About the service: Chalcraft Hall is a residential care home that was providing personal care to18 people over the age of 65 at the time of the inspection. The home is registered for up to 20 older people living with dementia or frailty. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service: Quality assurance systems did not always identify issues in practice. Accidents and incidents were recorded. However, these records did not always show management oversight and action taken when trends in incidents were identified. This did not provide assurance that the registered manager had full oversight of accidents and incidents. This is an area of practice that needs to improve.

People were safe from the risk of abuse. One relative told us, “Mum is very safe here. She is very unsteady on her feet and has a frame to walk with. The staff seem to have eyes in the backs of their heads because they don’t miss a trick.” Specific risks to people had been assessed and were known by staff. The home was clean and people were protected from infection risks. Staffing levels met people’s needs and staff were suitable to work with people.

People received effective care from skilled, supported and knowledgeable staff. Staff had access to a range of training and development opportunities and worked well as a team and with other professionals to meet people’s needs. People were supported to maintain a balanced diet. People were given choice and control over their lives which promoted their independence.

People received kind and compassionate care. A relative told us, “They’re lovely. They’re just so caring and lovely with everybody.” People’s privacy and dignity were respected and their views listened to.

People received person centred care that was specific to their needs. People had access to a range of activities which enhanced their lives. There was a complaints procedure in place which was accessible to people. People were supported with compassionate end of life care.

People, staff and relatives spoke positively of the registered manager and their leadership. One person told us, “The manager is very nice. She is very kind and is always around.” There were a range of audits in place with the aim of driving the quality of the home and most were effective in this. People were supported to be engaged in the running of the home and their opinions were listened to.

Rating at last inspection: Requires Improvement. (The last inspection report was published on 16 January 2018). The overall rating has improved since the last inspection.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our reinspection schedule for those services rated Good.

We inspected Chalcraft Hall Care Home on 21 November 2017. Chalcraft Hall Care Home is registered to provide care to up to 20 people, some of whom were living with dementia. The service is arranged over two floors, with a lounge/dining area. There were 17 people living at the service during our inspection. This was the first time we have inspected this service.

There was a lack of effective leadership at the service. A registered manager was not 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 and associated Regulations about how the service is run.

People's individual needs were not routinely met by the adaptation of the premises.

There was a range of quality assurance systems to help ensure a good level of quality of care was maintained. However, these systems had not fully ensured that people received a consistent and good quality service that met individual need. Robust day to day management support was not available for staff.

Risks associated with the safety of the environment and equipment were not always identified and managed appropriately.

Although some staff spoke positively of the culture and how they all worked together as a team, feedback from other staff was mixed and indicated that there was a lack of support and a negative culture in the service.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. People were cared for in a clean, hygienic environment and infection control protocols were followed.

People were being supported to make decisions in their best interests. Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future.

People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Staff had a good understanding of equality, diversity and human rights. Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including the care of people with dementia and managing behaviour that may challenge others. Staff had received supervision meetings with their manager.

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. Health care was accessible for people and appointments were made for regular check-ups as needed.

People chose how to spend their day and they took part in activities. They enjoyed the activities, which included singing, films, exercises and themed events, such as reminiscence sessions and visits from external entertainers. People were also encouraged to stay in touch with their families and receive visitors.

People felt well looked after, supported and empowered to make their own decisions. We observed friendly and genuine relationships had developed between people and staff. Care plans described people’s preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible.

People were encouraged to express their views and had completed surveys. They also said they felt listened to and any concerns or issu