We carried out the inspection of Headingley Hall Care Home on 08 and 12 May 2017. At the time of our inspection there were 44 people using the service. This was an unannounced inspection.

Headingley Hall Care Home provides residential care for a maximum of 57 people and is situated in the centre of Headingley. The home is a two storey adapted building and close to local amenities. There is car parking to the front of the building and good wheelchair access. The home has gardens and a patio area for people to use.

The home had a registered manager but they were on annual leave at the time of 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 the last inspection on 22 February 2016 the service was rated ‘requires improvement’ in two of our key questions. At this inspection we found improvements had been made.

There were enough staff on duty to provide people with the support they needed and pre-employment checks had been carried out before new staff were appointed. Following initial employment the provider had not always security checked staffs criminal records. The provider took immediate action to start resolving this concern.

Staff were trained and supported to understand people's needs and provide their care in the right way. Staff told us they felt supported by the registered manager and confirmed they had received formal supervision from their line manager and regular staff meetings were arranged.

People told us they felt safe living in the service. Staff showed they had a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people. We found staff ensured they gained consent from people prior to completing care tasks. They worked within mental capacity legislation when people were assessed as not having capacity to make their own decisions.

People's medicines were stored safely and recorded appropriately. People received their medicines in line with their prescription. People received a well-balanced diet that offered variety and choice. People liked the meals provided to them and their nutritional needs were met. Staff worked closely with health and social care professionals to ensure people received effective care.

People were treated with respect, kindness and understanding. Staff demonstrated a good knowledge of the people they cared for, their preferences and abilities. People told us staff were friendly, caring and had time to sit and talk to them. We observed staff had developed good relationships with people who used the service and their relatives. People's privacy and dignity was respected by staff who encouraged people to be independent and make choices and decisions in their daily lives.

Care plans recorded people's needs and preferences and staff followed this information when providing support. People who became anxious were provided with individual reassurance and support.

We saw people were encouraged to engage in a range of meaningful activities and to maintain their independence where possible. Relatives told us they could visit at any time and staff welcomed them.

The service was run in an open and inclusive manner. There were systems in place to monitor and improve the quality of the services people received. People who used and visited the service were supported to share their opinion of the service provided. Two complaints had been made to the registered manager or registered provider and we saw these had been investigated and information fed back. People we spoke with knew how to raise concerns and told us they would be confident to do so.

We inspected Headingley Hall on 22 February 2016. The inspection was unannounced which meant the staff and registered provider did not know we would be visiting.

Headingley Hall is a large converted property with a modern extension attached. The service provides care and support for up to 57 older people and is accommodation for people who require personal care. The service is close to all local amenities.

The home 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.

We found systems in place for the management of medicines were not robust or effective in ensuring people received their medicines safely.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure people’s health and safety. Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Where changes were made to people’s care following incidents the information was not always transferred into the care plan documentation. Staff were able to tell us verbally the changes that had been made.

The call bell system in the old part of the building cannot be heard throughout the service. The registered manager told us they would implement a risk assessment to ensure staff members were available in this area so call bells would be answered effectively until a new system was installed.

We saw staff had received supervision on a regular basis and an appraisal. Staff had been trained and had the skills and knowledge to provide support to the people they cared for.

People told us there were enough staff on duty to meet people’s needs. We were reassured people were protected by safe recruitment process.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

We saw staff treated people with dignity and respect. Staff listened and were patient with people. Observation of the staff showed they knew the people very well and could anticipate their needs. People told us they were happy and felt very well cared for.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met.

People were supported to maintain good health and had access to healthcare professionals and services.

We saw people’s care plans were very person centred and written in a way to describe their care, and support needs. These were regularly reviewed but at times updates needed were not always reflected in the care plans. We saw evidence to demonstrate people were involved in all aspects of their care plans.

We saw there was a supply of activities and outings. Staff encouraged and supported people to access activities within the community. There was a current vacancy for the activities worker which had affected the level of activity on offer at the time of our visit.

The registered provider had a system in place for responding to people’s concerns and complaints. People were regularly asked for their views. We saw there was a keyworker system in place which helped to make sure people’s care and welfare needs were closely monitored. People said they would talk to the registered manager or staff if they were unhappy or had any concerns.

There were systems in place to monitor and improve the quality of the service provided. We saw there were a range of audits carried out both by

People who used the service and their relatives were complimentary about the service. One relative said “I am confident that this is the best place for my father, he is content and well cared for.” and “I would not want him to be anywhere else.” People who used the service said “The staff are very considerate.” and “The staff look after me well.”

People were consulted about their care and treatment and their wishes were recorded in their care plans. We found that people’s needs were assessed and their care and treatment was delivered in ways that met their needs. We observed people being supported in the lounge at lunch time. People who used the service looked well presented and cared for. The staff spoke respectfully to people and were attentive to their needs.

The provider had arranged a daily programme of activities and encouraged people who used the service to join in and socialise with other residents. People who used the service told us that “The staff are very good at trying to involve us in activities.”

People were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection. People told us that the home was “Always clean and tidy.” Staff felt well supported and enabled to provide care safely and to an appropriate standard. The provider had arrangements in place to regularly monitor and assess the quality of the service.

People told us what it was like to live at the home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drinks available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes were treated with dignity and respect and whether their nutritional needs were being met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by a practising professional and an Expert by Experience, who had personal experience of using or caring for someone who used this type of service.

People were complimentary about the food and said they had more than enough to eat. They were able to make suggestions and request for future meals. If they didn’t like what was on the menu they were able to ask for something else to be prepared. People we spoke with confirmed that the meals were warm enough when they were served.

People felt the staff respected their privacy and dignity although one person commented, “Some do some don’t respect your dignity but by and large they are very nice.” One person said, “Nothing but kindness and respect from the staff” and another person concluded, “Couldn’t find anywhere nicer.”

We spoke with a relative of someone who used the service. They said, “There seems enough staff about when I visit and they have the skills to look after the people here.”

People we spoke with told us they felt safe living at Headingley Hall. They also told us that they had been provided with information on who to contact if they had any concerns or wanted to make a complaint.