This inspection took place on 8 September 2016 and was unannounced.

Wheatlands is registered to provide accommodation with personal care to a maximum of 53 people. There were 36 people living at the home on the day of our inspection. Some people occupied double rooms which were used as single occupancy. Due to this the home was considered full when 46 people were accommodated there. People were cared for on two units, the Corris unit and the Ellis unit which predominantly provides care for people with dementia.

A registered manager was in post and was present during 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.

People felt safe living at Wheatlands and felt safe when staff supported them. Staff had received training in how to protect people from any abuse, discrimination and avoidable harm. They understood the action they would need to take if these occurred. Risks to people and the environment had been identified and assessed. Staff followed the plans which were in place and helped to reduce these risks.

Relationships between people, their relatives and staff were positive, caring and respectful with plenty of smiles and laughter. Everyone was relaxed and comfortable in each other’s company. People felt they mattered and felt listened to when expressing their choices and wishes.

People were supported and spoken with in a dignified and respectful manner. Staff showed warmth and affection when caring for people. Staff respected people’s privacy and encouraged their independence whilst keeping them safe. People were given the time they needed to understand, respond and communicate with others.

People were supported to be involved in conversations and interests that meant something to them. Staff encouraged and supported people to reminisce and identify how they wanted to spend their time. Staff knew the people they supported and what was important to them. People were cared for as an individual and staff responded to changes in people’s needs to make sure these were met.

People received the care and support they wanted and felt staff respected and knew their preferences in how they wanted their care delivered. Staff understood people's care needs and how to support them effectively. They were provided with training to ensure they had the skills and knowledge to effectively meet these needs.

People were involved in making decisions and giving consent to their own care. When people could not make their own decisions their rights were protected. Where decisions were made on people’s behalf these were made in their best interests.

Staff supported people to maintain a healthy balanced diet and supported them to make their own choices about what they wanted to eat and drink. People’s routine health needs were met and referrals were made quickly when people needed other healthcare support or staff were worried about a person’s health.

The provider had introduced a new programme to enhance dementia care. This had improved and enhanced the wellbeing of people who lived at the home.

People were happy with the care and support they received and gave positive comments about the staff and management at the home.

The culture at Wheatlands was positive, warm and friendly. People were involved in what happened at the home which included the recruitment of new staff. Staff were proud to work at the home and were passionate about delivering care that responded to people’s individual needs.

We visited the home on this occasion because we had received concerns about inadequate staffing levels at the home.

During our visit, we saw positive interactions between staff and people who lived at the home and people were treated with dignity and respect. Care was provided in a calm and relaxed manner.

The number of people living in the home, and consequently the dependency levels had recently reduced. This meant that staff felt able to meet the needs of the people currently living at the home.

We confirmed therefore that there were enough qualified, skilled and experienced staff to meet people’s needs. We did, however, find that previously there had been a problem with staffing levels when dependency levels were higher. The provider may wish to note that staffing levels were not always reviewed and increased to reflect people's changing needs. This meant that people were at increased risk of not receiving care that was safe and met their needs.

Not all the people we met were able to speak with us about the care they received and their experience of living in the home. Therefore we observed how staff interacted and supported people. This helped us to make a judgement on how their needs were being met.

Everyone we spoke with told us they were satisfied with their care. Care plans were well written, clear and contained detailed information about people’s individual needs. This meant staff understood how people preferred their care to be delivered.

People who used the service and their representatives were able to contribute to their reviews. People told us that they enjoyed the food and drink provided within the home. They said they were able to choose what they wanted to eat from the menu and where they preferred to eat a meal.

People were protected from the risk of infection because appropriate guidance had been followed.

There was a robust recruitment procedure in place to ensure people were protected. This meant that only people who were fit to work in health and social care were appointed.

Staffing levels on Ellis unit were not sufficient to meet the current needs of the people that lived in the unit. We discussed this with the regional operations manager who was present during our inspection. They acted promptly during our visit to increase the staffing levels.

We spoke with 16 of the 42 people who were living at the home. People shared positive experiences of the care and support they received. Comments included, “I have no complaints, I am very well looked after here. The staff are very helpful in every way.” “We are rarely left with nothing to do, there is a good spirit here and the staff are superb.”

People told us they visited the home before they moved in to make sure it was the right place for them. They told us they felt involved in the planning of their care and were able to choose what they wanted to do, for example activities, trips and their meals. People told us the staff respected their privacy and dignity.

People said they felt safe living at the home. One person commented, “The staff treat me well”. Staff told us they had received training in keeping people safe. They demonstrated an understanding of the different forms of abuse and knew the procedure to follow if they suspected abuse.

People told us they liked that staff were kind and caring. One person said, “The staff are lovely here.” Staff told us they had attended a range of training courses to equip them with the knowledge and skills to effectively carry out their duties.

People said they were satisfied with the service they received. We saw the provider had arrangements in place to seek the views of the people who used the services through residents’ meetings and satisfaction surveys.