Denecroft Residential Care Home is a residential care home for 15 people living with a dementia.

At our last inspection we rated the service 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.

A registered manager was 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.

People we spoke to told us they were happy living at Denecroft Residential Care Home. They were all complimentary about the care they received, specifically the support they received from staff. Staff we spoke to were passionate about delivering high quality care and were supported and trained appropriately within their role.

People had choice in the food they received. The cook was passionate about the menu and explained they had the freedom to modify the menu to suit people’s needs and preferences.

There was no dedicated activities coordinator at the service, however staff described to us how they made activities part of everyday life. People also told us about events that had been arranged within the service, such as a yearly fate, and external visitors such as pet therapy, exercise groups and entertainer and singers.

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. Staff we spoke to were knowledgeable about the mental capacity act and described how they would always encourage people to make choices.

The registered manager had a thorough quality audit process which included regular audits, surveys and spot checks. We noted the system was designed to not only identify errors but also areas for improvement.

Further information is in the detailed findings below.

This was an unannounced inspection carried out on 11 March 2016.

We last inspected Denecroft Residential Care home in March 2014. At that inspection we found the service was meeting all the legal requirements in force at the time.

Denecroft provides accommodation and personal care for up to 13 people. Care is provided to older people, some of whom are living with dementia or dementia related conditions. Nursing care is not provided.

A registered manager was 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.’

People said they were safe and staff were kind and approachable. There were sufficient staff to support people. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Systems were in place for people to receive their medicines in a safe way. People had access to health care professionals to make sure they received appropriate care and treatment.

Denecroft was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Best interest decisions were made appropriately on behalf of people, when they were unable to give consent to their care and treatment. The environment was mostly well-maintained but some areas required attention to ensure they were designed to promote the orientation and independence of people who lived with dementia. We have made a recommendation with regard to this aspect of the environment.

Appropriate training, supervision and support were provided to staff to help them meet any specialist needs of people. Staff knew the people they were supporting well. Care was provided with kindness and people’s privacy and dignity were respected by Denecroft staff.

People received a varied diet. There were activities and entertainment available for people. A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. The provider undertook a range of audits to check on the quality of care provided.

Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

The registered manager identified above is no longer employed by the provider, and is therefore, not in day-to-day control of the home.

The provider had taken action to comply with the warning notice we set. During this visit we found people were protected from the risk of inappropriate care and treatment because accurate and suitable records were maintained.

The provider had taken action to comply with the compliance action we set concerning the planning and delivery of care and treatment to people who used the service. During this visit we found people’s care and treatment was planned and delivered in a way that protected them from the risks of unsafe and inappropriate care.

The provider had taken sufficient action to comply with the compliance action we set about making sure that where people lacked capacity, the relevant legislation was followed. During this visit we found action had been taken to assess people’s capacity to make decisions where this was relevant.

We found the provider had put in place suitable arrangements for the storage and administration of medicines. People's medicines were safely stored and administered, and staff had had their competency to administer medicines assessed and verified.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. We found the provider had taken steps to address concerns identified by the local fire service.

We found evidence, in the majority of records we looked at, that appropriate checks had been carried out before staff began working at the home.

We found the provider had not taken steps to comply with the Mental Capacity Act (2005) when staff at the home made a best interest decision on behalf of a person who used the service. We also found appropriate records had not been kept.

Care and treatment was not planned and delivered in a way that was intended to ensure people’s safety and welfare.

The provider failed to ensure people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.

We did not speak directly with people who lived in the home.

The people we saw / spoke with were able to express their wishes and choices freely. There was evidence, in plans of care, that people were involved in their care planning and reviews, and one example where a couple had moved in together in line with their expressed wishes not to be separated.

We had not intended to look at Outcome 20 before we carried out the inspection. However, during the course of our visit we identified the provider had failed to tell us about a number of notifiable incidents that had occurred within the home. This meant people who used the service were not protected from harm because the provider had failed to make sure important events affecting their welfare, were reported to the Care Quality Commission so that, where needed, action could be taken. We are writing to the provider separately about this matter.

The provider complied with the compliance action we set regarding the premises. We found improvements had been made to the premises. People who used the service, or others working at or visiting the home, were protected against the risks of unsafe or unsuitable premises.

The provider complied with the compliance action we set regarding the provision of effective supervision for the registered manager. The arrangements for making sure that people were cared for by staff who were supported to deliver care and treatment safely, and to an appropriate standard, were satisfactory.

We found the provider had made good progress in complying with the compliance action we set regarding some people’s personal records being inaccurate and not up-to-date. We have decided to re-issue the compliance action we set following the last inspection, in order to give the provider additional time to achieve compliance.