The inspection visit took place on 13 June 2017 and it was announced.

Pax Care Home provides care for up to two people and on the day of our inspection there were two people living there.

At the last inspection, the service was rated good. At this inspection we found the service remained good overall.

There was a registered manager at the home. 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 and relatives were complimentary and satisfied with the quality of care they received. People received care that enabled them to live their lives as they wanted and were able to make choices about keeping their independence. People were encouraged to make their own decisions about the care they received and care was given in line with their expressed wishes. People were supported to maintain relationships with people who were important to them.

Care plans contained accurate and detailed relevant information for staff to help them provide the individual care people required. People and relatives were involved in making care decisions and reviewing their care to ensure it continued to meet their needs.

For people assessed as being at risk, care records included information for staff so risks to people’s health and welfare were minimised. Staff had a good knowledge of people’s needs and abilities which meant they provided safe and effective care. Staff received essential training to meet people’s individual needs, and effectively used their skills, knowledge and experience to support people and develop trusting relationships.

People’s care and support was provided by a caring staff team and there were enough trained and experienced staff to meet people’s needs. People told us they felt safe living at the home and a relative supported this. Staff knew how to keep people safe from the risk of abuse. Staff and the registered manager understood what actions they needed to take if they had any concerns for people's wellbeing or safety.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the home support this practice.

People received a choice of meals and drinks that met their individual dietary requirements at times they wanted them. People received support from staff when they required it, and anyone at risk of malnutrition or dehydration, were monitored and if concerns were identified, medical advice was sought and followed.

People and relatives knew how to voice their complaints and felt confident to do so.

Systems to monitor and improve the quality and safety of the service provided were not in place or not always recorded. This meant the registered manager could not demonstrate how they ensured the staff and service worked in line with their expectations and the essential standards of care.

Further information is in the detailed findings below.

We inspected Pax Care Home on 29 January 2015 as an announced inspection. We announced our visit due to the small number of people using the service, to make sure we could speak with people there. At the last inspection on 4 April 2013 we found there were no breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008.

Pax Care Home is registered to provide accommodation to a maximum of two people, there was one person using the service at the time of our inspection.

A requirement of the service’s registration is that they have 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. At the time of our inspection there was a registered manager working at the service.

The provider had appropriate procedures in place to protect people against the risk of abuse and to minimise risks to people’s health and wellbeing.

People were offered the support they needed by appropriate numbers of suitable, qualified and skilled staff. Staff had the support and training they required, so that their skills were kept up to date.

People had the support they needed to access interests and hobbies that met their individual needs and preferences.

The provider had systems in place to manage the administration of medicines safely.

The rights of people to make their own decisions were protected. Staff understood the legal requirements they had to work within to do this. The Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) set out these requirements. People were able to make everyday decisions themselves, which helped them to maintain their independence.

People were supported to access healthcare that met their needs, their privacy and dignity was respected

People had access to advocacy services. An advocate is a designated person who works as an independent advisor in another’s best interest. Advocacy services support people in making decisions about their health and care requirements, which could help people maintain their independence.

The provider completed a number of checks to ensure they provided a good quality service. This ensured that the service continuously improved.

We observed the care of both people who lived at Pax Care Home and spoke with one person about their experience of the service. We also spoke with the member of staff and the provider, who supported people who used the service.

A person we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and we saw reviews were held to reassess people’s needs. We saw people had regular visits from an independent advocacy service.

We saw that the care plans were person centred and reflected people’s needs. Whilst the people had resided at Pax Care Home for a number of years, we saw that their needs were assessed on a monthly basis. We saw care plans reflected the changes in people’s needs.

A person we spoke with told us that staff were friendly and supportive with their needs. They told us that an advocate would help explain anything they did not understand, when they attended any meetings.

We saw care plans related to people's nutritional needs were reviewed every month. We saw that people were supported during meal times and the right equipment was available for people to use.

We saw there were sufficient numbers of staff who were experienced to meet the needs of the people who used the service.

Records were kept securely and could be located promptly when needed. We saw that records were stored securely in an office away from the public area.

We spoke with two people who lived at Pax Care Home. We also spoke with the member of staff and the provider, who supported people who used the service.

People we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and we saw reviews were held to reassess people’s needs. We saw people had regular visits from an independent advocacy service.

We saw that the care plans were person centred and reflected people’s needs. Whilst the people had resided at Pax Care Home for a number of years, we saw that their needs were assessed on a monthly basis. We saw care plans reflected the changes in people’s needs.

People we spoke with told us that staff were friendly and supportive with their needs. People also told us they were able to help with cooking and undertook activities within the community.

We spoke with the staff member about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding abuse.

We saw that whilst there were no formal reviews, the manager and the member of staff consulted with people on a daily basis about the quality of the service provided. We saw there were systems in place to raise complaints.

We asked both people who use the service their view about the quality of care given. They told us they were happy with the care they receive and that the staff are "all very good". One person also confirmed that their individual privacy was respected and that staff always knocked on their bedroom door and waited before entering.