Camelot Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Camelot Rest Home provides personal care for up to 39 people, some of whom are living with dementia. At the time of the inspection 35 people lived in the service.

The inspection visit took place on 27 November 2018 and was unannounced.

There was a registered manager in post who was there at the time of the 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.

At our last inspection we rated the service good. At this inspection we found evidence that led the key questions of Effective and Well Led to be rated as Requires Improvement. This meant that the rating at this inspection was overall Requires Improvement.

Audits did not adequately identify all areas of concerns. Consistent monitoring was not in place to mitigate risks.

Not all staff received an adequate level of training. Equipment was not always utilised in the safest way possible, for instance slings for hoists were not individual to the user.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People were assisted to access appropriate healthcare support and received an adequate diet and hydration.

People continued to receive care that made them feel safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and guidance about how to manage these was available for staff to refer to/follow. Safe recruitment of staff was carried out and adequate numbers of staff were available to people. People received medicines as prescribed.

People continued to receive care from staff which was kind and caring. People were supported to express their views and be involved as much as possible in making decisions. People’s needs were recognised and staff enabled people to access activities should they so wish.

People continued to receive a responsive service. The provider had systems in place to regularly review people’s care provision, with their involvement. People’s care was personalised and care plans contained information about the person, their needs, choices and cultural needs. Care staff knew people’s needs and respected them. People spoke openly with staff and understood how to make a complaint.

People and staff were positive about the leadership skills of the registered manager. We were provided with information we expected to receive.

Camelot Rest Home is registered to provide accommodation and personal care for up to 33 people, who are mainly older people with dementia. At the time of our inspection 29 people were using the service. Our inspection was unannounced and took place on 22 June 2016. The service was last inspected on the 12 December 2013 where the provider was found to be meeting all of the required standards.

The manager was registered with us as is required by law. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Medicines were given appropriately and the recording of their administration was clear and concise. They were kept and disposed of as they should be. People’s long term health needs were addressed and people saw medical professionals when they needed to. People received adequate food and drink.

There were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People felt safe and they were able to raise any concerns they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and their consent was sought before any care was carried out. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People, their relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision, allowing staff to understand their roles, and responsibilities were in place. Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs were effective. Quality assurance audits were undertaken regularly and the provider gave the registered manager support.

Notifications were sent to us as required, so that we could be aware of how any incidents had been responded to.

This was the home's first inspection since the new owners took over in June 2012. We spoke with seven of the 27 people living there, the registered manager, deputy, three care staff, two visiting relatives and two health care professionals. Not everyone was able to share their views about the home verbally, so we went spent time observing how staff provided their care.

People had been involved in making decisions about their own care and we saw staff offered people choices about all aspects of their care throughout the day. One person said, "The staff asks me first before they help because there are things I do for myself”.

People's care plans showed how their health and care needs were met. These were detailed and included their personal routines. One person said, ”I am very happy here and more so because I still have control over some of my needs”.

Arrangements were in place to ensure that people were protected from harm by ensuring staff were suitably trained.

The facilities had been extended and improved. People told us they were comfortable and we saw the environment was clean, warm and safe.

Staff were supported in their care role by regular training opportunities and meetings with a manager in which to reflect on their practice. One staff told us, "We have a great team, no staff turnover and a great manager”.

Systems were in place to regularly monitor the quality of the service. This included seeking the views of people using the service, their relatives and external stakeholders which were positive.