The inspection visit took place on 03 November 2017 and was unannounced.

Albert House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate 29 people across two separate units, each of which has separate adapted facilities. One of the units specialises in providing care to people living with dementia. At the time of the visit there were 28 people who lived at the home.

At the last inspection in October 2016 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was available at 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.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service. Our observations and discussions with staff and relatives of people who stayed at the service confirmed sufficient staff were on duty. Before the inspection we had received concerns about insufficient staffing levels at the home. We found the provider was in the process of recruiting an additional member of care staff in response to the concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care.

Risk assessments had been developed to minimise the potential risk of harm to people who stayed at the service. These had been kept under review and were relevant to the care and support people required. Additional measures had been taken to minimise risks in response to serious incidents that had occurred in the home.

We found improvements were required to demonstrate how staff observed people after falls and documentation and to ensure people at risk of choking were adequately monitored. There was no business contingency plan which would provide staff with guidance on dealing with unplanned events and emergencies in the home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who stayed at the service were all positive about the quality of meals provided. One person said, “The food here is the best.”

We found people had access to healthcare professionals and their healthcare needs were met.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of Albert House. These included external audits, regular internal audits of the service, surveys and staff and relatives meetings to seek the views of people about the quality of care being provided.

The inspection visit took place on 03 November 2017 and was unannounced.

Albert House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate 29 people across two separate units, each of which has separate adapted facilities. One of the units specialises in providing care to people living with dementia. At the time of the visit there were 28 people who lived at the home.

At the last inspection in October 2016 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was available at 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.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service. Our observations and discussions with staff and relatives of people who stayed at the service confirmed sufficient staff were on duty. Before the inspection we had received concerns about insufficient staffing levels at the home. We found the provider was in the process of recruiting an additional member of care staff in response to the concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care.

Risk assessments had been developed to minimise the potential risk of harm to people who stayed at the service. These had been kept under review and were relevant to the care and support people required. Additional measures had been taken to minimise risks in response to serious incidents that had occurred in the home.

We found improvements were required to demonstrate how staff observed people after falls and documentation and to ensure people at risk of choking were adequately monitored. There was no business contingency plan which would provide staff with guidance on dealing with unplanned events and emergencies in the home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who stayed at the service were all positive about the quality of meals provided. One person said, “The food here is the best.”

We found people had access to healthcare professionals and their healthcare needs were met.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of Albert House. These included external audits, regular internal audits of the service, surveys and staff and relatives meetings to seek the views of people about the quality of care being provided.

We did not talk to people living in the home (residents) as the purpose of the visit was to check if the records of people's care needs, and the records of staff recruitment and induction training, had been sufficiently improved to comply with the regulation. Due to shortfalls in written information about these matters Albert House was found to be non compliant with regulation 20, outcome 21 Records at the last inspection in October 2013. We received an action plan from the provider telling us how and when the home would be compliant.

At this inspection in January 2014 we looked at the relevant records and discussed them, and the progress made, with the manager. We found the records in question had been sufficiently improved to ensure compliance with the regulation. For all residents the written assessments of their needs and their care plans had been reviewed and updated and included more information about how staff needed to look after them. This included written assessments of the risks associated with some aspects of care, including the risks of developing pressure sores and the risks associated with poor nutrition. This should help staff look after people safely.

We also found that staff records had been improved. Information about people's previous qualifications had been collected and recorded. There were also records of the induction completed by new members of staff. These records helped to demonstrate staff were suitable for employment.

We spoke with ten people living in the home (residents) and four relatives, two members of staff and the manager. We also undertook a 'structured observation' in the dementia unit .

All the residents said they were treated with respect and their right to privacy and dignity was upheld. One resident said, "Carers always speak politely to me and knock on my door in the morning". Another said, "The staff are all polite here; they do respect you".

Some people recalled speaking to staff about the care and support they needed. One person said, "I know as much as I need to know". However most people did not know they had a 'care plan' and there was no evidence that people had agreed to the information written down about their care needs.

Everyone we spoke with, including relatives, were complimentary about the home and the staff. They made the following comments: "I'm a happy lady; I get very good care", "I think the staff are very good with me; they know what I like to do", "This is a good home. It was recommended by a friend and I can see why". However we saw the written information about people's care needs should be improved, including recording more information about dementia related needs.

There was sufficient equipment to help people with mobility problems, including in the bathrooms and toilets. The equipment was appropriately maintained.

We saw staff recruitment processes needed to be improved to help ensure residents were protected from unsuitable staff.

We carried out this inspection because at the last inspection in September 2012 we judged Albert House to be non compliant with Regulation 17, Outcome 1, Respecting and involving people who use services. We had concerns that people in the dementia unit were not always supported in a manner which showed them respect and upheld their dignity.

At our recent inspection in March 2013 we spoke with some people living in the home (residents), four members of staff including the deputy manager, and spent time observing some aspects of support given to people in the dementia unit. Staff informed us there had been an improvement in the care and support practices for people with dementia. They had undertaken training since the last inspection and had a better understanding of the needs of people with dementia and how to support them. Staff spoken with also told us there had been changes to the staff team working in the dementia unit that had resulted in more people working there with the right skills and interests.

We observed residents being supported with patience and kindness. The staff on duty at the time of our visit spoke respectfully to residents and explained to them what they were doing, such as being assisted to the dining room. We also saw staff assisting people with their meal in an appropriate manner. They did not rush and interacted with the residents in a pleasant and respectful way. Residents we spoke with told us staff treated them properly and were kind.

People living in the home we spoke with who could give their views told us they were well looked after. One person thought it was the best home in the area but that, "It wasn't like being at home". People in general felt they were treated with respect and cared for in a way that protected their dignity, though one person said, "Some are better than others". Another person said, "The carers are marvellous" and, "They have a very good laundry system here". However we observed some practices in the dementia unit which did not show respect for people or uphold their dignity. These were discussed fully with the manager on the day of the visit.

People also felt they had sufficient choices in their daily routines. They told us they could get up and go to bed when they wanted, spend as much time in their room as they preferred and had a good choice of meals. They told us there were some activities such as games, exercises and the occasional trip out. People we spoke with had no complaints and no concerns about the way they were treated.

Staff we spoke with also told us they enjoyed working in the home, and felt supported with suitable training opportunities.

People told us they were happy for care workers to administer their medicines. One person we spoke with had chosen to self-administer one of their medicines. They told us that they had everything they needed and were happy with how staff supported them.

People living in Albert House told us that they were happy living in the home. One person said that "i wouldn't want to live anywhere else". They told us that the staff were caring and attentive and that they always got the attention they needed and there were enough staff on duty. We were told that staff treated people with repsect and that their rights to privacy, independence and dignity were upheld.

One person told us that they had been able to view the home and their bedroom before moving in and also that they had agreed with staff what their care and support needs were . People were satisfied with the food served and the choices they could make in other aspects of the routines such as getting up and going to bed. People were able to go out in to the town of Colne either on their own or with staff.