The inspection took place on the 26 May and 1 June 2017 and was unannounced.

Bayith Rest Home is a family-owned residential care home for up to 12 people. At the time of our inspection the home was fully occupied. People were accommodated on two floors. Shared areas comprised a dining area, activities area and a lounge. There was an enclosed secure garden which was accessed from the rear of the property.

The home had 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.

The provider had whistleblowing and safeguarding policies and procedures in place. All staff had received safeguarding training to raise awareness of how to recognise signs of potential abuse and poor practice and what actions they would need to take. Staff told us they were confident they understood what might constitute abuse and how to report it.

The service operated safe recruitment practices to ensure staff were suitable for their role. People's needs were understood and met by sufficient numbers of skilled and experienced staff.

People were protected from the risk of harm. The provider assessed any identified risks to people and put measures in place to minimise them.

Staff had been inducted into the service and had received relevant training to enable them to support people effectively.

Medicines were stored and secured appropriately and safely administered.

People were encouraged to eat a varied diet that took account of their preferences and dietary needs. Where necessary, people were supported to eat. People were supported effectively with their health needs and had access to a range of healthcare professionals.

People were looked after by kind and caring staff who knew them well. They were supported to be involved in all aspects of their care. People were treated with dignity and respect.

People using the service and their relatives knew who to speak to if they wished to make a formal complaint or were unhappy with the care they had received.

People living at the home all thought that the home was well-led. They all spoke positively about the registered manager and staff group.

There were a number of quality audits in place to assist the registered manager in reviewing the delivery of care in the home.

On the day of our visit there were 11 people living at the home. We spoke with three people and a relative who said that they felt their loved one was “safe” at Bayith. “It is not ideal but it is the best situation in the circumstances I cannot imagine them being anywhere else”.

We carried out an inspection in May 2013 when we identified concerns with cleanliness and infection control. We made a compliance action asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care. The provider wrote to us and told us what action they were going to take and that they would be compliant by the end of May 2013.

We inspected on 21 June 2013 to review the progress the provider had made. We found that the provider had taken steps to improve cleanliness and infection control.

We spoke with three members of staff and the manager who told us about the changes which had recently occurred in the home regarding cleanliness and infection control. The staff told us about their induction and the training they had undertaken. They said they were able to speak openly with senior staff about any concerns. We observed staff being respectful, asking people if they needed support and only assisting when asked.

On the day we inspected there were 12 people living at the home. Most of the people living at Bayith had memory impairment and or a physical health disability. During our inspection we spoke with three staff and three people who use the service. The manager was not at the service on the day of the inspection however, they did call the home throughout the day to speak with us and clarify questions we had asked staff.

People we spoke with said that the staff “Are nice and helpful”. One said “Sometimes I have to wait for a while when I need help, they come eventually”.

Staff we spoke with told us that they were happy working at the home and that the registered manager was open and friendly. One member of staff had come in early to ensure their records such as care plans were up to date “My choice” they said.

We observed staff being respectful, offering people a choice of activities and asking them where they wanted to sit although many people had their favourite seats. We looked at care plans and how the provider ensured the environment and equipment were safe, clean and free from infection. We found that care plans addressed people’s needs. However, whilst the home was clean and tidy we had concerns about the lack of effective systems to reduce the risk and spread of infection.

We carried out an inspection in November 2011 as part of our routine schedule of planned reviews. We identified concerns with standards 4 care and welfare and 7 safeguarding. We made compliance actions asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care with regard to standards 4 and 7.

We carried out an inspection on 23 April 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had assessed them as non compliant.

We spoke with four staff, five people who use the service and three visitors. People told us that they were happy with the care and they liked the staff and the manager, two people said, ‘she always has time for a chat’. We observed interaction between staff and people at Bayith and the atmosphere was homely and relaxed.

Staff told us about the training they attended since our visit and the changes in the style of care plan records. They said they are supported by the management of the home and that they can speak with senior staff about any concerns they have about the running of the home.

During our visit we spoke with three people who live at the home, three visitors, three staff and the manager. We observed interactions between staff and people using the service in the dining area and lounges.

We observed lunch being served and how staff interacted with people and ensured they had a choice of meal. Visitors told us that they were happy with the care and that staff were very friendly, “ten out of ten”.

Staff told us that they received regular training, are supported by the management of the home and that they can speak with senior staff about any concerns they have about the running of the home.

This inspection took place on 1 and 2 December 2014 and was unannounced.

Bayith Rest Home is a small, family-owned residential care home for up to 12 people. At the time of our inspection the home was fully occupied. People were accommodated on two floors. Shared areas comprised a conservatory dining and activities area and a lounge. There was an enclosed garden which was accessed from the conservatory.

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.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider needed to make improvements in how they applied for authorisation under the DoLS to ensure people were protected against the risk of being unlawfully deprived of their liberty. The service was not meeting the requirements of the Mental Capacity Act 2005 and its associated Code of Practice as it did not have arrangements in place to establish, and act in accordance with, people’s best interests if they did not have capacity to consent to their care and support.

People were at risk of receiving care which was not effective because care plans did not contain all the necessary information. The deputy manager was reviewing all care plans at the time of our inspection.

People were very happy with the standard of care and support they received. One said, “You could search the length and breadth of Britain and you’d be hard pressed to find anywhere better.” Another person said, “It is like a family. I am very lucky.” People visiting their relations were also complimentary. One visitor told us their family member was “more than happy”.

People were kept safe because the service had arrangements in place to protect them from the risk of avoidable harm. There were sufficient numbers of staff to meet people’s needs. Suitable arrangements were in place for the safe management of medicines.

Staff were trained and supported to deliver care to the required standard. Meals were appetising and well presented, and staff checked people who were at risk of poor nutrition to ensure they ate and drank enough. People had access to healthcare services when they needed them for routine appointments or for treatment of individual conditions.

We saw there were caring and positive relationships between people and the staff who supported them. People were given the time and information they needed and were involved in decisions about their care. Staff took steps to maintain people’s dignity and privacy.

The registered manager and deputy manager communicated a philosophy of care which was focused on people as individuals. They were in the process of updating everybody’s care records to ensure this philosophy was carried through into practice. The care people received was responsive to their needs. Activities were available which reflected people’s interests and preferences.

We saw there was a culture of openness and transparency in which the managers’ values were communicated to staff. There was good management and leadership. Quality assurance processes were in place to maintain the standard of service.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the end of the full version of this report.