This inspection took place on 10 and 27 April 2018. This inspection was unannounced, and it was the providers first inspection since they took over ownership of the care home.

Marmaduke street is situated in Liverpool and provides personal care, nursing care and accommodation for up to 48 people. The home is situated over two floors. All bedrooms are single occupancy, and there are communal areas on each floor with a shared garden.

Marmaduke Street is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Marmaduke Street accommodates 48 people in one adapted building. There is a downstairs section of the home, which offers residential support, and an upstairs section, which is designed for people with nursing needs. Both sections of the home specialise in providing care to people living with dementia.

At the time of our inspection there were 20 people receiving support in the upstairs section of the home and 16 in the downstairs section.

There was a manager in post, however they had not yet registered with the Care Quality Commission.

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.

It was not always clear that the Mental Capacity Act 2005 (MCA) was applied correctly and decisions were being made in people's best interests. Most records we viewed in relation to the MCA did not have specific decisions recorded on them and best interest processes for people were not always considered.

Care plans, paperwork and records were not organised or set out in a format which was clear and concise. Some people's records were missing pieces of information or not completed accurately or in full. There was a lot of information in people’s care plans which was out of date and still had the logo from the old provider on the front. We saw on day two of our inspection that the provider had already begun to amend this information and they showed us a completed care plan, in a new and more organised format.

Governance arrangements were in place and regular checks on service provision were being completed, however these checks were not always effective. They had failed to highlight some of the issues we saw during our inspection.

Staffing was a concern on day one of our inspection, particularly on the residential section of the home. We observed staff to be exceptionally busy, and people had to ask for things repeatedly. Staff did not raise any concerns however some people we spoke with did confirm this could sometimes be an issue. There were no issues with regards to staffing in the nursing section of the home.

We have made a recommendation regarding this.

People told us they felt safe living at the home.

Medication was safely managed, stored and administered. People received their medications on time.

Staff were recruited and selected to work at the home following a robust recruitment procedure. The manager retained comprehensive records of each staff member, and had undertaken checks on their character and suitability to work at the home.

The home was clean and tidy. There was provision for personal protective equipment stationed around the home, and staff were trained in infection control procedures. We did raise on day one of inspection that the outside smoking areas were untidy, due to the disposal of cigarette butts. We saw on day two of our inspection this had been actioned and the outside areas had been tidied to a high standard.

Staff were able to describe the process they would follow to ensure people were protected from harm and abuse. All staff