people and understood the provider's policies and procedures for raising concerns.

The provider's recruitment process ensured risks to people's safety were minimised. Records showed new staff underwent an application and interview process so the registered manager could check their skills and experience. Staff were required to complete induction training when they started at the home and completed ongoing essential training to maintain their skills.

There were sufficient numbers of staff to support people’s needs and people told us staff were available when they needed them. People were very positive about their experiences of the care they received and of the staff that supported them. We saw staff were caring in their approach to people and ensured people’s privacy and dignity was maintained. Staff responded promptly to any requests people made and always acknowledged people when they walked past them.

The processes to manage medicines had been reviewed to ensure people received their medicines as prescribed. Medicine records were regularly checked to identify any errors to ensure medicines were managed safely. However, staff competencies were not regularly checked to make sure they followed good practice when administering medicines.

The registered manager had some understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). They reported that all people in the home had some capacity and were able to make day to day decisions. They had therefore not needed to make any DoLS applications in regards to any restrictions placed on people’s care. Most staff understood they needed to gain people’s consent before delivering care. MCA training was planned for those staff who had not completed this or were unclear of their responsibilities.

People were assessed to identify any risks associated with their care and staff were aware of these risks and supported people to minimise them. People had care plans detailing how they liked to spend their day which included information about their wishes and preferences when staff provided support or care. Sometimes people’s care plans did not detail clear instructions to staff to ensure a consistent approach to their care.

Most people said they were not aware they had a care plan and did not feel involved in planning their care. However, people told us they were satisfied with the care they received and we saw care plans were person centred and described how people liked to receive their care and support throughout the day.

People were provid

We visited the home unannounced. We observed care and spoke with people at the home. We saw staff being attentive to people and showing a good understanding of their needs and how to meet them. We saw suitable equipment in place to help people and effective monitoring of people’s needs to ensure they were promptly and properly met. The home was fresh, light and airy throughout.

We spoke with nine people who lived at the home. People told us they were very happy with the care and support provided. Their comments included “The food is good”, “They check on me regularly” and “It’s a good medical service.”

We spoke with four relatives who were at the home on the day of our visit. They were all full of praise for the home, the staff and the manager. One relative said “It is an excellent service here” and added “I would feel comfortable about complaining.” Another said that the manager had been quick to respond positively to suggestions. One person told us of the attention to small details and observed “There are always nice napkins and table cloths.”

Other comments made to us were “Very good staff”, “Very good manager”, “They listen” and “No complaints.”

We also spoke with the manager and the four care staff on duty that morning. They were all able to demonstrate a good knowledge of the individual needs of the people at the home. They showed a commitment and ability to meet those needs in ways best suited to each individual.

We spoke at length with three of the people living at the home, as well as speaking with ten other people living there during our visit. All were very complimentary about the home, the staff, the management, and all aspects of the home, such as the food, the cleanliness, and the attentiveness to care and health matters. Typical comments included “happy with care”, “very nice” and “the staff are lovely”. We spoke with six visiting relatives during our time at the home. They too were full of compliments. Among the comments were “You can tell how well looked after my mum is just by looking at her”, “first class care”, and “so glad we found this place”.

This inspection took place on 5 and 6 May and was unannounced.

St Judes is a care home that provides personal care for up to 27 older people. On the day of our inspection there were 24 people living in the home.

The home has a registered manager. 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.

People felt safe and at ease to raise any concerns with staff if they needed to and they were supported by sufficient numbers of staff to keep them safe. Staff had completed essential training to maintain their skills and this included training in safeguarding people so they knew how to recognise abuse and take the necessary actions to protect people.

We found improvements were needed in relation to medicine management. Some of the medication administration records were not completed clearly to show that people were receiving their medicines as prescribed. We also found risks associated with people’s care were not always clearly demonstrated to show how risks were being managed.

The registered manager had an understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) so that people who lacked capacity to make decisions could be appropriately supported. Some staff were not clear about their responsibilities in relation to these but the registered manager was aware of this and training had been planned. Staff understood they needed to gain people’s consent before delivering care.

People were provided with choices of nutritious food that met their needs. There were regular choices of drinks available during the day and where necessary people were supported to eat their meals. Social activities were provided and most of these were in accordance with people’s interests and choices.

There was clear leadership within the home and the provider carried out regular checks on the quality of care and services to identify any areas that required improvement. The provider could not always demonstrate improvements had been carried out as a result of audit processes and risks identified due to limited information being recorded. This included lack of information in records relating to medication and accidents and incidents. Quality satisfaction questionnaires had been completed and those seen showed positive responses.