This unannounced inspection took place on 15, 16 and 19 November 2018.

Sennen Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sennen Lodge is a care home that provides accommodation for up to eight adults with a learning disability. There were eight people living at the home when we visited. The home is based on two floors. The second floor was accessible via stairs. There were communal rooms and a garden which people could access. All rooms were single occupancy. At the time of inspection there were six people living at Sennen Lodge.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion to help ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection August 2017, we found a breach of regulations 17, 18 and 19 of the Health and Social Care Act (Regulated Activities) Regulations 2014. This was in relation to safe recruitment practices, staff training and systems to monitor the quality and safety of the service. During this inspection we found improvements had been made and the service had met the requirements of these regulations.

The service had a registered manager in place at the time of our inspection. 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 registered manager started in their role since our last inspection. They had overseen the effective implementation of improvement plans, which addressed the key areas where the service required improvement. People’s relatives and professionals told us the registered manager was competent, approachable and had significantly improved the service since they started in their role.

People’s relatives told us they were kept informed about their family members care and that they were involved in making decisions where appropriate. People’s needs were fully assessed to help ensure they received an appropriate level of care. Where people had external professional input into their care, the provider implemented recommendations to help ensure appropriate plans of care were in place.

There were systems in place to ensure staff had the right training, induction and supervision in their role. The registered manager monitored staff’s working practice and behaviours, providing additional support where necessary.

Staff understood people’s needs and were confident in providing support around people’s personal care, communication and behaviour. Staff were caring and attentive to people and treated them with dignity and respect.

There were sufficient numbers of staff in place to meet people’s needs. The registered manager had successfully recruited many new staff since our last inspection in August 2017. The provider had made improvements to its recruitment processes to help ensure that only suitable staff worked with people.

The provider had made improvements to its quality assurance system to help ensure the registered manager could effectively monitor the quality and safety of the service.

Risks to people were assessed and mitigated. The registered manager analysed incidents to put measures in place to reduce the risk of reoccurrence.

Staff understood their responsibilities in safeguarding people from abuse and harm. The registered manager provided strong leadership in this area and was transparent with relatives and other stakeholders when concer

This inspection took place on 12 July and 3 August 2017 and was unannounced. After the first day of inspection, the provider made us aware of some specific concerns relating to the service following receipt of some video footage. The provider took immediate action to remove the risk to people's safety by suspending a number of staff while full investigations were carried out. Two inspectors subsequently visited the service on 3 August 2017. These concerns are the subject to an ongoing investigation and as a result this inspection did not examine those circumstances.

Sennen Lodge is a care home that provides accommodation for up to eight adults with a learning disability. There were eight people living at the home when we visited. The home is based on two floors. The second floor was accessible via stairs. There were communal rooms and a garden which people could access. All rooms were single occupancy.

The service did not 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. The registered manager had recently resigned. A new manager had been appointed at the time of our first inspection visit on 12 July 2017, and had started work at Sennen Lodge on 31 July 2017.

People were at risk of receiving unsafe or inappropriate care because the service did not always robustly risk assess and consider an appropriate induction into the service for staff where areas of concern arose from their pre-employment checks. The provider had made changes to their recruitment policy to make the process safer and more robust, but these had only recently been introduced and therefore were not embedded within the service.

People were at risk of receiving unsafe or inappropriate care because not all staff had consistently received supervision and induction training to help their effectiveness in their role and monitor their behaviours and working practice.

There were systems in place to monitor the quality of the service. These included regular audits, competency assessments of staff and an internal inspection from the provider’s quality team. However these audits and checks were not always effective in driving or sustaining improvements.

There were systems and processes in place for identifying, reporting and recording concerns. However incomplete records meant we could not be sure all staff had completed training in safeguarding or that they put their learning into practice.

Staff we saw at the service were kind, considerate, patient and caring. There were adequate numbers of staff available.

Risks relating to people’s health and medical conditions were assessed, monitored and managed. Risk assessments looked for ways to reduce risks associated with activities, enabling people to pursue their interests. People had access to a range of different activities according to their preference. This included activities inside the home and in the community.

The environment at Sennen Lodge was busy, but the provider had made adaptations to the building to provide quieter spaces for people if they wanted. The provider had also made adaptations to the garden and kitchen which helped enable people to participate in activities in these areas.

People’s care plans were detailed and included information around effective ways for staff to provide support and respect people’s preferences. They were regularly updated when people’s needs changed and also included details relating to healthcare services and dietary requirements. The service had successfully worked in partnership with other stakeholders to enable people who were reluctant to attend healthcare appointments to access these services.

We identified three breaches of regulations. You can see the