The Swallows Residential Care Home is a care home for up to 16 people older people. 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 Swallows Residential Care Home is situated in Helion Bumpstead on the outskirts of the town of Haverhill, Suffolk. There were 13 people living at the home when we inspected on 5 and 6 March 2018. One person was in hospital during the first day we visited, however they arrived home during the second day.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good overall. Whilst we have rated the key question of Safe ‘Requires Improvement there was no other evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of this inspection there was a registered manager in post. 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 manager was also a partner in the provider company. We have referred to this person as the registered manager throughout this report.

People we spoke with told us they felt safe living at the home. Risks were assessed and safety of people was monitored by staff on an on going basis. Improvements were needed to fire safety arrangements; we shared this with the fire service.

There were not always sufficient staff to meet people’s needs in a timely manner. We have recommended the provider review staffing levels.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received a service that was caring. Staff knew people's needs well and were responsive and supportive. Staff treated people with dignity and respect. Staff sought to gain people's views.

The service had a complaints procedure which was made available to people and their relatives. People were happy living at the home and had no complaints.

People who lived at the home, relatives and staff told us the service was well led. Staff were aware of their roles and responsibilities and were well supported.

Further information is in the detailed findings below.

We carried out an inspection on the 22 September 2015 and it was unannounced. The last inspection was on the 16 August 2013 and the service was found to be meeting the required standards.

The service is registered to provide personal care for up to sixteen older people. At the time of our inspection there were fourteen people who lived at the home. The home is owned by a husband and wife. There is a registered manager in post. 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 service provided comfortable accommodation to people and we identified no hazards to people’s safety. Staffing was adequate and people’s needs were met in a timely way.

Risks to people’s safety were minimised as far as possible and any known risk was documented to show how the risk was being managed and reduced as far as possible.

Staff understood their responsibilities towards safeguarding people and how to report concerns if they felt people were at risk of harm or abuse.

People’s needs were met by staff who were adequately recruited and trained and understood how to care for people effectively.

People were supported to eat and drink enough for their needs and staff promoted people’s well- being by encouraging people to stay mobile. Any change in people’s health was followed up to ensure medical health conditions were carefully managed and illness treated.

Staff promoted people’s independence and gave people choices about their care and welfare and how they would like their needs to be met. Where a person lacked capacity to make a decision about different aspects of their care and welfare, the home adequately supported the person and acted in accordance with the Mental Capacity Act 2005.

People were offered a range of activities to help keep people occupied and mentally stimulated. Staff were observed to be kind, caring and familiar with people’s needs.

The service was inclusive of families and there was information around the service to tell people and their family members what was going on and information about advocacy or how to raise concerns if the service fell short of their expectations.

Records demonstrated that staff were proactive and monitored people’s care and support needs to ensure they were met as far as reasonably possible.

The service was well managed and provided good outcomes for people. There were systems in place to assess the level of care provided and effectiveness of the service. This enabled the provider to address any improvements identified.

We spoke with five people and one person's relative in the service. We saw that people were asked for their permission before care was provided, and that people were complimentary about the service. One person told us that, "I'm well looked after, you couldn't do better than here." Another person told us, "The carers are kind, my doctor recommended this home to me." The relative told us that, "Staff are approachable, they keep me informed about any changes in my relative's condition, I am pleased there are different activities for my relative in here."

We found that staff were well supported by the provider, training and regular supervision were appropriate for their role.

We found that medications were stored in secure cupboards and trolleys but the temperature of the cabinets had been recorded by staff as being above recommended levels for the safe storage of medications on three occasions during hot weather in July 2013. Some medications were stored in a food refrigerator that we saw was above the recommended temperature level after a food delivery. There was inadequate management of the administration of medicated creams.