Edge Hill is a 'care home'. People in care homes receive accommodation and 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. Edge Hill is a detached building situated approximately one mile from Oldham Town Centre and is surrounded by a large garden. There is a small car park to the rear of the property. It provides accommodation for up to 36 people. At the time of our inspection there were 26 people living at the home.

The service had a 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.

At our last inspection in June 2017 we rated the service ‘requires improvement’ overall, although we did not find any breaches of the Health and Social Care Act 2008. However, because the service had previously been in ‘special measures’ (because it had been rated ‘inadequate’ overall) we could not rate it as good until we could be sure it could adequately sustain the improvements it had made.

At this inspection we found the service had sustained its improvements and we have therefore rated it ‘good’ overall.

There were systems in place to help safeguard people from abuse. Staff understood what action they should take to protect vulnerable people in their care. Recruitment checks had been carried out on all staff to ensure they were suitable to work in a care setting with vulnerable people. At the time of our inspection there were sufficient staff to respond to the needs of people promptly.

The home was well maintained and attractively decorated and was free from any unpleasant odours. Staff used appropriate personal protective equipment (PPE), such as disposable aprons and gloves when carrying out personal care tasks. This protected people from the risk of cross infection. Maintenance checks on services and equipment were up-to-date.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

New staff received an induction to provide them with the skills to care for people. Regular face-to-face training was provided to ensure all staff updated their mandatory training annually. Staff received regular supervision and an annual appraisal. This gave staff the opportunity to discuss their work and training needs and for management to check staff remained competent.

Staff encouraged people to make choices where they were able. People’s independence was encouraged and promoted. The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

People who used the service were complimentary about the staff. We observed kind and caring interactions between staff and people who used the service. Care plans, which were reviewed regularly, were detailed and reflected the needs of each person.

We received mixed views about the quality of the food. Some people felt there was not sufficient choice or variety, while other people were happy with it.

People's day to day health needs were met by the staff and the service had good relationships with external healthcare professionals. A range of activities were provided.

Audits and quality checks were undertaken on a monthly basis and any issues or concerns addressed with appropriate actions.

This inspection was carried out on the 25 and 26 April 2017. Our visit on the 25 April 2017 was unannounced.

Edge Hill Residential Care Home provides care and support for up to 36 people. At the time of our inspection there were 16 people living at the home. It is a detached building situated approximately one mile from Oldham Town Centre and is surrounded by a large garden. There is a small car park to the rear of the property.

The home had a 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.

At the last inspection on the 24 and 25 November 2016 we rated the service as ‘Inadequate' which meant it was placed in ‘special measures.’ At that inspection we identified five regulatory breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. These were in relation to unsafe moving and handling practices, poor infection control, poor food hygiene practices, inadequate staffing levels, poor training, failure to work within the principles of the Mental Capacity Act 2005, poor record keeping, failure to handle complaints correctly and poor governance. We also made three recommendations. These were in relation to dignity and privacy, activities and staff handover meetings.

Following the inspection the provider sent us an action plan detailing how the identified breaches would be addressed. This inspection was to check improvements had been made and to review the ratings.

At this inspection we found significant improvements had been made and the provider was compliant with all the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. The service is therefore no longer in ‘special measures’. We have made one recommendation. This is in relation to Deprivation of Liberty Safeguards.

The home was well maintained and attractively decorated and was free from any unpleasant odours. Environmental checks of the home, such as for the gas and electricity supply were up-to-date. We identified a ladder propping open a door which was a risk to peoples’ safety. It was removed immediately. Work was underway to improve the garden environment.

Medicines were stored safely and were administered by staff who had received appropriate training and been assessed as competent to safely administer medicines.

We identified that a person had bed-rails in place without a robust assessment having been undertaken to ensure that this was safe. The registered manager to the appropriate steps to rectify this situation by referring them to the district nursing service for an equipment assessment.

Staff had a good understanding of the procedures needed to keep people safe and what action they should take in order to protect vulnerable people in their care. At the time of our inspection there were sufficient staff to respond to the needs of people promptly.

Staff had undertaken a variety of face-to-face training to ensure they had the skills and knowledge required for their roles. Staff supervision was undertaken regularly.

Two people who required Deprivation of Liberty Safeguards (DoLS) did not have these in place. Applications were submitted to the local authority during the course of our inspection.

People were complimentary about the caring nature of the staff and our observation of staff interactions with people during the inspection confirmed this. We saw that people were treated with dignity and respect.

A new documentation system had been introduced since our last inspection and we found the care plans were detailed and person-centred.

An activities co-ordinator had recently been employed at the home and we saw that there were a range of activities on offer.

The service had a complaints procedur

This was an unannounced inspection of Edge Hill Residential Care Home carried out on 24 and 25 November 2016. We last inspected the service in July 2015. At that inspection, we found the service was meeting all the regulations that we reviewed.

Edge Hill Residential Care Home provides care and support for up to 36 people. It is a detached building situated approximately one mile from Oldham Town Centre and is surrounded by a large garden. There is a small car park to the rear of the property. At the time of our inspection Oldham Metropolitan Borough Council (OMBC) had put in place a temporary suspension on new admissions to the home, following a number of concerns raised by different health and social care professionals about aspects of the care provided. These included concerns about poor moving and handling practices, lack of meaningful activities, out-of-date support plans and poor staffing levels.

The service had a registered manager 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 and associated Regulations about how the service is run.

We found five breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014, which were in relation to unsafe moving and handling practices, poor infection control, poor food hygiene practices, inadequate staffing levels, poor training, failure to work within the principles of the Mental Capacity Act 2005, poor record keeping, failure to handle complaints correctly and poor governance. We made three recommendations. These were in relation to dignity and privacy, activities and staff handover meetings. You can see what action we told the provider to take at the back of the full version of the report. We are currently considering our options in relation to enforcement and will update the section at the end of this report once any action has concluded.

During our inspection we observed some staff using incorrect and unsafe methods for moving and repositioning people despite receiving training in this topic. We found that moving and handling risk assessments and care plans were not up-to-date.

Infection prevention and control measures were not fully implemented in order to protect people from the risk of infection, although the registered manager had taken steps towards rectifying this by purchasing handwashing posters and foot operated waste bins to install in the bathrooms and toilets.

Food hygiene practices were not thorough as we found opened, uncovered and undated food had been left in the fridge, and fridge and freezer temperatures in the kitchen had not always been monitored. This meant there was a risk that contaminated food could be given to people who used the service.

There were not always sufficient staff to provide prompt care and support to people who used the service. On one occasion we saw that a person had to wait for forty minutes before there were staff available to assist them to change their position.

The management of medicines was carried out in a safe way and those staff with the responsibility to administer medicines had been trained to do so.

Arrangements were in place to safeguard people from harm and abuse. Recruitment processes were robust and protected people who used the service from the risk of unsuitable staff being employed to provide care and support to vulnerable people.

Staff had received training in a variety of subjects which enabled them to carry out their roles. However, although staff had received training in moving and handling we observed some staff supporting people to move in an unsafe way.

One member of staff who was in their induction period and should have been working under supervision told us that they had assisted a person with their meal without the appr