This was an unannounced inspection that took place on 7 March 2018.

Eskdale House is situated in the centre of Longtown and is near to all the amenities of this small town. It is operated by Cumbria County Council who run similar services across Cumbria.

Eskdale House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home accommodates 26 people in one purpose built building. The home has three separate units, each of which have separate adapted facilities but at the time of our visit only two units were routinely used as there were only 19 people in residence.

The home had a suitably qualified and experienced 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.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and could talk to us about how they would identify any issues and how they would report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been suitably vetted and that they were the right kind of people to work with vulnerable adults. Any accidents or incidents had been reported to the Care Quality Commission and suitable action taken to lessen the risk of further issues.

The registered manager and her senior team kept staffing rosters under review as people's dependency changed. We judged that there were suitable staffing levels in place by day. We asked the provider to ensure that the staffing levels at night reflected numbers and needs.

Staff were suitably inducted, trained and developed to give the best support possible. We met experienced and confident team members who understood people's needs.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary. The team made sure that strong medicines and any sedation were kept under review with the local GPs.

We saw that good assessment of need was in place and that the staff team analysed the outcomes of care for effectiveness.

People were very happy with the food provided and we saw well prepared meals that staff supported and encouraged people to eat.

Eskdale House is a purpose built home that was refurbished over twenty years ago and has been updated by the provider since then. The house was warm, clean and comfortable on the day we visited. Suitable equipment was in place to help people with things like mobility.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who lived in the home told us that the staff were extremely caring. We observed kind, patient and suitable care being provided. Staff knew people and their families very well. They made sure that confidentiality, privacy and dignity were maintained. People were encouraged to be as independent as possible. Staff were trained in end of life care and we saw evidence to show that this kind of care had been done to good effect for many years.

Risk assessments and care plans provided detailed and relevant guidance for staff in the home. People in the service were aware of their care plans and were able to influence the content. The management team had en

This unannounced inspection took place on 7 January 2016. We last inspected Eskdale House in October 2013. At that inspection we found the service was meeting all the regulations that we assessed.

Eskdale House is situated in a residential area of Longtown and is near to all the amenities of this small border town. The home is operated by Cumbria County Council and provides accommodation and personal care for up to 26 older people.

All the bedrooms are for single occupancy apart from one that could be used for two people if they wish to share.

Lounge and dining areas are on the ground floor with some bedrooms. The remaining bedrooms are situated on the first floor and are accessed by a passenger lift.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 living in Eskdale House told us they “felt safe and happy”. Relatives said they were pleased with the support and caring attitude of all the staff.

People were protected by staff who knew how to keep them safe and managed individual risks well. Staffing levels were appropriate during the day and the manager brought in extra night staff when necessary to meet the needs of those using the service and to promote their independence. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

We spent time with people in all areas of the home. We saw that the staff offered people assistance and took the time to speak to people and take up the opportunities they had to interact with them and offer reassurance if needed. People living there told us that care staff were mindful their privacy and treated them with respect. We saw that the staff approached people in a friendly and respectful way and people we spoke to who lived there told us that it was a “homely” and “comfortable” place to live.

The registered manager provided details of the staff training that evidenced staff training was up to date. Staff confirmed they received training appropriate to their roles within the staff team.

People had access to external health care services which ensured their health care needs were met. Staff had completed training in safe handling of medicines and the medicines administration records were up to date. People were provided with sufficient food and drink in order to maintain good levels of nutrition and hydration. People told us “We have a choice of meals and if there is anything we don’t like we can choose something else” and “The food is excellent and all home cooked”.

Medicines were being safely, administered and stored and we saw that accurate records were being kept of medicines received and disposed of so all of them could be accounted for.

We saw evidence that staff recruitment and selection was robust and guaranteed only suitable people were employed to care for and support people using this service.

There was an appropriate internal quality audit system in place to monitor the quality of the service provided.

People knew how they could complain about the service they received and information about this was displayed in the home. People we spoke to were confident that action would be taken in response to any concerns they raised. People told us they felt comfortable giving their views about the service and what they wanted in their home.