This inspection took place on 8 March 2017 and was unannounced. Cartlidge house is registered to provide accommodation for people who require nursing or personal care. At the time of our inspection there were 53 people living at the service. Most people required support due to living with dementia. Some people were there to receive short term support to regain skills to help them maintain their independence.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People were protected from harm. Staff understand how to safeguard people and manage risks effectively. People received support from sufficient staff that have been recruited safely. People have support from staff to safely administer medicines as prescribed.

People are supported by staff that understand their needs. Staff are knowledgeable and have regular updates to training. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People have a good choice of food and drinks have access to support to maintain their health and wellbeing.

People told us staff were caring and they had positive relationships with staff. People are involved in all aspects of their care and are encouraged to maintain their independence. People’s privacy and dignity was maintained by staff.

People were supported by staff that understood their needs and preferences. People were able to spend time doing things they enjoyed and were supported by staff to take part in activities. People understood how to make a complaint and we could see complaints were used to improve the quality of the service people received.

People told us the service was well led and they felt able to engage with the management team. Staff told us they could access support from the management team. We saw the provider had systems in place to ensure people received a good quality service.

This inspection took place 17 February 2015 and was unannounced.

Cartlidge House is registered to provide accommodation with nursing and personal care for a maximum of 54 people. On the day of our inspection 53 people were living at the home.

The home had a registered manager in post who was present for our 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.

People told us they felt safe living at home. Staff knew how to protect people and report incidents of concern.

People's medicines were managed safely and staff followed the organisation's guidance in administration, storage and disposal of people's medicines.

People were supported by sufficient staff numbers and by staff who received appropriate training support and supervision. There was a recruitment procedure in place which was followed. This ensured staff were appropriately checked before they started work at the home.

The registered manager and staff were familiar with their role in relation to MCA and DoLS and to follow published guidance where people do not have the capacity to make their own decisions.

A menu was produced which provide a range of choices. The home catered for special diets.

Health care professionals were accessed for people when they needed them.

People were supported to maintain independence and control over their lives by staff who treated them with dignity and respect.

A variety of social activities were available for people to choose from.

The Registered provider had a complaints policy which was available to everyone. Complaints were managed well and in line with the policy.

Systems were in place to regularly audit the quality of the service and the registered manager acted where audits identified improvements were required.

Not all the people we met were able to speak with us about the care they received and their experience of living in the home. Therefore we observed how staff interacted and supported people. This helped us to make a judgement on how their needs were being met.

People who used the service and their representatives told us they were happy with the care and support they received.

The care plans we sampled were disorganised and were not easy to get an overall picture of how staff should meet people's needs. The manager told us care plans were in the process of being changed and would be much clearer than existing care plans. People who used the service and their representatives told us they were able to contribute to their monthly reviews. We saw evidence of this.

People were protected from the risks of inadequate nutrition and dehydration.

There were suitable arrangements in place which ensured the safe management of medicines.

There was a robust recruitment procedure in place to ensure people were protected. This meant that only people who were fit to work in health and social care were appointed.

People were cared for by, suitably qualified, skilled and experienced staff. People told us their needs were met and staff were, “Kind and Caring”. The manager agreed to review staffing arrangements on Tree Tops and Rosewood at busy times of the day to ensure people's health, safety and welfare was maintained.

We issued a compliance action about record keeping in February 2011. The provider told us of improvements and we visited to carry out a routine inspection. We added two outcomes in response to issues we noted and good examples found.

We spoke with 11 out of 54 people who used the service and one visitor, and observed staff interaction with other people in the four units. We spoke with five staff and two managers. We looked at two people's care records and medication records for other people, records about staff and the running of the home.

People were complimentary about the way staff supported them to maintain their dignity. We were told, "the staff are very kind”; “everybody’s happy.” Most people liked the food, the lively and homely atmosphere and said there were enough activities and worship to take part in. Consent was sought or best interest care decisions were made with people’s representatives and professionals. Medication and falls risks had been reviewed with health professionals in line with national best practice. The home was clean and people's health was protected by high standards of hygiene.

Staff and managers felt well supported and had professional development for their roles. There were no complaints, however events that mattered to people could be monitored through the complaints process. There were robust systems to maintain quality, health and safety. Record-keeping had improved and the provider regularly monitored compliance.

Three people staying in the respite unit were very positive about their experiences of being at Cartlidge House. Their comments included, “staff are very kind”, “the food is lovely” and “I’ve got no complaints”. They told us that they were always asked what they would like to eat and alternatives to the menu were always available. People said that they were given a cup of tea when they wake up and are able to get up and go to bed at times to suit themselves.

Two visitors to the home were very pleased with the care their relative received but also commented that at weekends the home appeared short of carers as they had to leave the units to work in the laundry.

One person told us that they “liked living here” and that staff were “very good, they look after me”. They also told us that their family was made welcome when they visited and could come at times to suit them.

One person told us that “it’s very good here” and that staff “do everything for me”.

One person told us that there were activities going on if people wanted to join in, including the opportunity to go on trips out of the home.