This inspection took place on 10 and 11 November 2016. It was an unannounced inspection.

Kirlena House is registered to provide accommodation for up to 12 older people who require personal care. At the time of the inspection there were 12 people living at the service.

At the previous inspection on 2 October 2015 we found the home was not acting in accordance with the principles of the Mental Capacity Act 2005 (MCA) and associated code of practice. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

We also found that the registered manager had not taken reasonable steps to mitigate the risks to the health and safety of service users receiving care. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

At this inspection we found that the home had made significant improvements to address the areas of concern and bring the service up to the required standards.

The service had 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.

Staff understood the MCA and applied its principles in their work. The home had taken reasonable steps to mitigate the risks to the health and safety of service users receiving care. Care records contained up to date guidance for staff to manage the risks associated with peoples care. Staff followed this guidance.

People told us they were safe. People were supported by staff who could explain what constitutes abuse and what to do in the event of suspecting abuse. Staff had completed safeguarding training and understood their responsibilities.

People received their medicines as prescribed. Staff administering medicines checked each person's identity and explained what was happening before giving people their medicine.

There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

The service sought people's views and opinions. Relatives told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service the home provided. Learning from audits took place which promoted people's safety and quality of life.

People had sufficient to eat and drink. Where people required special diets, for example, pureed or fortified meals, these were provided by kitchen staff who clearly understood the dietary needs of the people they were catering for.

Staff spoke positively about the support they received from the registered manager and the provider. Staff had access to effective supervision. The registered manager’s visions and values of the home were embedded within service delivery.

We inspected this service on 20 October 2015. This was an unannounced inspection. This was the first inspection of this service since a new provider had taken over the running of the service.

Kirlena House is registered to provide accommodation for up to 12 older people who require personal care. At the time of the inspection there were 11 people living at the service.

The service had 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. People, their relatives and staff were complimentary about the registered manager and provider. The registered manager and provider were open to any suggestions to improve the service. They had a clear plan of further changes they were going to make to the service to improve the quality of service people received.

People felt safe living at the service. Staff understood their responsibilities around safeguarding vulnerable adults and knew how to raise concerns. However, for two people staff did not always follow guidance in their care plans and risk assessments to ensure they were safe and their needs were met.

Medicines were administered safely. Most medicines were stored safely. However, one medicine that could present a risk to people if not taken in the right way was stored within reach of people on a kitchen work surface. We showed this to the registered manager who took immediate action to ensure it was stored safely.

Staff did not fully understand their responsibilities under the Mental Capacity Act 2005 (MCA). The MCA provides legal safeguards for people who may be unable to make their own decisions. Capacity assessments were not always completed appropriately. Where people may have been deprived of their liberty for their own safety, applications to the supervisory body had not been made to ensure any restrictions in place were being made lawfully, were the least restrictive and in the persons best interest.

There was a calm and homely atmosphere at the service. People told us they were happy living at the service. People were cared for in a kind and respectful way. Staff engaged with people and offered support to promote people’s independence. Staff knew the people they cared for and what was important to them. People's choices and wishes were respected by care staff and recorded in their care records.

People had been involved in reviewing their care. People had a range of individualised assessments in place to maintain their independence. People were assessed regularly and care plans were detailed. Where required, staff involved a range of other professionals in people’s care. Staff were quick to identify and alert other professionals when people’s needs changed.

People were supported to have their nutritional needs met. People liked the food, regular snacks and drinks were offered and mealtimes were relaxed and sociable.

There were enough staff to meet people’s needs. People felt supported by competent staff. Staff were motivated to improve the quality of care provided to people and benefitted from regular supervision, team meetings and training.

People were cared for in a clean and tidy environment. Staff adhered to the provider’s infection control policies. Equipment was stored appropriately and maintained in line with nationally recommended schedules.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we took and what action we told the provider to take at the back of the full version of the report.