This unannounced comprehensive inspection took place at the Oriel Care Home on 4th December 2018. Phone calls were undertaken to people with experience of the service on 5th and 17th December 2018.

Oriel Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The care quality commission, (CQC), regulates both the premises and the care provided, and both were looked at during this inspection.

Oriel care home accommodates 33 people and has adapted facilities. There were 28 people living at the home, at the time of this inspection. The service has a registered manager, who was present during our inspection. A registered manager is a person who has registered with the CQC 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.

This was the first inspection and rating of this service, since it was taken over by a new provider in January 2018.

The service has been rated as requires improvement.

We found areas of service provision where the provider was in breach of regulations. The providers systems for governance were not effective in identifying and addressing risks to people and needed improvement. We found that care was not always delivered safely. You can see what action we told the provider to take at the back of the full version of this report.

Risk assessments were in place for each person. These did not effectively identify, assess or mitigate risks to people, to ensure effective safe care. People had suffered multiple falls, in some cases resulting in serious injury. The registered manager did not recognise or consider the potential for raising safe guarding concerns or following the duty of candour regulations, regarding these serious injuries.

Staff were recruited safely and new staff completed induction training. There was a training plan in place for all mandatory safety training. Staff had received training in how to safeguard people from abuse. Staff received supervision and attended staff meetings on a regular basis. We found that issues raised by staff were not always effectively dealt with, this meant that safeguarding was not as effective as it could have been.

We found that the safe evacuation of the home was compromised. Emergency evacuation routes were found to be blocked and one emergency exit door was found securely bolted. We spoke with the provider about this, who took immediate action to remove bolts from doors and to remove obstructions from the evacuation routes. We also informed the West Midlands Fire Service, who undertook an inspection of the home.

We saw medication being safely administered, however we found medications were not safely stored. During this inspection we found that storage temperatures were too high, which could make medication less effective or unsafe. We also found some medications were left unsupervised, this is an unsafe practice and poses a risk to people in the home.

People told us they were happy with the care they received. Staff used support plans to ensure people were effectively cared for. Support plans were regularly reviewed and updated. We noticed that where accidents had taken place, these were detailed in support plans as an event, however preventative strategies were not recorded. People told us that the staff were caring, compassionate, attentive to their needs, patient, very nice, very good, pleasant, and helpful. During our observations we saw people sitting, in silence, for long periods of time without any interaction or meaningful activity.

People were supported to have enough to eat and drink. People told us they enjoyed their meals. Meals were well presented and nutritious. People were not provided with snacks and refreshments to help themselves to during