St Marguerite provides care and support for up to 24 older people with care needs associated with older age. The needs of people varied, some people were mainly independent, some had low physical and health needs and others had a dementia and memory loss. The service provided some respite care that included supporting people while family members were on a break, or to provide additional support to cover an illness. Some people had more complex care needs that were met with community health care support that had included end of life care when required. At the time of this inspection 20 people were living at the service.

The service had a registered manager in place. 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 registered providers for this service maintained regular contact with staff and people who use the service.

St Marguerite was inspected in August 2015. We found the provider was in breach of two regulations. Improvements were required to ensure accurate and correct records were used to inform the care of people. Staff needed further training to ensure they were fully aware of what procedures to follow when an allegation or suspicion of abuse was raised. The provider sent us an action plan and told us they would address these issues by November 2015.

This inspection took place 30 November and 8 December 2016 and was unannounced. At the time of this inspection, 20 people were living in the home. This was a full comprehensive inspection to see what improvements the provider had made to ensure they had met regulatory requirements. We found improvements had been made. The provider had ensured people’s care records had improved. Staff had a good understanding of safeguarding procedures and how to protect people from abuse.

The quality monitoring systems needed further development to make sure they were used to promote best practice and to identify areas of improvement and any actions that may be required. This included the use of suitable guidelines for all medicine administration and to demonstrate staff delivered these in a consistent way. In addition although care records had improved some care documentation was not completed to record the care required and provided. This could lead to staff not having up to date guidelines on people’s needs and the appropriate care to be provided.

People were looked after by staff that knew and understood their individual needs well. Staff treated people with kindness and compassion and supported them to maintain their independence. People’s dignity was protected and staff were respectful. All feedback received from people and their relatives was positive about the care, the atmosphere in the service and the approach of staff, registered manager and the providers. One person said “This is a wonderful place.” Two other people told us they would recommend St Marguerite to friends and family. “I would strongly recommend it to my friends.” All feedback from visiting professionals was positive. They told us staff worked with them to improve outcomes for people and to ensure their health was maintained.

Medicines were stored, administered and disposed of safely by staff that were suitably trained. People were protected from the risk of abuse because staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Staff were trained on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and knew the correct procedures to follow in order to protect people’s rights.

Staff were provided with a training programme w

At our previous inspection we found that accurate records had not been recorded in respect of each person using the service. Records did not provide appropriate information in relation to care and treatment provided to each person.

The provider sent an action plan informing us that systems had been put in place to ensure accurate and suitable records were put in place and maintained.

Evidence gathered at this inspection showed that the provider had achieved compliance.

People we spoke with told us that they enjoyed living at the home. One person told us, "The food is lovely and the staff are very kind and patient." Another said, "I love it here."

We examined four people's care plans, spoke to people and staff and observed care. We found that care was thoroughly assessed and reviewed and delivered to a consistently high standard.

We found that staff were appropriately trained regarding safeguarding vulnerable adults. People were protected because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We examined medicine storage, administration and recording systems and found them to be safe and accountable. This meant that people were protected against the risks associated with the unsafe use and management of medicines.

We examined staff files and recruitment processes and found that robust systems were in place to ensure that the provider employed suitably qualified people of good character.

We saw that there was a well-advertised and transparent complaints system in place. People we spoke with told us, "There's nothing to complain about but if there was I would be happy to tell the staff."

People we spoke with enjoyed living at the home. One person told us, “I like it here. The staff are very kind and do whatever I ask.” Another person said, “I’ve been ill a couple of times and they’ve got me through it.” Others told us,” The food is very good and we go out for trips in the minibus.” The district nurse told us, “This is a lovely home. I wish they were all like this.”

The staff we spoke with were well qualified, knowledgeable about people’s needs and familiar with the support people needed.

We saw the service ensured that staff were able to deliver care and treatment safely due to the training and audits in place. The home had quality assurance systems to assess their performance and ensure improving standards. This included canvassing the views of people living who lived there, their relatives and visiting professionals.

St Marguerite is located in a residential area close to Eastbourne town centre. It provides care and support for up to 24 older people with care needs associated with age. The needs of people varied, some people were mainly independent others had low physical and health needs and others had a mild dementia and memory loss. The care home provided some respite care and can meet more complex care needs with community support including end of life care when required. At the time of this inspection 21 people were living at the home.

This inspection took place on 12 and 14 August 2015 and was unannounced.

The service had a registered manager in place. 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. At the time of this inspection the registered manager was on extended leave. In his absence the acting deputy manager was managing the service.

The staffing arrangement did not take account of the increasing care needs for people at night. This could put peoples care and safety at risk.

We found staff had completed training on safeguarding and could describe different types of abuse. However staff were not able to confirm the correct safeguarding referral actions they would take. This meant that safeguarding issues would not be dealt with effectively and could put people at risk of abuse.

People received care and support that was responsive to their needs because staff knew them well. However care records were not always complete or accurate. This meant staff were not always provided with clear guidance to follow to ensure consistency or to demonstrate that people’s care needs were being identified and met.

Feedback received from people their relatives and visiting health professionals through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. The home was described as having a relaxed, homely and calm atmosphere. One relative said “It’s a marvellous place. We all love everything about it. If mum’s happy, we’re happy, and she’s happy here.”

People told us they felt they were safe and well cared for at St Marguerite. Recruitment records showed there were systems in place to ensure staff were suitable to work at the home. Medicines were stored, administered and disposed of safely by staff who were suitably trained.

Staff were provided with a training programme which supported them to meet the needs of people. Staff felt well supported and on call arrangements ensured suitable management cover. Staff knew and understood people’s care needs well and there were systems in place for all staff to share information.

Staff treated people with kindness and compassion and supported them to maintain their independence. They showed respect and maintained people’s dignity. People had access to health care professionals when needed.

There was a variety of activity and opportunity for interaction taking place in the service. This took account of people’s preferences and choice. Visitors told us they were warmly welcomed and people were supported in maintaining their own friendships and relationships.

People had their nutritional needs assessed and monitored and were supported to enjoy a range of food and drink throughout the day. Mealtimes were pleasant and relaxed occasions.

People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be.

There was an open culture at the home and this was promoted by the providers who were visible and approachable. Staff enjoyed working at the home and felt supported. Systems for quality monitoring were in place and were being used to improve the service. People were encouraged to share their views on a daily basis, though ‘residents meetings’ and satisfaction surveys were being used.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.