We carried out an unannounced inspection of York House Care Home on the 6 September 2016. The service had previously been inspected in September 2013 when it was found to be fully compliant with the regulations.

The service had 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.

We spent time with people seeing how they spent their day and observing the care and support being provided. Most people were able to talk to us and reported that they were happy with the care and support they received. We saw people were treated with care and respect by the staff team who they approached for support without hesitation. People told us, “It’s not like your own home, but staff are lovely and kind” and “Some carers are better than others, but on the whole they are very supportive.” While people’s relatives said, “The carers are, I think excellent” and “I think [my relative] is very happy and well looked after.”

Staff knew people well and provided compassionate care and support throughout our inspection. People requested support from staff without hesitation and staff responded promptly to people request for support. We saw numerous examples of people and staff laughing and joking together and staff said, “We all have a good laugh.”

The service was short staffed during the morning of our inspection as a member of care staff had become ill and had been sent home and staff were noticeably busy. Staff told us it was unusual for the service to be short staffed and commented, “It’s normally four carers in the morning and four in the afternoon”, “It’s busy today” and “Today there are only three of us on, the fourth person does make a huge difference. Tomorrow there are five staff.” We reviewed the services staff rota and found that the service was normally staffed by four or five care staff during the day and confirmed that the reduced staffing level on the day of our inspection was unusual.

The service did not employ staff with specific responsibility for organising activities. During the morning of our inspection there was a noticeable lack of meaningful activities for people to engage with. In addition in the early afternoon we observed that staff were unable to support people to go outside when they wished. These issues may have been a result of unexpected staff shortages. However, people told us activities within the service were limited and staff told, “It is frustrating when you can’t respond immediately” and “In the afternoon between three and five they [staff] have more time to do things.” We have made a recommendation about the provision of meaningful activities.

Staff understood their role in safeguarding people from abuse and had completed appropriate training to ensure they were sufficiently skilled to meet people’s care and support needs. Staff told us, “We are all up to date with our training”. Staff recruitment processes were robust and designed to help ensure all new staff were suitable for work in the care sector. Once recruited staff received formal training and shadowed experienced staff before being permitted to provide care independently. In addition, staff new to the care sector completed six weeks of shadowing during which they were supported to complete the care certificate training designed to provide new staff with a good understanding of current best practice.

Records demonstrated staff had received regular supervision during which their performance was discussed and any additional training needs were identified. Staff told us, “I do feel supported” and “I’ve had supervisions, I raised some issues and they were dealt with straight away.” Staff handover meetings were held at each change of sh