Rugby Care Centre is divided into three separate units and provides accommodation and personal care for up to 29 older people, including people living with dementia. There were 27 people living at the home when we inspected the service. This inspection visit took place on the 8 and 17 August 2017. The first day of our inspection visit was unannounced. We returned to the service a second day to meet the registered manager who was not present on our first visit, and talk with staff.

At the last inspection in September 2015 the service was rated Good. At this inspection we found the service remained Good.

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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection visit. We refer to the registered manager as the manager in the body of this report.

There were enough staff available to safeguard the health, safety and welfare of people. Staff were given induction and training so they had the skills required to meet the needs of people living at the home. People were protected against the risk of abuse as the provider took appropriate steps to recruit staff of good character, and staff knew how to protect people from harm.

The manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Decisions were made in people’s ‘best interests’ where they could not make decisions for themselves.

Care staff treated people with respect and dignity, and supported people to maintain their privacy and independence. People made their own choices about who visited them at the home. This helped people maintain personal relationships with people in their community.

People were provided with food and drink that met their health needs and their preferences. People were supported to access healthcare professionals to maintain their health and wellbeing.

People were offered opportunities to take part in interests and hobbies that met their individual needs.

People knew how to give feedback to the management team, or make a complaint if they needed to. Quality assurance procedures identified where the service needed to make improvements and where issues had been identified, the manager and provider took action to continuously improve the service.

We inspected this service on 10 and 14 September 2015. The inspection was unannounced.

The provider had taken over the ownership of the home in April 2015. They had retained the registered manager and staff who were employed by the previous provider at that time.

The registered manager had been in post for a continuous period of ten years, as they had been employed by two previous providers. 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 service provides accommodation and personal care for up to 29 older people, some of whom are living with dementia. Twelve people were living at the home on the day of our inspection.

There were policies and procedures in place to minimise risks to people’s safety. Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks.

There were enough staff on duty to meet people’s physical and social needs. The registered manager checked staff’s suitability to deliver personal care during the recruitment process. The premises and equipment were regularly checked to ensure risks to people’s safety were minimised. People’s medicines were managed, stored and administered safely.

Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff until they knew people well. Staff received training and support that ensured people’s needs were met effectively. Staff were encouraged to reflect on their practice and to develop their skills and knowledge, which improved people’s experience of care.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had obtained guidance from local and national agencies to make sure the care they provided did not deprive people of their liberty. No one was subject to a DoLS at the time of our inspection.

Risks to people’s nutrition were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs and staff understood the importance of helping people to maintain a balanced diet.

Staff were attentive to people’s moods and behaviour and understood when to implement different strategies to minimise people’s anxiety. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health or when their needs changed.

People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs, abilities and preferences and care plans were regularly reviewed.

The provider’s quality monitoring system included regular checks of people’s care and health, medicines management, meals and suitability and management of the premises. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.

People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality of the service. The new provider had consulted with people, their relatives, staff and external specialists before making improvements to the garden, the décor and to the meals. The provider took account of people’s opinions to make sure planned improvements improved people’s actual experience of the service