This inspection took place on 12 and15 November 2018. The inspection was unannounced. This meant that the provider and staff did not know we were coming.

The Mews Care Home is a 'care home.' People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Mews Care Home is registered to provide residential care and support for up to 46 people. At the time of our inspection 43 people were living at the service.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the service had deteriorated to ‘Requires improvement.’ This is the first time the service has been rated ‘Requires improvement.’

The service did not always ensure safeguarding issues were identified and responded to appropriately. Following our intervention, the provider took action to address this matter. Accurate and up to date records were not maintained to ensure people, staff and visitors remained safe. The service did not ensure Disclosure Barring Service (DBS) checks were followed up in a timely manner to ensure vulnerable people were supported by suitable staff. Care plans contained conflicting and inaccurate information. Mental capacity assessments and best interest decisions did not always have the involvement of the person, relatives and health care professionals. The provider’s quality assurance systems didn’t identify the issues we found during our inspection.

People were not always supported to have maximum choice and control of their lives and to maintain their independence. Staff did not support them in the least restrictive ways possible. The policies and systems in the service did not always support this practice.

The service was clean and there were systems in place to protect people from the risk of infection. Health and safety checks were conducted regularly.

Appropriately trained staff safely managed medicines. People had access to health care professionals when necessary.

People and relatives were complimentary about the care and support given. When supporting people, staff treated them with dignity and respect. People were encouraged to be as independent as possible.

Staff felt supported and received regular training, supervision and an annual appraisal.

People had access to a range of activities and entertainment. People were supported to maintain relationships and links to the local community. Staff supported people to practise their religious beliefs.

The provider had a complaints process in place and investigated concerns raised. The provider actively sought feedback from people, relatives and external healthcare professionals.

Staff were positive about the registered manager. Staff told us they felt able to raise concerns and were confident issues would be addressed.

The service worked closely with the local authority commissioners, safeguarding teams, social work teams and external healthcare professionals.

You can see what action we told the provider to take at the back of the full version of the report.

The Mews Care Home has been a care home for many years. In November 2015 a new provider purchased the home and registered with the Care Quality Commission to operate it. This was the first inspection of The Mews Care Home since the new provider was registered.

This inspection took place over two days. The first visit on 27 April 2016 was unannounced which meant the provider and staff did not know we were coming. Another visit was made on 28 April 2016.

The Mews Care Home is registered to provide up to 46 places for people who require nursing or personal care, some of whom may be living with dementia. There were 44 people living at the home during this inspection, and the remaining two places had been booked.

The home had a registered manager who had been in this role for over four years. 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 and their relatives said the home was a safe place to live. One person said, “They make me feel I’m well looked after. If I need something I call them and they come quickly.” A relative commented, “It’s very safe and comfortable.” Staff had training in keeping people safe and how to report concerns.

The provider carried out checks to make sure only suitable staff were employed. The provider calculated staffing levels from the number of people with different needs, for example living with dementia. At the time of this visit the staffing levels and skill mix throughout the day and night was suitable to meet people’s needs, although two new people were going to move to the home so staffing levels would be reviewed.

People and relatives we spoke with felt staff had the right skills to provide the right support. One person commented, “They’re very good and know exactly what they’re doing.” A relative told us, “[My family member] is getting the care they need here.” Staff said they felt well trained, motivated and supported in their role.

People told us the meals were good and they were “well-fed”. A relative also commented, “My [family member] enjoys the meals very much and he’s getting well-fed which is good for his health.”

People were supported to get health services when they needed these. There were good working relationships between staff and care professionals. One healthcare professional told us, “The staff take their responsibilities seriously.” Another told us, “I am frequently touched by the manner in which they care for the patients.”

People described the staff as caring and kind. One person said, “The girls are very nice, very accommodating.” Another person told us, “They are all very helpful, and very friendly.”

There was a friendly, warm atmosphere in the home. One relative told us, “I noticed it had a warm vibe about it as soon as I came to look around.”

Care professionals also commented positively on the kindness and consideration shown towards people. One health care professional told us, “It’s definitely a caring place – the staff are lovely towards people.”

People received personalised care from staff who knew them well. People’s care was planned to make sure they got the right support to meet their specific needs. Health care professionals told us staff were “knowledgeable” about people. Information about people’s needs was up to date, detailed and individualised.

People told us there were “plenty” of activities and entertainment to take part in if they wanted. The activities programme was displayed in large pictures and in writing in the hallway for people and visitors to see. People also had the chance to go out to shops and other local places.

People, relatives and staff said the takeover by the new provider had gone well. They said the home was well managed and they