The inspection took place on 5 and 6 September 2017 and was unannounced. At our last fully comprehensive inspection in 20 July 2016 we found three breaches of legal requirements. This was because we continued to have concerns regarding the management of medicines, systems were not in place to ensure the appropriate recruitment checks were in place prior to employing new staff and there were a lack of systems or processes in place in order to ensure the service operated effectively and complied with the requirements of the regulations.

Following the inspection, the provider sent us an action plan, telling us how they intended to meet the legal requirements in relation to the breaches identified.

We undertook an unannounced focused inspection on 8 March 2017. That inspection was to check that the provider had followed their action plan and to check that they were meeting the legal requirements. At that inspection, we found that the areas for improvement identified on the action plan and in relation to meeting the legal requirements, had been met.

Veronica House provides accommodation for up to 52 people who require nursing or personal care, for younger or older people, people with a learning disability or a physical disability. At the time of the inspection there were 37 people living at the home.

There was 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.

The introduction of an electronic system for the recording and administration of medicines was not as effective as hoped and had created a number of problems for the service. Systems in place for the management of medicines could not demonstrate that people always received their medicines as prescribed.

People felt safe and were supported by staff who had receiving training in how to recognise signs of abuse and were aware of what actions to take should they suspect someone was at risk of harm.

People were supported by staff who were aware of the individual risks to them on a daily basis. Staff were aware of how to manage those risks and how to keep people safe. Where accidents and incidents took place, they were reviewed and lessons were learnt.

Staffing levels were based on the dependency levels of the people living at the home. The deployment of staff across the home was under review in order to ensure staff responded to people’s needs in a timely manner.

Staff benefitted from an induction that prepared them for their role. Staff received specialist training in order to meet the needs of the people they cared for.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to have sufficient amounts to eat and drink and were offered choices at mealtimes that were tailored to their individual preferences and dietary needs.

People were supported to access a variety of healthcare professionals to ensure their health and wellbeing.

People were supported by staff who were kind and caring and treated them with dignity and respect. Staff were aware of people’s preferences with regards to their care and what was important to them.

People were involved in the development of their care plan. Care plans included information which reflected people’s likes and dislikes and family history.

People were supported to take part in a variety of activities that were of interest to them. The activities co-ordinator had a comprehensive knowledge of people and what was important to them and developed activities that were of interest to people.

People felt listened to and were confident that if they had any c

The inspection took place on 8 March 2017 and was unannounced. At our last inspection on 20 July 2016 we found three breaches of legal requirements. This was because with continued to have concerns regarding the management of medicines, systems were not in place to ensure the appropriate recruitment checks were in place prior to employing new staff and there were a lack of systems or processes in place in order to ensure the service operated effectively and complied with the requirements of the regulations.

Following the inspection, the provider sent us an action plan, telling us how they intended to meet the legal requirements in relation to the breaches identified.

We undertook this unannounced focused inspection on 8 March 2017. This inspection was to check that the provider had followed their action plan and to check that they were meeting the legal requirements. At this inspection, we found that the areas for improvement identified on the action plan had been met. This report only covers our findings in relation to the regulations that had not been met at the previous inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Veronica House on our website at www.cqc.org.uk.

Veronica House provides accommodation for up to 52 people who require nursing or personal care, for younger or older people, people with a learning disability or a physical disability. At the time of the inspection there were 21 people living at the home.

There was a new manager who had been in post since November 2016 and had recently become registered manager of 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.

Improvements had been made in relation to how medicines were managed and administered to people. People received their medicines safely and effectively and staff practice was regularly observed and additional training provided where required.

There was a robust recruitment system in place to ensure that people were supported by staff who were safely recruited.

People and relatives were complimentary about the care and support received. People and staff all told us that the registered manager was approachable and supportive and commented positively on the improvements made to the service since his arrival. The registered manager had worked hard to engage staff and bring them on board with his vision of the service. There was a positive and open culture and staff were enthusiastic about the improvements planned.

The registered manager had introduced a number of audits in order to assess the quality of care delivery. The audits covered all aspects of care delivery and provided the registered manager with the information required to enable him to identify any areas for improvement.

This inspection took place on 20 and 21 July 2016 and was unannounced. On the day of our inspection, there were 28 people living at the home.

We carried out an unannounced comprehensive inspection of this service on 1 September 2015 at which a breach of legal requirements was found. This was because people’s medicines were not always managed safely.

We carried out a further inspection on 7 March 2016 to look at how the provider had made improvements to their medicines management processes. At this inspection we found that although some improvements had been made, there still remained a number of areas outstanding.

Veronica House provides accommodation for up to 52 people who require nursing or personal care, for younger or older people, people with a learning disability or a physical disability.

Prior to our inspection, we were told that the registered manager had left 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.

On the day of the inspection we were shown round by the manager of the home’s sister home, who had stepped in to oversee the home whilst another manager was recruited into post.

People told us they felt safe in the home and were supported by staff who had been trained to recognise abuse.

People did not always receive their medicines as prescribed by their doctor. A number of concerns highlighted at previous inspections remained in place and had not been addressed.

A number of staff had been recruited without references being sought and management had failed to identify this as a concern.

Staff felt well trained to do their job, and were supported to attend specialist training. Not all staff benefitted from an induction process that equipped them with the skills to do their job.

Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards, but information relating to this was not reflected in people’s care records and where some people had the capacity to make their own decisions, this was not taken into account.

People were supported to have a nutritionally balanced diet and adequate fluids throughout the day.

Staff were concerned that information was not always communicated to them in a timely manner.

People benefitted from access to a number of healthcare services such as their GP, the dentist and physiotherapy services.

Most people told us staff were kind and caring but not all people agreed with this statement. People’s privacy and dignity was not always positively promoted.

A number of people told us they were not involved in the development of their care plan or asked how they wished to be supported. Care plans did not hold information regarding peoples likes, dislikes or preferences.

Activities were available but did not reflect the personal interests of the people living in the home.

People and staff had not been made aware and reassured regarding the recent management changes in the home. Audits that were in place did not fully reflect an accurate picture of what has happening in the home.

Staff were not confident that if they raised concerns regarding the running of the home, that they would be listened to.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

The inspection took place on 7 March 2016 and was unannounced. This was a follow up inspection in response to a breach in Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which took place on 1 and 2 September 2015. At this inspection, a number of concerns were raised with regard to the management of people's medicines. The provider had submitted an action plan in response to the concerns raised and at this inspection we examined the actions that the provider had put in place to determine whether the necessary improvements had been made. We found there were still a number of areas outstanding.

Veronica House provides accommodation for up to 52 people who require nursing or personal care, for younger or older people, people with a learning disability and or a physical disability.

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.

There was also a new manager in post, who had recently taken over responsibility for the running of the home and had submitted her application with CQC to become the registered manager.

Improvements had been made in relation to how medicines were managed and administered to people. However, the provider remained in breach of Regulation 12.

More improvements were required in relation to the management of out of stock medicines. When medicines have been administered, refused or omitted records must clearly record this information in order for staff to ensure medicines are given consistently and safely.

This inspection took place on 1 and 2 September 2015 and was unannounced. The inspection was carried out by two inspectors and a pharmacy inspector. The home was registered on 2 April 2014 and this was their first inspection.

Veronica House provides accommodation for up to 52 people who require nursing or personal care, for younger or older people, people with a learning disability and or a physical disability.

There was 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. On the day of the inspection the registered manager was on leave and we were shown round by the Clinical Lead.

People and their relatives told us that they felt safe in the home. Staff were aware of the risks to people living at the home but risk assessments were inconsistently reviewed and care plan paperwork was not always completed in a timely manner.

People did not always receive their medicines on time. People’s medical conditions were not always treated appropriately by the use of their medicines and there was a lack of written protocols to inform staff on how to prepare and administer particular medicines. We saw that some medicines were not being stored correctly which could render them ineffective.

Staff were concerned about being able to respond to people’s care needs in a timely manner due to staff sickness levels and the number of new people being admitted to the home.

Staff felt well trained to do their job and supported by the registered manager. Staff spoke positively about the training they received and the induction process.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and what this meant for people living at the home.

We saw that people were supported to have a nutritionally balanced diet and adequate fluids throughout the day and were offered a choice at meal times. A pictorial menu was being developed to assist people in making their choices.

Communication systems across the home were not consistently applied which meant people’s needs were not always effectively met.

People were supported to access a number of healthcare services such as their GP, the dentist and optician. However, this was not always applied consistently across the home.

People and their relatives told us that staff were kind and caring and helpful and treated them with dignity and respect. We saw instances where staff spoke warmly to people, using their preferred method of communication and offered reassurance when required.

People told us that they were not involved in their care plan and had not been asked how they wished to be supported. Activities were available but were not person centred and did not reflect the personal interests of people living in the home.

There was a procedure in place for staff to follow when investigating complaints, but it was not evident that this process had been followed.

People were not asked for their views of the service and the provider’s own quality audits had failed to identify a number of areas of concern that were highlighted during the inspection. This meant that issues which could affect people’s experience of the service were not being routinely identified and addressed.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.