This inspection took place on 29 and 31January 2018 and was unannounced. Which meant the provider and staff did not know we would be visiting.

St Thomas Complex is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. This home does not provide nursing care. At the time of our inspection there were 30 people living at the home.

There was a registered manager in post 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Staff had completed safeguarding training to ensure they were able to recognise the types of abuse and take appropriate action. Safeguarding concerns had been investigated. Where risks were identified they were assessed and managed to minimise the risk to people who used the service and others.

A robust recruitment process was in place with the service carrying out relevant checks to ensure staff were suitable to work with vulnerable people. Staff received relevant training to ensure they had the appropriate knowledge to carry out their role. Supervisions and appraisals were regularly held.

Medicines continued to be managed safely. Medicines records we viewed were accurate and up to date including records for the receipt, return and administration of medicines.

The service carried out monthly health and safety checks including fire safety to ensure people lived in a safe environment. Systems were in place to ensure people would remain safe in the event of an emergency including a continuity plan to ensure people would continue to receive care.

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.

The service had developed good working relationships with external health care professionals visiting the service. We saw evidence in care plans of cooperation between care staff and healthcare professionals including, GPs and nurses.

People were supported to have a balanced diet. Kitchen staff had a sound understanding of people’s dietary needs. People’s cultural and religious needs were supported.

Staff were respectful and patient when supporting people. People and relatives told us staff were kind and caring. People were supported to make their own choices and to be as independent as possible. Staff we spoke with were able to describe people’s personal preferences.

The service offered a range of activities. People were supported to maintain links to their local community. Care plans were person centred and gave clear information on how to support people in line with their preferences. People and relatives knew how to make a complaint. Relatives told us both the registered manager and deputy manager were approachable.

The service regularly sought feedback from people, relatives and staff in order to monitor and improve standards. The provider had effective quality assurance processes to monitor the quality and safety of the service provided. The registered manager ensured statutory notifications had been completed and sent to the CQC in accordance with legal requirements.

Further information is in the detailed findings below.

The inspection took place on 7 December 2015 and was unannounced. A second day of inspection took place on 10 November 2015 and was announced. This is the first time the service has been inspected since it was registered on 17 October 2014.

St Thomas Complex is a three storey home that provides personal care and support for up to 52 people, some of who are living with dementia. At the time of our inspection there were 40 people using the service.

At the time of our inspection the service did not have a registered manager. However, the person managing the service had applied for 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.

Staff had a good understanding of safeguarding and were confident in their role in safeguarding people.

Risk assessments were in place for people when required and there was a clear link to care plans in place. There were also general risk assessments regarding the premises and environment.

Medicines where managed safely, effectively and in a way which reflected people’s individual needs. All records were up to date and fully completed, with medicine audits being carried out regularly.

Staff were recruited in a safe and consistent manner with all appropriate checks carried out. Staffing levels had recently been increased, and plans were in place to introduce a more robust system to analyse staffing requirements in line with people’s needs. From staffing rotas we saw that staffing levels were consistent and alternative arrangements were available to cover shortages of staff.

Staff had some up to date training but at the time of the inspection this did not include safeguarding, Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguarding (DoLS). However, the manager had identified this as was planning to book staff on the next available training courses.

The registered manager and staff we spoke to had a good understanding of the MCA and Deprivation of Liberty Safeguards (DoLS). Best interest assessments were evident within care files and DoLS authorisations were in place for every person who used the service.

Staff received regular supervision and told us they felt supported in their roles and they could approach the manager if they had any issues or concerns. Annual appraisals were out of date for all staff members. The manager had a plan in place to bring appraisals up to date in early 2016.

We observed people and staff during mealtimes. People were enjoying their meals, some independently and others with support from staff. There were choices available for people and support provided by staff was caring, compassionate and at an appropriate pace to each individual.

Care plans were personalised, detailed and contained people’s personal preferences, likes and dislikes. Care plans were up to date and reflective of each person’s individual needs.

The manager and staff carried out regular audits. These related to people’s specific needs and the environment.

There was a range of activities available for people in the service. Activities ranged from a church service every month, chair exercises, singers, pantomimes, animal therapy, cookery, cards, arts and crafts, dolls and soft toy therapy. Staff had a good understanding of activities each individual enjoyed doing. People who used the service discussed activities at residents’ meetings and with the activities co-ordinator individually.