We inspected Emm Lane Care Home on 14 June 2016 and the inspection was unannounced. At our previous inspection in April 2016 we found breaches in relation to the safe management of medicines and good governance. We issued requirement notices for the service to improve in these areas and a plan was sent to us by the provider detailing what actions were being taken. At this inspection we found improvements had been made and the service was no longer in breach of Regulations.

Emm Lane Care Home is a semi-detached period property providing care and accommodation for up to 14 adults with a mental illness. The accommodation is situated on three floors with two twin and ten single bedrooms. There are two lounges and a dining room/kitchen. The home is situated approximately three miles from Bradford city centre. On the day of our inspection there were 12 people living at the service.

At the time of our inspection the service was managed by a care manager. Due to the provider being registered as an individual, the service does not require a registered manager to be 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. We saw the provider had daily oversight into the running of the service.

People told us they felt safe in the home. Safeguarding procedures were in place which staff understood although we saw one incident where a safeguarding referral should have been made. However, we saw a number of other appropriate safeguarding referrals had been made and these had been investigated. Accidents and incidents were documented with actions and analysis.

Medicines were safely managed. PRN processes and appropriate storage were in place, medicines records were completed and medicines were administered in a calm and safe manner. However, information about decisions regarding covert medicines needed to be fully documented.

The provider had made improvements to the environment and the service was safely maintained, although further improvements were required to lighting in some areas.

Risks to people’s health and safety were assessed and risk assessments which were in place were understood by staff. People's care and support needs were regularly reviewed which ensured the service remained responsive to people's individual needs. People were involved in the planning and reviewing of their care.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

There were sufficient quantities of staff to ensure people were kept safe and had opportunities to participate in activities. Effective recruitment procedures were in place. Training was in place to ensure staff provided effective care and support.

People were supported to eat and drink and maintain a healthy lifestyle with dietary needs and preferences considered. People's health care needs were met.

People said staff treated them well and were kind and caring. They told us staff ensured their dignity and choices were respected. We saw positive relationships had developed between people and staff and the atmosphere in the home was calm and relaxed.

The service helped people maintain their independence by encouraging them to assist with daily life within the home and engaging with activities outside the service.

Complaints and concerns were taken seriously by the service, investigated and documented with outcomes. We saw these were mainly minor concerns but still treated in the same manner.

Staff told us they felt supported by management and we observed a positive culture at the service, with good staff morale. People told us they felt able to approach the care manager and provider with any c

The inspection took place on 18 April 2016 and was unannounced. The service was previously inspected on 20 March 2014 and was found to be meeting regulations.

The service provides personal care and accommodation for up to 14 adults with a mental health illness. At the time of inspection, there were 12 adults living at the service. Accommodation was provided over three floors with communal areas where people could spend time, as well as a large enclosed garden.

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.

People told us they felt safe in the home. Staff told us they felt confident people were safe and that they had not seen anything of concern whilst working in the home. Safeguarding procedures were in place which staff understood.

There were shortfalls in the medicine management systems which meant people were at risk of not receiving 'as required' medicines when they needed them. The storage arrangements for some medicines were not safe, and some medicine records were not always fully completed.

There were some concerns about the safe maintenance of the service with some areas being in a poor state of repair.

Risks to people’s health and safety were assessed and risk assessments which were in place were well understood by staff. People's care and support needs were regularly reviewed which ensured the service remained responsive to people's individual needs. People were involved in the planning and reviewing of their care.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

There were sufficient quantities of staff to ensure people were kept safe and had opportunities to participate in activities. Recruitment procedures were in place. However these needed to be more robust to ensure staff were of suitable character to care for vulnerable people.

Staff had access to a range of training to support people's care and felt they had access to personal development within the service.

People were appropriately supported to eat and drink and maintain a healthy lifestyle.

The service supported people to access a wide range of healthcare services to help ensure their healthcare needs were met.

The atmosphere in the service was relaxed. People said staff were caring and treated them well, with attention paid to maintaining people's dignity and respect. During observations, we saw people were treated with kindness and respect and that positive relationships had developed between people and staff.

The service helped people maintain their independence by encouraging them to assist with daily life within the home and engaging with activities outside the service.

Staff told us they felt supported by management in their roles and that staff morale was good.

Some systems were in place to monitor the quality of the service. However these were inconsistent, for instance the medicines audit had last been completed in 2012.

We found two breaches of the Health and Social Care Act (2008) Regulated Activities 2014 Regulations. You can see what action we asked the provider to take at the back of this report.

During our inspections of March and June 2013 we found the registered care provider was not fully compliant with the Essential Standards of Quality and Safety. The registered care provider wrote to us to tell us about the improvements they were making to enable them to become compliant. We carried out this inspection to see if they had taken action to become compliant with the standards.

We found that the necessary improvements had been made to ensure people received safe and effective care. We found staff were polite and respectful towards the people who used the service. We spoke with three people who used the service one person said "It's good here I'm happy I can go out when I want and have lunch with my social worker and go out shopping, they do encourage me here" and another said "I like it here". Another person we spoke with said "I like the food and it was a nice place to live".

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment.

We found the provider had taken sufficient steps to ensure the care, welfare and safety of individuals using the service due to accurate and appropriate records being maintained. All relevant records looked at were in date and stored in appropriate ways to protect peoples confidential information

During our inspection on 8 November 2012 we found the registered care provider was not fully compliant with the Essential Standards of Quality and Safety. The registered care provider wrote to us on the 28 March 2013 to tell us about the improvements they were making to enable them to become compliant. We carried out this inspection to see if they had taken action to becomecompliant with the standards.

We spoke with two people who used the service who said they liked it at Emm Lane and felt they were looked after okay. They told us the food was good and the staff were kind, helpful and supported them.

We found the provider had made improvements and increased the numbers of staff on duty on a daily basis. The provider had also upgraded the fire safety at Emm Lane.

We used a number of different methods to help us experience the needs of people who used the service.

People at the home commented they liked the home and staff were caring and friendly. We saw staff interacting with the people who used the service in a considerate way, but sometimes they failed to give time for people to respond, and moved on to do other things.

At the time of the inspection we spoke with three people who used the services. One person told us, "it's very good here I like having my own room, there is nothing I dislike I find the staff excellent." another said, "the staff are great, it's very good here."

The care records we reviewed showed that people or their relatives were involved in making care decisions. However care plans did not always reflect the needs of people living at the home.

The system in place for recruiting staff was not robust and placed people living at the home at risk. The staffing arrangements did not meet the needs of service users.

People using the services at the home commented that they liked the home and that staff are caring and friendly. People also commented that they felt safe.