This inspection took place on 19 July 2018 and was unannounced. This was the provider's first inspection since their registration in January 2018.

Duncan House is a care home that provides nursing and personal care and support for up to 20 older people and works closely with the clinical commissioning groups in providing services to support planned discharges. People stayed at Duncan house for a period of up to 28 days whilst they were assessed. They then moved on to a more suitable placement or back 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. At the time of our inspection, 17 people were using the service.

There was 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.

At this inspection, we observed that staff did not always support people safely to mobilise. We observed staff members using unsafe moving and handling techniques when supporting one person to move. The person’s care plan recorded that a full hoist should be used when mobilising the person, but this was not done. There were processes in place to monitor the quality and safety of the service but they were not always effective as they had not identified this issue. Other risks to people were assessed, identified and safely managed.

People told us they felt safe. There were appropriate safeguarding procedures in place to protect people from the risk of abuse. The home had a system in place to record accidents and incidents and acted on them in a timely manner. We saw accidents and incidents were discussed with staff and learning disseminated. Medicines were stored, administered, managed safely and accurate records were maintained. People were protected from risk of infection as staff followed practices that reduced the risk of infection. There were enough staff deployed to meet people’s needs in a timely manner and the provider followed safe recruitment practices.

Staff received an induction when they started work at the home and were supported through regular training and supervisions to enable them to effectively carry out their roles. People's needs were assessed prior to moving into the home to ensure their needs could be met. The registered manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA). 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. Staff told us they asked for people’s consent before offering support. People were supported to have enough to eat and drink and had access to healthcare professionals when required to maintain good health. The service met people's needs by suitable adaptation and design of the premises, which included appropriate signage to help people orientate themselves and appropriately adapted bathrooms to manage people’s needs effectively.

People told us staff were caring and respected their privacy and dignity. People were supported to be independent wherever possible. People said staff involved them in making decisions about their daily care and support requirements. People were provided with information about the service when they joined in the form of a 'service user guide' so they were aware of the services and facilities on offer.

People’s care plans were reflective of their individual care needs and preferences and care plans were reviewed on a regular basis. Activities were on offer and available for people to enjoy and take part in. People