The inspection took place on 13 December 2016. It was unannounced. At our previous inspection in August 2014 we found breaches of two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider had failed to make the necessary pre-employment checks and records of mental capacity assessments did not show that legal requirements had been met. At this inspection we found improvements had been made, and the provider was now meeting the requirements of the regulations.

Saltmarsh House Residential Care Home is registered to accommodate up to 12 people. It provides personal care services for older people who may be living with dementia. At the time of our inspection people were accommodated in private rooms on three floors of an adapted private home. Shared facilities included a lounge, dining room, conservatory, and an enclosed garden.

The provider was registered as an individual (sole trader) with direct responsibility for the carrying on of the regulated activity at the location. As a "registered person" they have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. As a consequence they did not need to have a registered manager.

The provider had put arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely. Recruitment practices were in place to make sure only workers suitable to work in a care setting were employed. There were arrangements in place to store medicines safely and securely, and to administer them safely and in accordance with people’s preferences.

Staff received training, supervision and appraisal to maintain and develop their skills and knowledge to support people according to their needs. Staff were aware of the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People had a choice of home-cooked menus. People were supported to access external healthcare services, such as GPs.

Staff had developed caring relationships with people they supported. People were able to take part in decisions about their care and support and their views were listened to. Staff respected people’s independence, privacy, and dignity.

Staff delivered care and support which were based on assessments and plans which took into account people’s needs and preferences. Staff supported people to take part in leisure activities where they wanted to. People were aware of the provider’s complaints procedure, but there had been no complaints made.

The home had a welcoming, homely atmosphere. The registered provider managed the service efficiently and monitored the quality of service provided. The provider responded to feedback to improve the service people received.

The inspection took place on 13 December 2016. It was unannounced. At our previous inspection in August 2014 we found breaches of two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider had failed to make the necessary pre-employment checks and records of mental capacity assessments did not show that legal requirements had been met. At this inspection we found improvements had been made, and the provider was now meeting the requirements of the regulations.

Saltmarsh House Residential Care Home is registered to accommodate up to 12 people. It provides personal care services for older people who may be living with dementia. At the time of our inspection people were accommodated in private rooms on three floors of an adapted private home. Shared facilities included a lounge, dining room, conservatory, and an enclosed garden.

The provider was registered as an individual (sole trader) with direct responsibility for the carrying on of the regulated activity at the location. As a "registered person" they have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. As a consequence they did not need to have a registered manager.

The provider had put arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely. Recruitment practices were in place to make sure only workers suitable to work in a care setting were employed. There were arrangements in place to store medicines safely and securely, and to administer them safely and in accordance with people’s preferences.

Staff received training, supervision and appraisal to maintain and develop their skills and knowledge to support people according to their needs. Staff were aware of the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People had a choice of home-cooked menus. People were supported to access external healthcare services, such as GPs.

Staff had developed caring relationships with people they supported. People were able to take part in decisions about their care and support and their views were listened to. Staff respected people’s independence, privacy, and dignity.

Staff delivered care and support which were based on assessments and plans which took into account people’s needs and preferences. Staff supported people to take part in leisure activities where they wanted to. People were aware of the provider’s complaints procedure, but there had been no complaints made.

The home had a welcoming, homely atmosphere. The registered provider managed the service efficiently and monitored the quality of service provided. The provider responded to feedback to improve the service people received.

Following an inspection of Saltmarsh Residential Care Home, in November 2013, the service was identified as not being compliant with one of the essential standards. This standard related to care and welfare of people who used services . This concern was judged to have had a minor impact on people who used the service.

The provider wrote to us telling us that they were compliant with this standard on 23 January 2014.

At this inspection we spoke with a person who used the service, the registered manager, deputy manager and two members of staff.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. Accidents/incidents were recorded, risk assessments carried out and care plans updated to reflect the care needs of people who used the service.

People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.

Care plans were person centred and documented people's wishes in relation to how their care was provided. Staff members understood how people expressed their needs and wishes about how they wanted to be supported with their care. Staff knew exactly how each person communicated which meant people's wishes were understood and respected. A family member told us "the care here is excellent, they accommodate her needs and look after her very well".

People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas singing with staff and interacting with each other. During our inspection we observed people spending time in their bedrooms listening to music and talking to family members. We also saw one person spending time in the workshop completing woodwork projects.

Incident forms were not completed following every fall at the service and there were discrepancies between the accident file and falls register. There was not any evidence of risk assessments being reviewed following a fall or accident within the service. The lack of updates meant that people using the service were not protected from harm and the risks were not reduced.

People told us what it was like to live at Saltmarsh House Residential Care Home and described how they were treated by members of staff and their involvement in making choices about their care. People told us they felt that their personal care was carried out in a manner that promoted their privacy and dignity.

People told us that there are many activities to participate in. They were given opportunities to take part if they chose to. They told us that the staff always asked how they were and staff discussed with them how they were going to do to assist them. We spoke with two relatives who told us they were happy with the care provided.

We spoke with people who told us that they found the home comfortable. They liked the food and told us that the members of staff were “nice” and “helpful.” We spoke with one person who said: “Since my first day here, the people here have been just wonderful.” We spoke with one person who told us the home was cleaned every day and that his room was “clean and tidy.”