The Vineries is a ‘care home’. People in care homes receive accommodation and 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 Vineries accommodates up to 24 people, some of whom may be living with dementia, in one adapted building. At the time of our comprehensive unannounced inspection on 1 November 2018 there were 23 people living in the home.

The service also provides short stays for people who require a period of reablement. The purpose of reablement is to help people who have experienced deterioration in their health and have increased support needs to relearn the skills required to keep them safe and independent at home. Health and social care professionals visit the home and support therapy, nursing and social care needs of people admitted on a temporary basis.

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.

We had previously inspected the service on 9 and 10 August 2017. We found that the provider was not meeting the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider was in breach of four regulations including need for consent, safe care and treatment, good governance and staffing. The overall rating for the service was requires improvement. The provider sent us an action plan stating that they would take immediate action to comply with the regulations.

During this inspection on 1 November 2018, we found that sufficient improvements had been made and the provider was no longer in breach of the regulations. However, we have made a recommendation under the key question of well led.

The service was well led and people were happy living in the home. Staff enjoyed their work and knew what was expected of them. People, their families and staff were involved in the service and there were regular meetings and opportunities to provide feedback for everyone involved with the service.

Improvements had been made in relation to the quality assurance systems which assessed and monitored the quality of service being delivered. A formal audit of a chosen area was carried out each month and recorded. The registered manager carried out more frequent checks relating to the quality of the service but these were not documented. We have recommended that the provider implements a system that allows for these checks to be recorded.

People were cared for in a way that promoted their independence and upheld their dignity and respect. Staff consistently treated people with compassion and respected people’s preferences and wishes about how they liked their care to be delivered.

People were involved in day to day decisions about their care and treatment and staff knew the importance and guidance around making a decision in a person’s best interest. Where people were deprived of their liberty, records relating to this had been completed in line with the Mental Capacity Act 2005.

Records about people’s care were person-centred and were developed with people and their relatives. These were reviewed and updated when people’s care needs changed.

There were consistently enough staff to support people in a safe way and people’s needs were responded to in a timely manner. Staff had time to spend talking with people and were able to engage people in activities that interested them.

People’s medicines were managed and administered in a safe way by staff who had received training in the safe management of medicines.

Staff worked collaboratively with other agencies to provide care that met people’s care and support needs.

Staff understood their r

The Vineries residential home provides accommodation and personal care for up 24 people, some who may be living with dementia.

The service also provides short stays for people who require a period of reablement. The purpose of reablement is to help people who have experienced deterioration in their health and have increased support needs, to relearn the skills required to keep them safe and independent at home. Health and social care professionals from the reablement team visit the service and support the therapy, nursing, and social care needs of people admitted on a temporary basis.

When we inspected on 9 and 10 August 2017 there were 23 people using the service (two of which were receiving reablement for a short period). This was an unannounced inspection.

The registered manager had left the service in 2016. 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. In January 2017, the previous deputy manager began managing the service, and has made an application with the Care Quality Commission to be registered. This report will therefore refer to them as the ‘manager’.

During this inspection, we found that the registered provider was in breach of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to medicines, governance, staffing and consent. You can see what action we told the provider to take at the back of the full version of the report.

Quality assurance and auditing mechanisms had not been effective at identifying issues we found during the inspection.

Staffing levels were not sufficient in order to meet the needs of people in a timely manner and keep them safe at all times.

Best interests documentation was not always in place or reviewed regularly where decisions had been made on behalf of people who lacked capacity. The manager was reviewing people in the service to ensure they were meeting their duties and responsibilities in relation to Deprivation of Liberty Safeguards.

People's medicines were stored safely and in line with legal regulations. However, we found some controlled drugs had not been logged as having been received. There were missing signatures for some medicines which had not been identified to ensure that people received their prescribed medicines. We also found issues with the recording of external applications, such as creams.

People told us they had good relationships with staff who protected their privacy and dignity. We observed pleasant and patient interactions throughout out inspection. Staff had a good knowledge about the people they supported. However, staffing level arrangements did not always allow staff to spend time with people that was meaningful and unhurried.

Staff had access to training which gave them the skills and experience needed to be effective in their roles and people told us they had confidence in the staff's ability to care for them.

There was an activity co-ordinator working in the service who delivered activities to people. However, we saw their time in delivering activity was often interrupted to assist care staff with tasks.

Care plans contained detailed information reflecting people’s individual needs and preferences. However, for people receiving reablement in the service on a temporary basis, we found more detail was required.

People’s nutritional needs were monitored, and people received support to manage a healthy diet where required.

People were referred to other health care professionals in a timely manner to maintain their health and well-being.

There was a complaints procedure in place and people knew how to complain.

Procedures were in place which safeguarded the people who used the service from the po