This unannounced inspection took place on the 5 and 6 December 2016. The home was last inspected in August 2013 where it was found to be compliant with the regulations at that time.

This residential home is registered to accommodate up to 40 older people. At the time of the inspection there were 31 people living in the home. There was 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.

Just prior to this inspection the home had an outbreak of diarrhoea and vomiting. This affected both the people living in the home and staff members. The infection was dealt with quickly and effectively but had an impact on the number of regular staff working in the home. Agency staff were used to cover for staff absences. The home had infection control policies available and these were effective throughout the outbreak. Staff had received training in infection control and how to prevent cross contamination.

Where people required assistance with medicines, these were administered by trained staff. The home had a medicine policy and this was adhered to. Medicines were stored securely, and only appropriately trained staff had access to them. We found some gaps in the guidance information for staff for “As required” medicines.

People’s safety and well-being had been considered by the service and steps had been taken to ensure that any risk of harm had been assessed. Environmental risk assessments were in place alongside risk assessments related to the care provided for people.

Staff knew how to report concerns of abuse. They had received training in how to safeguard people. Staff knew how to whistle blow and had no reservations about doing so if they had concerns. Learning had taken place from safeguarding concerns, complaints, accidents and incidents to improve the service to people. We saw actions had been taken following a safeguarding concern and staff were fully engaged with the learning from this incident.

Recruitment systems were in place to ensure people were protected as far as possible from unsuitable staff.

There were mixed responses regarding the food on offer in the home. People were involved in the planning of the menus and were satisfied they were provided with an additional option if they did not like the food on offer on any particular day.

We observed poor practice with regards to people’s choice, dignity and comfort during meal times. We observed one person was not given any choice about how their food was presented to them, for example the food was mixed together on the plate. People were not always seated in a good position to eat their food safely and comfortably. We have made a recommendation to the provider about person centred care. However, most people appeared to enjoy their food and drinks were readily available throughout the day.

Staff received support through training, induction and supervision. Staff told us they felt supported in their role and from our observations we could see the registered manager had a good rapport with staff and people. Staff felt the registered manager was approachable and staff were confident to raise concerns or issues.

Staff were knowledgeable about the Mental Capacity Act 2005 (MCA) and the deprivation of liberty Safeguards. (DoLS). They understood how this applied to their work and the lives of the people they cared for. The home was working within the principles of the Act.

People told us and we observed staff were caring and kind. Their interactions were positive with people, they showed patience and spoke respectfully to people.

Activities were available to people. Some people enjoyed the activities whilst others preferred to spend time on their own. Where

We received positive feedback about people’s care at the home. One person told us staff were flexible in supporting them. For example, they could have a bath at a time to suit them. One person said of staff “They’re all lovely’’ and “I get on with them all.”

We found there was good regard for people’s care and welfare. Each person had a care plan which outlined their needs and the support they required. Risk assessments were in place to identify and help minimise risks associated with providing personal care and support. We saw people had access to a range of external professionals to help meet their healthcare needs.

There were systems in place to manage people’s medication safely. We observed a medication round and found staff followed the home’s procedures. People we spoke with said they received their medicines appropriately.

We looked at how staff were supported. We saw new staff undertook a detailed induction. Training was provided to ensure staff had the skills and knowledge they needed for their roles. We found supervision sessions had not taken place as frequently as the provider expected. However, work was underway to ensure improvements were made in this area.

We found there was good regard for people's privacy and dignity. Staff were respectful towards people and called them by their preferred name. Regular meetings were held to consult with people and seek their views about their care.

Care plans were in place to document people's individual needs. Risk assessments had been written to identify and reduce the likelihood of injury or harm. We found people had access to healthcare professionals to help keep them healthy and well. Medicines were managed safely.

Staff undertook a thorough induction. There were on-going training opportunities to update their skills and knowledge. Systems were in place to supervise and appraise staff to make sure their performance was satisfactory.

The home had a statement of purpose in place. It contained all required information. This information is useful to people looking for care services, to help them decide if it can meet their needs.

We saw that people were free to sit outside or in any of the lounge areas. Those who sat outside were encouraged by staff to wear straw hats to keep the sun off them. Staff offered people a choice of hats and we saw that they chatted with people whilst doing this. People were offered a choice of drinks during the morning.

Most interactions that we observed between staff and people using the service were gentle and attentive to people's needs. We saw a couple of examples where staff carried out actions without involving people. One was when a member of staff walked by someone and put her straw hat back on her head without any comment. The other was when a person was pushed in a wheelchair into the hallway and then left by staff. This resulted in him crying out for help.

A relative said he was very pleased with standards of care and that his father had settled in at the home.

Staff that we spoke with said they knew who to speak with if they had any concerns about the home.