We inspected the service on 10 January 2019 and the inspection was unannounced.

Claremont Care Home is a care home. People in care homes receive accommodation and nursing or personal care as a 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.

Claremont Care Home is registered to provide accommodation and personal care for 17 older people and people who live with dementia. There were 16 people living in the service at the time of our inspection visit.

The service was run by a company who was the registered provider. The company was owned by a single director who was also the registered manager. 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. In this report when we speak about both the registered provider and the registered manager, we refer to them as being, the ‘registered persons’.

At the last comprehensive inspection on 6 April 2016 the overall rating of the service was, 'Good'. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found that the service remained, 'Good'.

People were safeguarded from situations in which they may be at risk of experiencing abuse. Risks to people's safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. Medicines were managed safely. There were enough care staff to provide people with the care they needed. Background checks had been completed before new care staff had been appointed. Suitable steps had been taken to prevent and control infection. Lessons had been learned when things had gone wrong.

Care was delivered in a way that promoted positive outcomes for people. Care staff had the knowledge and skills they needed to provide support in line with legislation and guidance. This included providing reassurance to people who lived with dementia if they became distressed. People were supported to eat and drink enough to have a balanced diet. Suitable steps had been taken to ensure that people received coordinated care when they used or moved between different services. The accommodation was designed, adapted and decorated to meet people’s needs.

People had been supported to live healthier lives by having suitable access to healthcare services. People were supported to have maximum choice and control of their lives. People only received lawful care that was the least restrictive possible. Policies and systems in the service supported this practice.

People were treated with kindness, respect and compassion. They were also supported to express their views about things that were important to them. This included them having access to lay advocates if necessary. Confidential information was kept private.

People received personalised care that promoted their independence. Information had been presented to them in an accessible way so that they could make and review decisions about the care they received. People were supported to pursue their hobbies and interests. The registered manager and care staff promoted equality and diversity. There were arrangements to ensure that people's complaints were resolved so that problems could be put right to improve the quality of care. Suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

Th

This inspection took place on 06 April 2016 and was unannounced.

Claremont Care Home is a privately owned care home providing personal care and support to up to 17 older people most of who were living with dementia. At the time of the inspection there were 16 people living at the service.

The service is run by a registered manager who is also the registered provider and who was present during 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. The registered manager was supported by two deputy managers.

People told us that they felt happy and safe living at the service. Staff knew how to protect people from the risk of abuse and the action they needed to take to keep people safe. Staff were confident to whistle blow to the registered manager or other organisations if they had any concerns and were confident that the appropriate action would be taken.

Risks to people’s safety were identified, assessed and managed. Risk assessments recorded people’s specific needs, and how risks could be minimised. People received their medicines safely and when they needed them. Accidents and incidents were recorded, analysed and discussed with staff to reduce the risks of them happening again.

Recruitment processes were in place to check that staff were of good character. There was a training programme in place to make sure staff had the skills and knowledge to carry out their roles effectively. Refresher training was provided regularly. People were consistently supported by sufficient numbers of staff who had worked at Claremont Care Home for a long time and knew people well.

People were supported to have a healthy diet. Choices of meals were displayed in the dining room and pictures were used to support people in making their dining choices. Their dietary needs were monitored and appropriate referrals to health care professionals, such as dieticians, were made when required. People were supported to maintain good health.

People received their care in the way that they preferred. Care plans contained information and guidance so staff knew how to provide people’s care and support. Staff were familiar with people’s life stories and were knowledgeable about people’s likes, dislikes, preferences and care needs.

People and their relatives were involved with the planning of their care. Care and support was planned and delivered in line with people’s individual care needs. People spoke positively about staff and told us they were and caring and kind. One person commented, “Staff are really helpful. They get shopping for me on their way into work”. Privacy was respected and people were able to make choices about their day to day lives. Staff were compassionate, respectful and caring when they were supporting people.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. Applications for DoLS had been made in line with guidance and were kept under review.

People were involved in activities they enjoyed. Relatives told us they were able to visit when they wanted to. One relative said “I regularly visit at different times and am always made to feel welcome” and another commented “They make me feel welcome and offer me a drink”. People, their

We spoke with most of the people who use the service, the provider, visiting relatives and to staff members. Everyone we spoke with said that they were very happy with the service provided at Claremont Care Home. One person said “The staff are very helpful, I feel right at home here.”

People told us that they felt safe and well looked after. One person said “The staff are very good with me, very attentive.” A visiting relative said “I have no complaints, we are happy with the home.” Everyone we spoke with said they had no complaints about the service.

People said that they were happy with their bedrooms and facilities. People told us that the food was very good and said “There is always a choice and the food is freshly cooked.”

People’s health and personal care needs were supported and the service worked closely with health and social care professionals to maintain and improve people’s health and well being.

Checks were made on staff, as part of the recruitment process, to make sure that people were safe and supported by appropriate staff. There were suitable arrangements in place to ensure the service was properly managed.

We spoke with some visiting relatives. They said that they were happy with the service. One relative said “We think it is a very good home. It is clean and there is no unpleasant smell. We are very pleased with it.” Another relative said “Overall, we are very impressed.”

When we arrived people were finishing their breakfast and some people were watching television in the lounge. People looked comfortable and the atmosphere was relaxed so that no one was rushed.

The provider had taken action to address the shortfalls we previously identified. The provider sent us a detailed improvement plan covering all the shortfalls. Care records including risk assessments had been audited and updated. Some care records had been re written so that they were clear, accurate and up to date.

Staff had been trained in safeguarding vulnerable adults from abuse and were able to tell us about different types of abuse and what they would do if they had any concerns. This corresponded to the home’s own policy and procedure showing that staff were aware of the content of these important documents.

The provider had recruited a full time manager to make sure that there was a manager to oversee the running of the home in his absence.

People’s privacy, dignity and independence were respected. The provider had made some changes, including staff training, to ensure that people were treated with respect and their dignity maintained. The service had complied with the warning notice served after our last visit and was compliant in this area.

Staff noticed when a person became anxious and upset. They suggested that they went for a walk with them which distracted the person and they calmed down. People said “The staff are very good and kind” and “The manager is nice, he seems concerned about us and always comes round to talk to us” and “(The deputy manager) is wonderful. She is excellent.”

People’s privacy, dignity and independence were not respected. People were not always spoken to with respect and their privacy was not protected and promoted.

People we spoke to told us that they were happy at the home. However, due to inaccurate out of date records their care and treatment was at risk of being compromised. This placed people at risk of inconsistent and inappropriate care.

Staff were not aware of how to respond to abuse placing people at risk of unreported abuse. Medication was handled safely.

People at the home told us that the care was “reasonably good”, and that the staff “were very kind, and put themselves out for people”. One person also told us that “if there’s something I can’t do, the staff will be able to help me out”. Another person told us “I’m very happy here”.