This inspection was unannounced and took place on 28 November, 11 December 2018 and 10 January 2019.

The Weir is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides accommodation and personal care for a maximum of 31 older people, some of whom may be living with dementia. It is located in the town of Hessle, in the East Riding of Yorkshire. At the time of our inspection there were 24 people using the service.

The service had a manager who was registered during this inspection, on 4 January 2019. 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 our last inspection, in November 2017, we found there were five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated 'Requires Improvement.' Following the inspection, we asked the provider to complete an action plan to show us what they would do and when by to improve the key questions to at least 'Good'. The provider sent us their action plan and we reviewed this as part of this inspection.

This inspection took place to follow up on our previous findings. We found a number of significant improvements had taken place. The provider had taken action and implemented sufficient improvements to their systems, processes and practice which meant they were now compliant with the regulations. The overall rating has improved to ‘Good.’

People using the service said they felt safe and that staff treated them well. There were policies and procedures in place to guide staff in how to keep people safe from abuse and harm. Staff we spoke with understood how to safeguard the people they supported. Medicines were administered as prescribed.

During this inspection, we observed the atmosphere in the home was calm and staff were not rushed when responding to people's needs. We were satisfied that there were enough staff on duty. Appropriate recruitment checks had taken place before new staff started work.

The cleanliness of the home was meeting expected standards. Infection control practices had been reviewed and improved. The home was clean and in the main free from unpleasant odours. Improvements had been made to the design and decoration of the premises to meet people’s needs.

People were supported with their health and wellbeing. Drinks were provided throughout the day and a picture menu was provided to support people with a choice of food. People received additional support from diet and nutrition specialists where this was required.

Staff were provided with the training to ensure they had the skills and knowledge to meet people’s needs. Since the last inspection the registered manager had created a training plan to ensure regular training and development was available to staff. Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have choice about how they lived their lives.

Care planning documentation had been improved and contained information for staff to follow around people’s care, support and treatment. People's needs were assessed on a regular basis and care plans were updated to reflect any changes. Risks to people had been appropriately assessed.

We saw great improvement had been made to the activities that were on offer to people. Staff had a good understanding of promoting and respecting people's privacy, dignity and independence. Staff were visible in the communal areas of the hom

This inspection took place on the 22 and 28 November 2017 and was unannounced.

We last carried out a comprehensive inspection of this service on 30 December 2015 and 5 February 2016. At the last inspection we rated the service overall Good with requires improvement for the key question "Is the service safe." We made a recommendation that the registered provider reviewed the staffing levels in the service to ensure that safe levels of staffing were maintained at all times.

At this inspection we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Weir is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides accommodation and personal care for a maximum of 31 older people, some of whom may be living with dementia. It is located in the town of Hessle, in the East Riding of Yorkshire and is close to local amenities. At the time of our inspection there were 24 people using the service.

The service had a registered manager. 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 were described by people as being caring and we saw kindness shown to people by some staff. However, other staff did not always promote and respect people's dignity through the care they provided.

Risks to people had been identified but the written assessments did not always provide staff with enough guidance on how to recognise risk and what actions to take to mitigate identified risks.

People's needs were not regularly assessed to ensure the appropriate care and support was being delivered. People's needs had changed and care plan reviews had not captured this to make sure staff were given the most up to date information.

The staff we spoke with demonstrated different levels of knowledge and understanding of safeguarding. Staff told us they received adequate training. The training records we reviewed were disorganised and we were unable to identify what training staff were expected to complete according to their roles and the frequency of this training. We saw gaps in training staff had received in areas such as safeguarding, dementia, the mental capacity act and equality and diversity.

People were placed at potential risk of harm because the registered manager and provider had not taken action to identify and minimise certain environmental health and safety risks. We identified several potential safety hazards as we walked around the building. For example, some carpets and flooring needed to be replaced and several wheelchairs were found to be unsafe to use. The registered manager did take action when shortfalls were raised with them. However, these issues should have been identified earlier through the provider's own audit and management systems, to ensure people's health and safety was protected at all times.

The registered manager and provider had failed to consistently implement systems and processes to monitor and improve the quality of care that people received. They had not established clear oversight of the service and we identified several examples where areas had failed to be monitored to ensure the safety and care that most people received. These areas included care plans, risk assessments, staff training and infection control practice.

The design and layout of the building was not ideal for people living with dementia. There was nothing made available to engage people who were able to mobilise around the building. There was no evidence of the implementation of

We spoke with two people who lived at the home, two members of staff and the manager as part of this inspection.

We saw that care plans reflected the needs of people who lived at the home and that they were reviewed and updated on a regular basis. People told us that they were happy with the care they received; one person told us that staff were pleasant and supportive and that they “could have a laugh with them”. There were contingency plans in place in respect of how people would be cared for in the event of an emergency.

The home was maintained in a clean and hygienic condition. There were infection control policies in place and staff had completed appropriate training. One person who lived at the home said, “Oh yes, my room is cleaned regularly, including my en-suite. I have no concerns”.

Staff were recruited in a way that ensured only people who were considered suitable to work with vulnerable people were employed. They received appropriate induction training and had regular refresher training.

There were quality monitoring systems in place that gave people who lived at the home an opportunity to express their views about the care provided. Regular resident and staff meetings were held and quality surveys had been distributed and were in the process of being analysed. Various quality audits had been carried out and these included a record of areas that required improvement. Complaints were handled and responded to appropriately.

The people who we spoke with told us that they liked the staff. One person said, ‘The staff are very good – you can have a laugh with them’ and a relative told us, ‘staff provide good care – they know what he needs’.

People told us that they enjoyed the food and that their bedrooms were nice.

We saw that people had opportunities to express their satisfaction with the care they received and that their relatives were also involved in care planning processes.

We observed good interaction between people who lived at the home and staff.

We carried out this inspection on 30 December 2015 and 5 February 2016. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The inspection was unannounced; which meant that the staff and registered provider did not know that we would be visiting.

The Weir Residential Care Home is registered to provide personal care and accommodation to older people, including those living with dementia related conditions. It is situated in the small town of Hessle, in the East Riding of Yorkshire and is close to local amenities. There are a number of communal areas where people can choose to spend the day and bedroom accommodation is provided in single rooms, some with en-suite facilities.

The registered provider is required to have a registered manager in post and there was a registered manager at this service. 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 found that staffing levels occasionally fell below the level the registered provider had identified as a safe number to effectively meet the needs of the people living in the home during busy times of the day. This included the morning when people required the highest levels of support with personal care. We have made a recommendation regarding staffing levels within the home.

People lived in a safe environment. Staff knew how to protect people from abuse and equipment used in the service was checked and maintained. Staff made sure risk assessments were carried out and took steps to minimise risks without taking away people’s rights to make decisions.

Medicines were stored, administered and disposed of safely. However we found when medication was refused this was not always accurately recorded. Training records showed the staff had received training in the safe handling and administration of medicines.

We saw that staff completed an induction process and they had received a wide range of training, which covered courses the home deemed essential, such as safeguarding, moving and handling and infection control and also home specific training such as dementia awareness. Staff told us they felt well supported, received regular supervision and attended staff meetings.

The manager understood the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act (MCA) (2005) guidelines had been fully followed.

People’s nutritional needs were met. People told us they enjoyed the food and that they had enough to eat and drink. They told us that drinks were provided throughout the day but one person told us you sometimes had to request these. People told us there was only one choice of hot meal at lunchtime and sandwiches were the only alternative.

People told us they were well cared for. We found that staff were knowledgeable about the people they cared for and saw they interacted positively with people living in the home. People were able to make choices and staff supported them to maintain their independence.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health care professionals based in the community.

The home employed an activity coordinator and they offered some activities for people to be involved in. However due to staffing levels in the home they were often required to support the care staff. We found that there were limited dementia friendly activities.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that any comments, suggestions or complaints were appropriately actioned.

We found the provider had audits in place to check that the systems at the home were being followed and people were receiving appropriate care and support.