This was an unannounced inspection which took place on 6 December 2016.

Wray Park Care Home is a residential care home for up to 24 older people. This includes people who are living with dementia. At the time of our inspection 12 people lived at the home. The building consists of three floors with bedrooms located on each. Communal areas include a large lounge and separate dining area.

During our inspection the registered manager (who is also the registered provider) was present. 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.

Wray Park Care Home was last inspected on 16 September 2015 when it was given an overall rating of ‘Requires Improvement.’ Four breaches of Regulations were identified and requirement notices were issued. These related to consent to care, safeguarding, staffing and quality assurance systems. At this inspection we found that the requirement notices were met and improvements had been made in all areas.

Quality monitoring systems had been reviewed and auditing systems implemented that helped to monitor the quality of service provided. They also ensured action was taken when areas for improvement were identified.

Staff had received safeguarding training and reporting procedures had been reviewed which offered greater protection to people. People said that they felt safe and we observed that they appeared happy and at ease in the presence of staff. Potential risks to people were assessed and information was available for staff which helped keep people safe.

People told us that there were enough staff on duty to support them at the times they wanted or needed and we observed this to be the case during our inspection. Robust recruitment checks were completed to ensure staff were safe to support people.

Systems for monitoring that staff were suitably trained and skilled had been reviewed and staff had received training relevant to the needs of people who lived at the home. Staff were fully supported and received group and one to one supervision.

People said that they consented to the care they received. Mental capacity assessments were completed for people and their capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise.

People said that they were happy with the medical care and attention they received. People’s health needs and medicines were managed effectively. People’s needs were assessed and care and treatment was planned and delivered to reflect their individual care plan.

People said that the food at the home was good and that their dietary needs were met. There were a variety of choices available to people at all mealtimes.

Equipment was available in sufficient quantities and used where needed to ensure that people were moved safely and staff were able to describe safe moving and handling techniques.

Information of what to do in the event of needing to make a complaint was displayed in the home. During our visit we observed staff assessing if people were happy as part of everyday routines that were taking place.

People said that they were treated with kindness and respect. We observed interactions by staff to people that were warm, positive, respectful and friendly whilst remaining professional. Staff routinely checked that people were happy with the support being offered. They Staff understood the importance of respecting people’s privacy and dignity and of promoting independence.

People said that they were happy with the choice of activities on offer and that they were supported to maintain links with people who were important to them. There had been an increase in the choice of activities people could participate in and people had m

Wray Park Care Home is a residential care home for up to 24 older people. This includes people who are living with the experience of dementia. At the time of our visit 13 people lived here.

Care and support are provided on three levels which includes rooms partially below ground at the base of the house. Communal areas include a large lounge and separate dining area.

The inspection took place on 16 September 2015 and was unannounced. At our previous inspection in October 2013 we had not identified any concerns at the home.

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.

Overall there was generally positive feedback about the home and caring nature of staff from people and their relatives. One person said, “They treat me well.” A relative said, “The staff are very friendly and sympathetic.” However people told us that sometimes their privacy was not respected, or that they could not always understand what staff said.

People were not always safe at Wray Park Care Home. There were insufficient staffing levels deployed to meet the needs and preferences of the people that live here. People who wanted to be up and about in the morning had to wait as staff were not available to help them. Staff were not always available when people at risk of falls were moving around, or when people asked for help. The rota that recorded the number of staff required to support people did not match with the actual staff deployed on the day of our inspection. Less staff were deployed than was recorded. During the course of the inspection additional staff came to the home from the provider’s other services. Not all staff understood their duty should they suspect abuse was taking place. The provider had not ensured that potential safeguarding incidents had been referred to the local authority for review.

Where people did not have the capacity to understand or consent to a decision the provider had not followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had not been completed. People told us that staff did ask their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

Quality assurance records were not kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all out of date. Accident and incident records were kept, but were not analysed and used to improve the care provided to people. Records of people’s involvement in their care planning was not clear.

People had enough to eat and drink, and received support from staff where a need had been identified. Specialist diets to meet medical or religious or cultural needs were provided. Some people commented negatively on the quality of the food. Pureed food had been blended together so people would not be able to taste the individual elements of the dish. People and staff told us that they had little input into the menu planning.

The staff were generally kind and caring and treated people with dignity and respect, but areas for improvement were identified. People’s personal care needs were not always noticed by staff, people’s privacy in their rooms was not always respected, and language used in some care plans was inappropriate and not respectful. Some good interactions were seen, such as holding people’s hands when sitting and talking with them.

Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People’s involvement in the review and generation of these plans had not been recorded. People did not always receive the care and support as detailed in their care plans, as staff were not always available to support them when they needed it.

People did not always have the opportunity to be involved in how the home was managed. People told us that residents meetings had not taken place for some time. The registered manager had arranged for a residents and relatives meeting in the autumn to address this.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received training to support the individual needs of people in a safe way, however records showed that staff were out of date in key areas such as first aid moving and handling, and dementia care.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines. People were supported to maintain good health as they have access to relevant healthcare professionals when they needed them.

People had access to activities that met their needs. Group activities were available to people during the week. Individualised activity plans were being further developed with people by the activities coordinator. Good use of technology was made to encourage people living with the experience of dementia to become involved in activities. The staff knew the people they cared for as individuals.

People knew how to make a complaint. Documents recorded that complaints had been responded to in accordance with the provider’s policy.

We identified five breaches of the regulations. You can see what action we told the provider to take at the back of the full version of this report.

People who used the service and their representatives were given appropriate information regarding the home to enable them to make an informed choice about living there.

People's needs were assessed and care and treatment was planned and delivered in line with individual care plans. People told us that they were fully involved in their care planning.

We saw evidence that people were able to express their views about their care and support needs and that they were as involved in making decisions about their care and treatment as they were able to do. At this inspection we looked at the care plans for five people. We saw that people’s needs were assessed and that in each record we looked at the person themselves had made comments about their needs or care.

Systems had been put in place which evidenced that people’s care plans were reviewed to ensure they were up to date. We found that care plans provided detailed information and guidance for staff to be able to meet people’s needs. Care plans included risk assessments based on the persons emotional, social and health needs.

People were protected by the safeguarding procedures in place and staff were knowledgeable about these procedures.

The staff told us they felt they had the appropriate training and support to enable them to undertake safeguarding and whistle blowing if necessary.

We saw people had access to the home's complaints procedure and they were confident their concerns and suggestions would be listened to and acted upon.

We did not speak with people who used the service on the day of inspection. However, staff that we spoke too were able to give us an overview of the training that was available, as well as providing us with sufficient evidence which summarised that staff were receiving appropriate training, professional development and regular supervisions and appraisals.

We were consistently told by people who used the service and their relatives that the staff were very caring, their comments included that they “were very kind” and were “treated very well.” One person told us “all in all I am very well looked after.”

However one person who used the service told us that “they could do more with activities.” One relative also told us that activities had “not been that good.”

Throughout our inspection we saw that staff approached people using the service in a respectful, supportive and accommodating manner.