This was an unannounced inspection which took place on 5 July 2017. The Franciscan Convent Blackburn is a home caring for the elderly Sisters of the congregation of the Franciscan Missionary of Saint Joseph. The service also accommodates females from other religious denominations. The service is registered to provide accommodation and personal care for up to 13 people. There were seven people living at the service at the time of our inspection.

The service had a manager in post who had registered with the Care Quality Commission in April 2017. They had previously been the assistant manager at the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers ('the provider'), 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 carried out in September 2015 we found the provider was in breach of one of the regulations we reviewed. This was because they had not taken appropriate action to safeguard the rights of people who could not consent to their care in the Franciscan Convent Blackburn. Following the inspection, the provider sent us an action plan which set out the action they were taking to meet the regulations. During this inspection we found the necessary improvements had been made.

People told us they felt very safe and well cared for in the home. They told us staff were always kind, caring and respectful of their dignity and privacy. Staff had completed training in safeguarding adults and knew the correct action to take should they witness or suspect abuse.

Interactions between staff and the people who used the service were warm, friendly and relaxed. The staff we spoke with had a good understanding of the care and support that people required. They told us they would always try and promote the independence of people who lived in the home. All the people spoken with confirmed staff would encourage them to do as much as they could for themselves.

Risk assessments were in place in relation to the care people required. These had been regularly reviewed and updated to ensure they accurately reflected people’s needs.

Although medicines were safely handled, we have made a recommendation that the provider ensures staff always act in accordance with NICE guidelines; this is to ensure an accurate record is always maintained of the medicines prescribed to people who use the service.

People were cared for in a safe and clean environment. Procedures were in place to prevent and control the spread of infection. Regular checks were made to help ensure the safety of the equipment used. Systems were in place to deal with any emergency that could affect the provision of care.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who had been safely recruited. Staff received the essential induction, training and supervision to enable them to deliver effective care.

People who used the service told us they were always able to make choices about their daily life and the care they received. We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The registered manager was aware of their responsibility under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected. The registered manager had submitted required DoLS authorisations to the local authority when people were assessed as being unable to consent to their care in the Franciscan Convent Blackburn.

People told us the quality of food provided in the home was very good. Systems were in place to assess and monitor people’s health and nutritional needs.

People we spoke with told us they appreciated the quiet and calm

This was an unannounced inspection which took place on 30 September 2015. The service was last inspected in January 2015 when we found it to be in breach of three of the regulations we reviewed. This was because the people were not protected against the risks associated with the unsafe management of medicines. In addition the provider did not have robust quality assurance processes in place and did not have suitable arrangements in place to ensure that people employed for the purposes of carrying on the regulated activity were supported by receiving supervision and appraisal.

Following the inspection in January 2015 the provider sent us an action plan telling us what they intended to do make the improvements needed. This inspection took place to check that the required improvements had been made.

During this inspection we found the previous breaches of regulations had been met. However, we identified a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

The Franciscan Convent is a home caring for the elderly Sisters of the congregation of the Franciscan Missionary of Saint Joseph. The service also accommodates females from other religious denominations. The service is registered to provide accommodation and personal care for up to 13 people. There were 9 people living at the service at the time of our inspection.

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 2008 and associated Regulations about how the service is run.

People told us they were able to make choices about the way they wanted their care to be provided. However we found the provider was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS); these safeguards ensure that any restrictions in place are legally authorised and in a person’s best interests. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We have made a recommendation that the provider takes the necessary action to review and record the legal basis on which people are authorised to take decisions on behalf of people who use the service.

People told us they felt safe in the Franciscan Convent. Staff had received training in safeguarding adults. They were able to tell us of the correct action to take should they witness or suspect abused.

Staff were safely recruited. We saw that staff received the induction, training and supervision necessary to enable them to do their jobs effectively and care for people safely. During the inspection we observed staffing levels were sufficient to meet people’s needs. People told us staff always responded immediately should they request any support or assistance.

All the people we spoke with provided positive feedback about the kindness and caring attitude of staff. Staff demonstrated they had a good understanding of the needs of people who used the service. They told us they would support people to maintain their independence as much as possible.

Systems for managing medicines in the service were safe and we saw that staff worked in cooperation with health professionals to ensure that people received appropriate care and treatment.

We saw there were risk assessments in place for the safety of the premises and equipment used. All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care such as a fire or the failure of the electricity and gas supply.

People’s care records contained good information to guide staff on the care and support required. People told us they received the care they needed. The care records we reviewed showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk.

Care records were regularly reviewed to help ensure they reflected people’s current needs. Systems were in place to help ensure staff were always informed should a person’s needs change.

People we spoke with told us they had chosen the service because of its quiet and calm nature. We saw people were supported to attend religious services and social gatherings in the Convent. A limited number of activities were organised but all the people we spoke with told us this suited their needs.

Staff told us they enjoyed working in the service and found the managers to be supportive and approachable. Regular staff meetings took place and were used as a forum to discuss how the service could be improved.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home.

This was an unannounced inspection which took place on 14 January 2015. The service was last inspected in January 2014 when it was found to be meeting all the regulations we reviewed.

The Franciscan Convent is a home caring for the elderly Sisters of the congregation of the Franciscan Missionary of Saint Joseph. The service also accommodates females from other religious denominations. The service is registered to provide accommodation and personal care for up to 13 people. There were 9 people living at the service at the time of our inspection.

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 three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

People who used the service told us they felt safe living at the Franciscan Convent. Relatives we spoke with confirmed they had no concerns about the safety of their family members.

All the people we spoke with gave very positive feedback about the caring attitude and approach of staff. People who used the service told us they considered staff knew them well and always respected their choices and preferences about the way they wished their care to be delivered. Although the ethos of the service was Catholic, people who used the service who were not of this faith told us they were treated equally and their views respected.

Care records we looked at showed people’s needs, wishes and preferences were recorded and regularly reviewed. Records provided good information for staff about how to promote people’s independence and ensure they were supporting people to achieve their goals.

Risk assessments and risk management plans were completed and regularly reviewed to help ensure people were protected against the risk of falls, pressure ulcers or poor nutrition and hydration.

We found the systems to ensure the safe administration of medicines in the service were not sufficiently robust to ensure people who used the service were adequately protected.

Staff were able to tell us of the correct procedure to follow should they have any concerns about the safety of a person who used the service. Staff also knew how to report any poor practice they might observe in the service. They told us they were confident they would be listened to by the managers in the service if they were to raise any concerns.

Some improvements needed to be made to ensure that recruitment processes in the service were sufficiently robust to protect people from the risks of unsuitable staff. We found staffing levels were appropriate to meet the needs of people who used the service.

Staff had received appropriate training for their role, including moving and handling, the administration of medicines and dementia awareness. However we found improvements needed to be made to the supervision and appraisal systems in the service to ensure staff were supported to continue their learning and development.

Staff we spoke with were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions. The assistant manager on duty during the inspection demonstrated their knowledge about the process to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

Staff told us they enjoyed working in the service and received good support from their colleagues and managers. They told us they felt valued in their role and appreciated being able to spend time with people who used the service.

People told us they were aware when they chose the service that limited activities were provided although they were supported to attend the daily religious services if they so wished. None of the people we spoke with expressed any concerns about the lack of activities and told us they enjoyed spending time in their own rooms. We were told Sisters living at the Franciscan Convent would spend time with people who used the service on a daily basis.

Some improvements needed to be made to the quality assurance systems in the service to ensure that the health, safety and welfare of people who used the service were always protected. This included the need for more robust health and safety checks.

All the people we spoke with told us the registered manager of the service was very approachable and would always listen and respond if any concerns were raised.

There were nine people accommodated at the home on the day of the inspection. We spoke with three people, the person in charge and a staff member. People who used the service told us, "I am happy here. I like to be quiet and they respect that", "I am very happy here. I could not think of any way to improve it" and "I am very satisfied with the care I get. I am very happy here". People we spoke with were happy living at this care home.

Plans of care had been developed with people who used the service and were updated on a regular basis. This meant people should receive the care they wanted.

The home was warm, clean, well decorated and homely. People we spoke with were satisfied with their personal space and the facilities provided at the home.

People who used the service told us, "I think there are sufficient staff to meet our needs. The staff are excellent. No fuss. You can have a laugh and chat to them", "There are enough staff to help me. I never have to wait long for help" and "The staff are all nice. I like them all and I treat them all alike. They know what they are doing". A staff member told us, "There are sufficient staff to meet people’s needs. There is a good staff team". People were supported by sufficient numbers of well trained staff.

All the records we looked at were up to date and stored securely.

All the people we spoke with said the food served at the home was good.

People told us that they felt safe and well looked after at the home. One person said, "I think it's great, it's wonderful. The staff are very nice – very helpful and kind" and another told us, "They're excellent, the staff, and the care is fantastic".

People said that staff listened to what they had to say and were confident their views would be acted upon. One person told us, "I've nothing to complain about but if I did I know they'd put it right – they're all very approachable".

People told us they could choose how they spent their time and that they could have privacy when they wanted it. They said that staff knew their preferences about their daily routines, such as what time they liked to get up and go to bed, what food they preferred and how they liked to spend their time.

We found new staff were recruited safely and all staff received regular training to give them the skills and knowledge to look after people properly. We spoke with three staff. They told us they would feel confident to speak out against poor practice if needed.

People told us they were satisfied with the quality of care and support they received. We

were told the staffing levels were sufficient to meet the needs of people living in the home

and that the staff were professional, caring and friendly.

Care staff received regular supervision from the senior staff and were trained in the tasks

they are required to complete.

Relatives told us they were always made to feel welcome in the home and were involved

in the planning and reviewing of care when appropriate.

People were provided with person centred care plans which were reviewed regularly and

updated when required.

People said they felt safe living in the home and were able to discuss concerns or issues

with the staff if they wished to. We were told that the service provided enjoyable and varied

activities for people.

There were comprehensive auditing and reviewing procedures in place to identify any

areas where improvements could be made.