The inspection took place on 8 February 2017 and was unannounced.

The home is registered to provide accommodation and personal care for up to 33 older people some of who may be living with a dementia. There were 28 people living at the home on the day we visited.

There was a registered manager for the home. 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 February 2016 the provider was not meeting the legal requirements in relation to medicines. At this inspection we saw that the provider had taken action to ensure people were consistently offered their medicines and was meeting the regulations. However, more improvement was needed around the recording of medicines prescribed as required (known as PRN). At this inspection the provider was not meeting the legal requirements in relation to providing person centred care. They had not ensured that care was planed to reflect people's needs or that people were involved in planning their care. You can see what action we told the provider to take at the back of the full version of the report.

The rating for our inspection in February 2016 was requires improvement and this has not changed at this inspection. Therefore, the registered manager and provider had failed to make the changes needed to provide a good level of care for people. This was because while the care was safe it did not reflect the standards of good practice that we expect to see in the environment for people living with dementia or the care plans in place to support people. The systems in place to monitor the quality of care had not identified these concerns.

People had all their basic needs met and received safe care which met their needs. Staff were trained to recognise situations in which people may be at risk of abuse and to take the appropriate action. However, the registered manager had not always reported this type of incident in an appropriate way.

People received appropriate food and drink to stay healthy and had access to healthcare professionals when needed. However, some people living with a dementia liked to spend time walking around the home and this impacted on others living at the home. There were no care plans or activities in place to manage this behaviour.

We have recommended that the provider review the guidelines for providing care for people with long term conditions and for those living with dementia.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect

themselves. We found the registered manager had taken appropriate action to comply with the requirements of the MCA and therefore people’s rights were protected.

The staff at the home were kind, caring and considerate of people’s needs and constantly monitored them to ensure they were safe and their needs were being met. There were enough staff to meet people’s needs and they received appropriate training and support to develop the skills needed to provide safe care.

The inspection took place on 8 February and was unannounced.

The home is registered to provide accommodation and personal care for up to 33 older people some of who may be living with a dementia. There were 33 people living at the home on the day we visited.

There was a registered manager at the home. 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 provider was not meeting the legal requirements in relation to the administration of medicines. While medicines were stored and administered safely, people were not always receiving their medicines as prescribed. You can see what action we told the provider to take at the back of the full version of the report.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves.

The registered manager was approachable and people living at the home, their visitors and staff told us that they could speak to the registered manager about any concerns. They were confident that the registered manager would take appropriate action to keep people safe and ensure that the care provided met their needs.

People were supported by kind and caring staff who received appropriate training and support. Staff knew how to keep people safe from harm and how to report any concerns. The registered manager ensured that there were enough staff available to meet people’s needs and that staff were safe to work with the people living at the home.

People were supported to make decisions about their lives and the care they received and were offered choices to tailor their care to their individual needs. Advice and support from healthcare professionals was accessed when needed. Risks to people were identified and appropriate equipment was available to keep people safe. A choice of meals were available to meet people’s nutritional needs and people had access to hot and cold drink whenever they wanted.

The provider had systems in place to monitor the quality of the service provided and support the registered manager to stay up to date with changes in legislation and best practice. However, we found that these systems were not always effective and that at times this impacted on the care people received.

We spoke with four people who used the service and three visiting relatives about their views of the home. We also spoke with nine care workers, the maintenance person, a cook, the registered manager, and the home owner.

We observed the support staff gave to people. We also looked at records, including the care files of four people who lived at the home. Throughout our visit we saw staff supported people in a dignified and respectful way.

We found people were involved in making decisions about the support they needed and staff were caring and responsive to changes in their care needs.

We asked people who used the service what they thought of the food that was provided for them, one person told us, “The staff make sure you get just enough and I think it is very good.”

People also made comments such as, "The staff are very good, I feel comfy here" and “I don’t think I can think of anything I would change the care is good."

We saw systems for recruiting staff were safe and the proper checks were carried out in advance of any new staff starting to work at the home.

We found the manager responded and maintained records regarding deprivation of liberty arrangements and injuries sustained by people who used the service but had not sent notifications to us about these events.

Overall we found the service was well led and the manager had training and supervision arrangements in place to support staff to enable them to carry out their work safely.

As part of our inspection we spoke with several people who use the service and their relatives, and a selection of staff members.

During our visit to Vauxhall Court on 6 July 2012 people told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They told us they were happy living there and were well looked after. The told us that they felt safe and that care staff understood their needs.

We conducted a Short Observational Framework for Inspection (SOFI 2). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us as some people living in the home have a dementia.