Our inspection took place on 11 May 2017 and was unannounced. At our last inspection on 22 and 27 October 2015 we rated the service ‘requires improvement’ and identified four breaches of regulations. These related to the assessment of risks associated with people’s care and treatment, understanding of the Mental Capacity Act (MCA), lack of systems to ensure accidents and incidents were robustly investigated and people living with dementia not being offered the same choices as other people using the service. We asked the provider to submit an action plan to show how improvements in these areas would be made. At this inspection we found they had followed their action plan and were now meeting the requirements of these regulations.

Walton Manor is on the outskirts of Wakefield and is situated in well-kept, private grounds. The home provides personal care and support for up to 47 older people, some of whom are living with dementia. There were 32 people using the service when we inspected.

There was a registered manager in post on the day of our inspection. 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 had been a change in registered manager since our last inspection.

People told us they felt safe living at Walton Manor. We found there were sufficient staff to provide safe care and support, and the provider ensured staff had guidance to follow to minimise any risks associated with people’s care and support needs.

Staff recruitment was safe, and staff we spoke with understood how to recognise potential abuse and their responsibility to report it.

We found the premises were well maintained, and regular servicing of equipment was up to date.

People received safe support with their medicines. Medicines were stored safely and securely, and we found record keeping was accurate.

Staff were provided with the training and on-going support required to remain effective in their roles. People told us they were confident in the staff’s ability to provide effective care and support, and we saw people had access to other health and social care professionals when this was needed.

People received appropriate support with decisions they could not make for themselves. 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

We received very good feedback about the caring nature of the staff and registered manager. We observed good practice throughout our inspection. For example, we saw people’s privacy and dignity was respected and found the home had a relaxed and sociable atmosphere.

People and their families were encouraged to participate in the writing of their care plans, and we saw these contained meaningful information staff could use to help build caring relationships with people.

Care needs were assessed before people started to use the service, and we saw care plans were regularly reviewed to ensure they reflected people’s up to date needs. There were plans in place to involve people and their families in this process.

People had access to a wide range of activities which they said they enjoyed. People who lived at Walton Manor were able to make suggestions for activities they wished to undertake. Several community and educational groups were also involved in providing activities for people.

There were policies and procedures in place to ensure complaints were responded to appropriately. People told us they knew how to make a complaint, and they and their relatives said they found the registered manager approachable.

We received good feedback about the registered manager. We saw they were a fa

People told us they could make decisions about their care and were treated with respect. One person said “I like my own space and they respect that.” and “I get help when I ask for it”

People told us that their dignity and privacy was respected when staff assisted them with personal care tasks. One person who used the service said, “The staff are very good.”

Several people who used the service told us many of the staff had worked at the home for a long time. They said staff knew them well and thought this contributed to the good standard of care. One person said, “I am very happy here” another said ”there are not a lot of rules here” and “I don’t have to worry, I can come and go as I please.”

People told us they would feel comfortable talking to their relative, staff or the manager if they wanted to discuss any issues or problems.

We spoke with a visiting professional who told us they had no concerns about the home. They described having a good working relationship with staff.

We spoke with one visitor. They praised the staff and were complimentary about the service people received.

Staff we spoke with said people were treated with respect and their privacy and dignity was upheld. One member of staff said, “People are treated as we would want to be treated.”

We saw staff received training on a range of topics. We were shown information that indicated the service were audited on a regular basis to make sure people’s needs were met and they remained safe.

People say they enjoy living in the home. One person said ‘ Moving into the home was the best thing they had ever done’. Another said the ‘staff are very good and nothing is too much trouble’. Another says the food is really very good indeed. Another says the food is better than good it is excellent and they have a choice of menu. One visiting General Practitioner says the care provided by the home is very good indeed. Two visiting District Nurses said they are always made to feel welcome and the care provided by the home is very good.

People say they like living in the home. One person said if they have any concerns they can speak to the manager who will sort things out.

One person said their ‘bedroom is very good’ and they ‘have everything they need’. People said the home is ‘always clean’ and ‘nice for when their visitors come to see them’.

One person said ‘moving into the home is the best thing they have ever done’. People living in the home were observed to be comfortable relaxing in a homely, well maintained and safe environment.

People say they like the people caring for them. One person said the carers are ‘brilliant’ and ‘very caring’. Another says ‘there is always someone there when you need them’. One person said they can go and talk to the manager whenever they want. A visiting District Nurse said the staff are always very helpful and accommodating.

People say they like the people caring for them and supporting them. One person said the “girls are wonderful) they are “always polite and caring”. Another says nothing is ever too much trouble for them. Two visiting District Nurses said the staff are very good and that they have very good working relationships with staff and the management team in the home.

A visiting General Practitioner said that the carers in the home are very good and meet peoples care needs.

People living in the home said the people caring for them and supporting them are very good. One person said they are always very polite and courteous and nothing is too much trouble for them.

One person said the ‘quality of the services is second to none’, The surroundings are ‘fantastic’ the ‘care is excellent’ and the food is ‘marvellous’. Another said after coming to the home it has ‘exceeded their expectations’. Another person said ‘it’s like living in a five star hotel’.

This inspection took place on 22 and 27 October 2015, it was an unannounced inspection and was in response to concerns about the service that had been made to the Care Quality Commission. The service was last inspected in October 2013 and was compliant with the regulations we inspected at the time.

Walton Manor is situated on the outskirts of Wakefield town centre. The home provides personal care and support to up to 47 older people some of whom are living with dementia.

There was a registered manager in place. 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.

People we spoke with told us they enjoyed living at the home. They felt safe and supported by staff that had the skills and knowledge to do their job.

Staff we spoke with told us they enjoyed working at the home. They felt supported and were able to develop their skills through supervision, annual appraisals. Staff were able to demonstrate to us how they would raise their concerns.

People who used the service felt there were enough staff to meet their needs safely and in a timely manner. People were given a choice of food and drinks and where required supported to eat their meals.

Medicines were administered safely by staff who had the training and skills to do so. Some people were able to take their own medicines and their medicines had been kept safe in locked cabinet in their rooms.

Care plans were person centred but did not contain details of how people were to be supported to meet their needs. Risk assessments were very general and did not contain sufficient detail to reduce or eliminate the risk of harm.

Staff did not have a full understanding of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards.

The registered manager carried out regular quality assurance audits and carried out monthly feedback sessions with people who used the service.

The registered manager was not referring incidents to the local safeguarding authority and the Care Quality Commission.

We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered manager was not notifying the local safeguarding authority and the Care Quality Commission of incidents that had occurred within the home.

You can see what action we have told the provider to take at the end of this report.