Frome Care Village provides care and accommodation for up to 60 people in two separate buildings. Woodlands provides nursing care in a purpose built building and The Parsonage an adapted building provides care and support for people living with dementia. At the time of our inspection there were 56 people living at Frome Care Village.

Frome Care Village is a “care home”. People living 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.

There is a registered manager for the service this is a legal requirement. 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 inspection took place on 18 April and 19 April 2018 and was unannounced for the first day and announced for the second day.

People spoke positively about the quality of the meals. One person said, "I always enjoy my meals here and there is always a choice." There were arrangements to make sure people's nutritional needs were catered for and meals were relaxed. However, this could be improved by looking at providing opportunities for some people to choose to have a shared and more social meal experience.

Ongoing improvements to The Parsonage had helped to make the environment suitable for people living with dementia. However, the top floor would benefit from the creating of a more light and airy environment.

People told us they felt safe living in the home. One person said, "I always feel safe here because there are always staff around when you need them." There was an environment which promoted independence and recognised the right of people to live the life they chose. Staff had a real understanding of people living with dementia specifically around how this could impact on people's communication and behaviour.

Staff supported people in a caring, compassionate and sensitive way. They recognised the importance of treating people with respect. One person told us, "You cannot fault the staff they are so caring and kind."

Staffing arrangements had improved since our last inspection with improved retention and recruitment of staff. There was consistency and continuity in the providing of care as a result of this improvement.

There was an approach, to ensure people particularly those with complex mental health needs were supported by specialist services with the home recognising the importance of working with other health and social care professionals.

The provider and registered manager were actively promoting a culture where people could be confident of receiving quality care which met their needs. They recognised the importance of having skilled and trained staff in providing consistent care to people living in the home.

People and staff spoke positively of an approachable management where they felt listened to and encouraged to be part of the home and how decisions were made and care provided.

This inspection took place on 28 February and 01 March 2017 and was unannounced.

Frome Care Village provides nursing and residential care to people who are living with dementia and people who have nursing care needs. There are two parts of the village one part being The Parsonage which is divided into three "houses" each supporting people who are living with dementia and are at differing stages of their illness. The other part of the home is called Woodlands and supports older people who have care needs because of physical disability and needs which can be associated with old age. At the time of our inspection there were 50 people living in the home. The home is registered to provide care and support to 60 people. There was 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.

There was differing understanding from staff about their responsibilities to report any concerns about possible abuse. Two members of staff which included a senior member of staff did not understand that incidents of aggressive behaviour, which may occur and could be viewed as abuse, should be reported to the local safeguarding team for investigation.

We identified two incidents which whilst incident reports had been completed had not been referred to the local authority safeguarding team or the commission. These two incidents were referred to the local authority safeguarding team at the time of the inspection. They judged the incidents did not warrant further investigation and that there were no ongoing concerns about the health and welfare of the people concerned. This decision reflected the actions taken by the provider.

There were failures to ensure the arrangements for the administering of covert medicines were safe and ensured people received their medicines in a way that was effective. Covert is where people receive medicines disguised in food or drink. There was no clear instructions and agreement about how medicines were to be administered in these circumstances.

There were administering errors in that records of administration of medicines had not been completed. This had included a medicine that required a signature from the staff member administering the medicine.

Arrangements for the use of slings (these are used to help move people when needing a hoist) did not ensure the risk of cross infection was alleviated in that there was a risk slings could be used for more than one person.

The arrangements for the monitoring of the quality of the service were not always effective in identifying areas for improvement.

People told us they felt safe living in the home and how they were confident about the skills of care staff. Staff were benefitting from training which looked at the values around how care for people living with dementia was to be provided.

People told us they were satisfied with the availability of staff. One person told us "I feel safe with them (staff) around all the time." Staff said how they felt there was sufficient staff on duty and able to respond to people's needs in a timely way. We observed staff being available and responding promptly to people.

Staff had received training specific to supporting people living with dementia. This had led to staff commenting how their confidence had improved and having a greater understanding of the needs of people living with dementia.

The registered manager had, as required, made applications under the Mental Capacity Act 2005 and obtained authorisations under Deprivation of Liberty Safeguards (DoLS) arrangements. Where people lacked capacity their rights were upheld and their health and welfare protected.

We identified a number of improvements since the last inspection. Healthc