We undertook an unannounced inspection of Maria Residential Home on 18 October 2016.

Maria Residential Home is a family run care home registered to provide care and accommodation for up to eight older people with dementia. At the time of the inspection there were seven people living at the home. The home does not provide nursing care.

There was a registered manager in post. 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 l Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 24 April 2015 the provider was in breach of four regulations. We asked the provider to take action and make improvements in relation to the management of medicines, notifying the Care Quality Commission of significant events or incidents, improve the quality assurance processes and to ensure fire risk assessments were in place and regular fire alarm tests were undertaken to protect people from potential harm. The provider sent us an action plan outlining the actions they were going to take. At this inspection we found improvements had been made and the provider had completed these actions.

People and their families told us they felt safe at Maria Residential Home. Staff understood their responsibilities in relation to safeguarding people. Staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the authorities where concerns were identified. People received their medicine as prescribed.

People benefitted from caring relationships with the staff. People and their relatives were involved in their care and people’s independence was actively promoted. Relatives and staff told us people’s dignity was promoted.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff sought people’s consent and involved them in their care where possible.

There were sufficient staff to meet people’s needs. Staff rotas confirmed planned staffing levels were maintained. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable to undertake their care role.

People and their families told us people had enough to eat and drink. People were given a choice of meals and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

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 provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the Registered Manager and all of the team at the home. Staff supervision and other meetings were scheduled as were annual appraisals. People, their relatives and staff told us all of the management team were approachable and there was a good level of communication within the service.

Relatives told us the service was very friendly, responsive and very well managed. Comments received included “its home from home”. The service sought people’s views and opinions and acted on them.

The management teams’ ethos was echoed by staff and embedded within the culture of the service.

Maria Residential Home is a family run care home registered to provide care and accommodation for up to 8 older people with dementia. The home does not provide nursing care.

At the time of our inspection there were seven people living in the home. There was a registered manager in post. 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 the 24 April 2015. The inspection was unannounced.

There was a warm, friendly atmosphere within the home and people received care and support in an unrushed calm manner. Staff treated people with dignity and respect and made time to sit with people and spend some quality time with them on a one to one basis.

Through our observations we could see that staff had built up good positive relationships with people who lived in the home as well as their visitors. Staff were very knowledgeable about the needs and histories of people who lived in the home and what they required support with.

The service generally worked in a way which kept people safe from harm. Any individual risks to people’s health, care and welfare had been assessed with risk management plans in place to prevent them from any avoidable harm. Any health and safety concerns were documented in people’s care and support plans. They were regularly reviewed and updated where any changes were evident.

Staff were knowledgeable in relation to how they would identify and respond to any safeguarding concerns. Their skills and knowledge was kept up to date through regular training. Similarly they were knowledgeable about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how it related to people living in the home. Staff we spoke with demonstrated an understanding of mental capacity and acting in people’s best interests.

The service had safe recruitment procedures in place to ensure staff employed were of good character and fit to undertake their role. Staff were provided with an induction, on going training and supervision to ensure they met people’s care and support needs safely and competently.

There was a complaints procedure in place, although people we spoke with told us they had no reason to complain, that they were happy with the care and support they received. Likewise relatives we spoke with told us there had been no reason to raise any formal complaints. They told us that if they had any small concerns they would relay them to the manager or staff and felt confident they would be dealt with appropriately.

The provider had failed to review and ensure they had an up to date fire risk assessment in place and also failed to undertake regular fire drills. These failures had the potential to place people using the service and others who entered the home at possible risk.

The provider’s system for checking in medicines failed to ensure the medication received from the pharmacy matched that prescribed by the GP

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

On the day of our visit eight people living with dementia were using the service. People were cared for by a care worker, the manager, the owner and the service development manager.

We conducted a Short Observational Framework for Inspection (SOFI) and saw that people were respected and involved. People were able to make choices about their care and day to day lives and their choices and preferences were respected. We saw that people were well cared for and their planned care was appropriate and person centred.

The provider had taken steps to ensure people were safe from the risk of abuse. All care staff in the home had received training in safeguarding vulnerable adults. They also received refresher training every year. The provider had a robust policy on safeguarding that was available to all care staff.

The provider had appropriate recruitment and selection procedures in place. All care staff had provided references before starting work and we saw evidence that background checks had been conducted. This meant the provider had checked to ensure that care staff were of good character.

The provider had a complaints policy that was available to people and their relatives. Comments were recorded and people's opinions sought. Accidents and incidents were recorded and appropriately managed. This meant the provider monitored the quality of service they provided.

Many people using the service had dementia and as such found it difficult to express their views and experiences about what it was like living at the home. Two people we spoke with told us the staff were polite, respectful, and encouraged them to do as much as they could for themselves.

People told us they and/or their family had been given the opportunity to visit the home before they moved in. This ensured it met their needs and expectations. They said the staff treated them as individuals and respected their views and choices. They were consulted about any changes to their care and could choose how they spent their day.

Care plans were in place to document people's individual needs. They were detailed, reviewed and updated regularly. Risk assessments had been written to identify and reduce the likelihood of injury or harm, with guidelines in place for staff.

People had access to healthcare professionals and specialist support to ensure they kept healthy and well.

Daily activities were provided for those who wished to take part. They included one to one activities and group sessions. They were tailored around people's likes, dislikes and individual needs.

During our visit we saw staff assisted people in a kind and compassionate way and were treated with dignity and respect.

Systems were in place to regularly assess and monitor the quality of service that people received to ensure people benefitted from safe quality care and support.

During the visit we spoke to people living in the home who told us that they were happy with the care and support that they received. They told us that they were involved in decisions about their care and the care planning process. They were confident in raising any concerns that they had.

People told us that the staff were always on hand to attend to their needs. They found them to be knowledgeable about their individual needs.

Carers visiting their relatives in the home told us that they were always made to feel welcome. They were kept informed of any changes to their relatives care and support needs. They found the home to be kept to a high standard of cleanliness.