The inspection took place on 16 and 20 February 2018. The first day of the inspection was unannounced.

Falcons Rest and Poachers Cottage is a 'care home'. People in care homes receive accommodation and nursing or 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.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments. The site consists of two purpose-built houses, named Falcons Rest and Poachers Cottage respectively. At the time of our inspection visit, there were 12 people living at the home.

A registered manager was in post at the time of 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.

At our last comprehensive inspection of the service on 10 July 2017, we found breaches of Regulations 12 and 17 of the Health and Social Care 2008 Act (Regulated Activities) Regulations 2014. We gave the service an overall rating of Requires Improvement. These breaches related to the provider's failure to review staff training and competency in relation to the management of people’s medicines, and the effectiveness of the provider’s quality assurance. The provider sent us an action plan setting out the improvements they intended to make.

At this inspection, we found that, although the provider had made some improvements to the service, they remained in breach of Regulations 12 and 17. We were not assured staff consistently followed the provider’s procedures for the handling and administration of people’s medicines, or that the provider’s quality assurance was as effective as it needed to be.

Staff did not always make appropriate use of personal protective equipment to protect people from the risk of infection. The risks associated with people’s care and support needs had not always been fully assessed and recorded. Mental capacity assessments and best-interests decisions had not always been carried out in line with the requirements of the Mental Capacity Act. People’s care plans were individual to them, but had not always been kept under regular review. People had enough to eat and drink, but the information recorded in relation to associated risks was not always accurate. People’s relatives contributed to decision-making that affected their family members living at the home, but care review meetings had not been organised on a consistent basis.

Staff had been trained in, and understood, their individual responsibilities to protect people from abuse and discrimination. Staffing levels ensured people’s needs could be met safely. Staff received a structured induction and ongoing training, designed to help them work safely and effectively.

Staff and management worked effectively with external health and social care professionals to ensure people received coordinated care, and ensure people’s health needs were met. The overall design and adaptation of the service reflected people’s individual care needs.

Staff adopted a kind and caring approach to their work, and helped people express their views. They recognised, and worked to promote, people’s rights to privacy and dignity. People’s individual communication needs had been assessed, and staff adjusted their communication with people accordingly. People had support to participate in in-house and community-based activities. People and their relatives understood how to raise concerns with the provider.

The management team had improved their working relationships, and communication, with people, their relatives, staff and community profession

The inspection took place on 10 and 12 July 2017. The first day of the inspection was unannounced.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments in two purpose-built houses. At the time of our inspection, there were 11 people living at the home.

A registered manager was in post at the time of 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 unavailable during our inspection. The provider's national service improvement manager, operations manager and temporary service manager were present.

The provider had not kept the training and competency of staff that administered medicines to people under review. There had also been a high rate of staff turnover at the service, which had resulted in fewer trained staff available to support people with social and therapeutic activities.

Staff understood the implications of the Mental Capacity Act 2005 for their work with people. However, people's right to make their own decisions about their own care and treatment was not always fully supported by the staff and management team.

People’s care plans included details about what was important to them, and how to best support them. However, these plans had not always been reviewed to ensure the information and guidance provided was accurate and up to date.

A lack of consistent leadership and management meant staff were not always fully supported to fulfil their duties and responsibilities. The provider’s quality assurance activities were not as effective as they needed to be.

Staff had received training in, and understood, how to recognise and report abuse. The risks to individuals had been assessed and plans put in place to manage these. The management team assessed and monitored people's staffing requirements, and followed safe recruitment practices.

People received individualised support to eat and drink, and any associated risks had been assessed with support from dietary and nutritional specialists. Staff supported people to access healthcare services and took prompt action when people were unwell.

Staff treated people with kindness and compassion and promoted their rights to privacy and dignity.

People’s relatives knew how to raise complaints or concerns about the service. The provider had developed formal complaints procedures to ensure these were investigated and responded to appropriately.

You can see what action we told the provider to take at the back of the full version of the report.

The inspection took place on 25 May 2016 and was unannounced.

Falcons Rest and Poachers Cottage provides accommodation and personal care for up to 14 people with a learning disability who may also have physical disabilities and/or sensory impairments. There were 11 people living at the home when we visited.

A registered manager was in post at the time of 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.

People were protected from avoidable harm and abuse because staff understood the potential signs of abuse and knew who to report any concerns about people’s safety or wellbeing to. The provider had clear procedures in place for responding to concerns raised by staff or others.

The risks associated with individual’s care and support needs had been assessed and plans developed to manage these. Incidents or accidents involving people living at the home were closely monitored by the management team and the provider to ensure lessons were learned.

There were enough staff on duty to meet the needs of the people living at the home and the use of agency staff was closely managed by the management team to promote continuity of care. The registered manager followed safe recruitment practices and all staff employed were subject to appropriate pre-employment checks.

People’s medicines were stored, administered and disposed of safely by competent staff.

Staff had the right skills and knowledge to support people effectively and understood people’s communication needs and preferences. Staff had been given an effective induction when starting work at the home and spoke positively about the range of ongoing training provided. This training reflected the individual needs of the people living at the home. The management team identified, recorded and reviewed staff training needs.

Staff were well-supported by the management team and received regular one to one sessions.

The service was working in accordance with the requirements of the Mental Capacity Act 2005 (MCA). Staff had a good understanding of the MCA and how to apply this in their day to day work. The provider had made DoLS applications for all of the people currently using the service, two of which had been fully processed and granted.

Staff had been trained in the safe and appropriate use of restraint and understood the circumstances in which restraint might appropriately and lawfully be used.

The people living at the home were offered a choice of food and drink and received appropriate support with eating and drinking. Any risks associated with people eating and drinking had been assessed, recorded and managed with the involvement of specialist external advice as required.

Staff understood people’s health needs and supported them to attend routine appointments and check-ups. A wide range of external healthcare professionals were involved in monitoring the health of the people living at the service.

Staff spoke to people in a warm, friendly and polite manner, listening to them and responding appropriately to their requests. People were relaxed and at ease in the home’s environment. Staff knew people well and treated them with dignity and respect.

There were no unnecessary restrictions upon the visiting arrangements at the service.

People were supported to make choices about their day to day care and support and the care and support provided was tailored to people’s needs. People’s relatives were involved in the planning of the care delivered to their family members.

People’s care plans set out their individual needs, interests and preferences and placed an emphasis upon supporting people’s decision-making. Staff were given the time needed to