St Omer is a large detached Victorian villa, set within its own landscaped gardens in a quiet residential area on the outskirts of Torquay. St Omer provides accommodation and personal care for up to 28 older people who may be living with a dementia. At the time of our inspection there were 23 people living at the home. The home offers both long stay and short stay respite care. This inspection took place on the 10 and 12 August 2016, and was unannounced. The service was previously inspected on the 24 February 2014, when it was found to be compliant with the regulations relevant at that time.

The home had 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 said they felt safe and well cared for at St Omer their comments included “I do feel safe” “I’m very happy living here”. Relatives told us the staff were lovely, and people were well looked after. Health care professionals said the staff were very caring and compassionate, people were safe. We saw people were happy to be in the company of staff and were relaxed when staff were present.

People were protected from abuse and harm. Staff had received training in safeguarding vulnerable adults and demonstrated a good understanding of how to keep people safe. The policy and procedures to follow if staff suspected someone was at risk of abuse or harm were displayed along with telephone numbers for the local authority and the Care Quality Commission.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Most of the people who lived at St Omer were living with a dementia, which affected their ability to make some decisions. Staff had received training and demonstrated a clear understanding of the principles of the MCA in their practice. Staff sought people’s consent and made every effort to help people make choices and decisions. However, not all the records we saw demonstrated that decisions were specific, made in consultation with appropriate people, such as relatives or were being reviewed. We raised this with the registered manager who agreed the way the home was currently recording best interest decisions was not as clear as it could be. Following the inspection, the registered manager confirmed they had changed the way best interest decisions where recorded and reviewed.

People received their prescribed medicines on time, in a safe way, and given the time and encouragement to take their medicines at their own pace. We looked at how the home managed people's topical medicines or creams and found it was not possible to tell if topical medicines or creams had been applied. Staff responsible for the administration of medicines told us they routinely signed Medication Administration Records (MARs) for people’s topical medicines or creams in the belief these had been applied. Following the inspection the provider confirmed they had taken immediate action to address this.

Risks to people’s health and safety had been assessed and regularly reviewed. Each person had detailed risk assessments, which covered a range of issues in relation to their needs. The homes computerised care planning and monitoring system allowed for this information to be updated immediately and flagged up where action needed to be taken. Each person had a personal emergency evacuation plan (PEEP) and the provider had contingency plans to ensure people were kept safe in the event of a fire or other emergency. The registered manager and staff carried out a range of health and safety checks on a weekly, monthly, and quarterly basis to ensure that any risks were minimised. However, not al

When we visited St Omer we found there were 21 people currently living in the home. At the time of our visit the home owner was upgrading two bedrooms, to provide en-suite facilities for all rooms. One room was held as a respite room and all rooms at the time were single occupancy.

We spoke to the people who lived there, the manager and nine other members of staff who were on duty during our visit. We reviewed the care records of the people living there, the staff files, including training files, audit and administration records. We also spoke to four relatives and friends of people living there and a district nurse.

People told us that the care given was excellent, the management were approachable and any requests acted upon immediately. We were told “this is our lovely home now” One relative told us they felt very lucky that a room had been available and in over two years had no occasion to complain.

People had formal meetings every six months, and annual questionnaires. We were told that the staff and management were always happy to discuss any problems and were satisfied that they would be consulted over any matters that might arise. Staff had regular meetings and formal supervision, with support available on a day to day basis.

We saw that all staff either had qualifications or were working towards them; we spoke to a training provider who told us the management were really good with all aspects of training, encouraging staff to progress to higher qualifications and keen to work with the provider.

We saw the home was open and inviting; people were coming and going throughout the day with activities in place during the afternoon. We saw that bells were answered quickly and that staff always had time to talk to people. One member of staff told us that the management “encourage the staff to spend time simply talking to people, it is seen as very important” There were sufficient numbers of staff on duty and people told us they felt secure and knew that any needs they may have would be responded to very quickly.

There were 22 people living at St Omer at the time of our inspection. We spoke with ten people who lived at the home and two relatives of people who lived there. People told us that they felt safe and were treated respectfully by care workers. People were involved in discussions about their care as much as they wished to be. Where people did not have the capacity to make significant decisions about their care appropriate procedures were used to protect their rights.

People and relatives were very positive about the care delivered. Comments included, "We are well looked after." and "I have had great peace of mind since X has been here, X is well cared for.” We had previously received a report of concern that people's condition was not monitored and that staff did not respond to call bells. We did not see any evidence to substantiate this. People's needs were assessed and their care was planned and delivered in line with those assessments. Care plans had been regularly reviewed and updated.

People enjoyed each other's company and a range of activities were available. Staff had time to talk with people as well as to complete tasks. Care workers had received training which supported them to meet people's needs and there were sufficient staff on duty to respond in a timely way.

Effective systems were in place to safeguard people and to assure the quality of the service. The provider had responded to a previous complaint had revised a procedure as a result.