The inspection visit took place on 19 and 24 October 2018. The first day was unannounced.

Ravenscroft Rest Home Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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.

Ravenscroft Rest Home Limited is registered to provide accommodation and personal care for up to 34 older adults who require support with their personal care needs. At the time of the inspection, there were 32 people accommodated in the home.

The service was managed by 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 last inspection in April 2016 the service was rated 'Good'. At this inspection in October 2018 we found the evidence continued to support the rating of good. However, we found some shortfalls in relation to staff training. Eight of the staff had not completed training in up to nine areas that the provider had deemed necessary for their role. The registered manager addressed these shortfalls immediately after our inspection. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People who lived at the home and their relatives told us they felt safe and were happy with staffing levels. They told us staff provided them with support when they needed it.

People told us the staff who supported them were caring and respected their right to privacy and dignity. They told us staff encouraged them to be as independent as they could be, and we saw evidence of this during the inspection.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Improvements were required to ensure incidents were analysed to identify patterns and lessons learned. Recruitment checks were carried out to ensure suitable people were employed to work at the service.

The majority of staff employed at the home had received induction, training and support and their knowledge demonstrated a commitment to providing high standards of care. However, this was not consistent throughout the staff team. We found some staff had not received training that the provider had deemed essential for the role. The registered manager and the owner took immediate action to address this. However, we would expect this to have been identified and rectified without our intervention. We made a recommendation about staff training.

The service put people's views at the forefront of the service and designed the service around their needs.

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 service supported this practice. Improvements were required to the process for seeking consent for equipment such as bedrails.

Risk assessments had been developed to minimise the potential risk of harm to people who used the home. These had been kept under review and were relevant to the care and support people required. Care plans were in place detailing how people wished to be supported.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. We noted some improvements were required to the documentation for medicines prescribed as ‘as required medicines’. The registered manager took immediate action to rectify this.

We found people had been assisted to have access to healthcare professionals and their healthcare need

The inspection took place on 07 & 12 April 2016 and was unannounced. We last inspected the service on 04 June 2014 when the service was found to be meeting all the requirements of the regulations we inspected against.

The home is registered to provide 24 hour residential care for up to 34 older people with a range of care needs. At the time of our inspection there were 28 people living in the home.

The home had 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.

People felt safe living in the home and staff knew how to keep them safe. People felt supported because staff were always nearby to help them when needed. The provider's recruitment procedure included checks to ensure the suitability of staff before they were employed. Safe care practices and systems in place reduced the risk of harm to people. Medicines were managed appropriately and people received them when needed.

People were cared for by staff who were trained and received regular supervision sessions with the registered manager. Staff were aware of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Where people were unable to make a decision about their care, a best interest decision was made on their behalf, in line with guidance. People had access to external healthcare services to help ensure their medical needs were met. Staff were aware of people's dietary needs and people were supported to eat and drink sufficient amounts.

People were treated with kindness, compassion and were supported to be involved in planning their care. People's diverse needs were respected and staff ensured people's privacy and dignity were maintained. People were encouraged to be involved in their assessment and care planning. People felt confident to share their concerns with the registered manager or staff and complaints were well managed.

People were given an annual quality assurance survey to complete and this gave them the opportunity to tell the provider about their experience of using the service. Regular meetings with staff gave them the opportunity to be involved with changes to the service. There was a clear leadership and people knew who was running the home. Governance systems were in place to promote good standards of care.

This inspection was carried out by one adult social care inspector over the course of one day. At the time of our inspection there were 31 people living at Ravenscroft Rest Home.

During this inspection we gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives and the staff supporting them, the manager and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe living at the home. Safeguarding procedures were in place and staff were fully aware of actions they needed to take, should they be concerned about someone's safety.

Plans of care and risk management plans were in place. These were detailed and provided guidance for staff on people's individual needs. People were not put at unnecessary risk, but also had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People’s health and care needs were assessed with them or their relatives and they were involved in writing their plans of care. People said their current needs were being fully met by a kind and considerate staff team. We established that a range of external professionals were involved in the provision of care. This helped to ensure people received the correct health care to meet their needs.

Those working at the home told us they received plenty of training and gave us some good examples of courses they had completed.

Is the service caring?

We spoke with four people who lived in the home. We asked them for their opinions about the staff that supported them. Feedback from people was consistently positive. For example, one person commented: "It's a good place to be", another said; "The staff are very caring...It's very pleasant and relaxed."

When speaking with staff it was clear that they genuinely cared for the people they supported. People who used the service and their relatives, completed satisfaction surveys. Where shortfalls or concerns were raised these were taken on board and dealt with. People’s preferences and interests had been recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

We noted that staff responded to the needs of people in a timely fashion and anticipated their needs well. This was because staff members were familiar with the needs of those in their care and had developed a good understanding of those living at the home.

People knew how to make a complaint if they were unhappy and felt they would be listened to, should they wish to make a complaint or raise any concerns. Comments and complaints were taken seriously and used to make improvements to the service.

Is the service well-led?

It was clear the manager and provider led by example and staff felt supported. People were aware of the lines of accountability within the home and it was evident that those living at the home trusted the manager and their staff team.

The service had a quality assurance system in place and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

We spoke with four people who used the service, three relatives who were visiting at the time of our inspection and a professional visitor. All the people we spoke with told us they were happy with the care provided at Ravenscroft. Comments included, "You get well looked after here" and “My relative trusts staff and feels cared for. I don’t have any worries about her being here”.

We reviewed the care records of four people who used the service. We found there were systems in place to ensure people consented to the care and treatment they received. We saw care plans clearly identified people’s needs and included information on how they wished their care to be delivered.

We found there were appropriate arrangements in place for the safe administration of medicines.

We found the premises were safe and secure and had been decorated and maintained to a good standard. All the people we spoke with told us they felt safe and comfortable within the home.

We spoke with three members of care staff and the activity coordinator employed to work in the home. They told us they felt well supported and confident in carrying out their responsibilities. We saw evidence that staff were appropriately qualified and provided with training relevant to their role.

We found there were effective systems in place for the completion and storage of records relating to the care of people who used the service and the maintenance of the premises.

People living in the home told us they were respected and well cared for. One person said, ‘’It’s nice here the staff are good they let me get on with things and help when I ask for it’’. The staff told us about different ways that they ensured independence was promoted.

At the time of our visit the dining room was being refurbished and a temporary dining room established in one of the communal areas. The people living in the home we spoke with were keen to tell us about the improvements and that they had been involved in choosing the new décor.

Staff we spoke with could tell us what action they should take to protect people from harm if it was to occur. They also told us they would feel confident to report any concerns about about fellow workers if they thought they were not working in the correct mannner.

We reviewed the recruitment records of three staff and found that they had been recruited using an effective procedure that included all of the appropriate checks to ensure that the person being employed was of good character.

People we spoke to told us they had no complaints about the service but would be happy to raise their concerns with the staff or matron. One person told us, "I don’t bother with the residents meetings, I would just tell matron if something was wrong".

Those we spoke to who use the service were positive about the care that they receive. Some of the things people who use the service told us were:

‘I am happy at the home and the food is fantastic, the cook is brilliant’.

‘Staff are very quick to respond to the call bell if I ring it and are always polite and friendly when they attend’.

People said that they were well cared for. One person told us that there are always two members of staff who assist them with the hoist and they have never been hurt when using the hoist. The person added that they have never slipped or fallen when being helped by the staff. Another person said "all the staff provide excellent care".

People at the home said that they felt safe living there. One person said that if they thought someone was being ill-treated then they would report it to the manager straight away. When asked if they thought the manager would take it seriously, the person said "Of course she would, and not only her, but any staff member you spoke to would take it seriously and deal with it."

The relatives and visitors who were spoken with regarding the quality of care and support offered by the staff and management team, all were very complimentary, and believed it to be of a high standard. They said that the staff appeared to know what they were doing; that they were approachable anode very professional. Three people said that that the staff team is very caring, kind and considerate.