We inspected this service on 13 December 2018. This inspection was unannounced.

The last inspection took place on 11 September 2017 when the provider for this location was Bupa Care Homes (CFH Care) Limited. This was the first inspection of the service since the provider changed to HC One Oval Limited.

A comprehensive inspection took place during September 2017 and the overall rating awarded was ‘Requires Improvement.’ The provider was meeting the regulations that we checked, however improvements were needed to ensure the service was ‘safe’ and ‘responsive’. Staffing levels were not always sufficient to consistently meets the needs of the people using the service. Improvements were also needed to ensure peoples well-being was promoted through social activities. At this inspection we saw that there were sufficient staffing levels to support people and people were given the opportunity to take part in activities. However further improvements were required under 'safe' to ensure management of medicines was safe.

Shelton Lock Care Home 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.

Shelton Lock Care Home is situated in the Shelton Lock area of Derby. Shelton Lock provides long term and respite care for adults with a range of physical nursing needs, including palliative and end of life care and respite care for adults. The home is registered to provide personal care and accommodation for up to 40 older people and younger adults. At the time of our inspection there were 30 people using the service

A registered manager was 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.

The management of medicines was not always safe. We found that the medication trolley was not locked and left unattended. In the clinic room we saw medicines were left on the side and not locked away securely.

People were protected from the risk of abuse. People told us they felt safe with the care provided by staff. Staff had received training in safeguarding people and knew how to report their concerns including external agencies such as the local authority.

People told us they felt safe. Sufficient staff were employed to support people. Recruitment procedures were thorough to ensure prospective staff were suitable to care and support people at Shelton Lock Care Home.

Risks were managed according to individual need and we saw staff support people safely and appropriately with transfers.

People were protected by the provider's infection control procedures, which helped to maintain a clean and hygienic environment.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported with their dietary needs.

People were cared for by staff who were kind and caring. Staff respected people's privacy and dignity. People were supported with their independence by staff. Visitors were welcomed at Shelton Lock Care Home.

The provider’s complaints policy and procedure were accessible to people who used the service and their representatives. People knew how to make a complaint and felt the provider would take action to address any concerns.

Quality assurance processes were in place to monitor the quality of care delivered. The registered manager worked in partnership with external health and social care professionals to ensure people's health and social care

The inspection took place on 11 September 2017 and was unannounced. Shelton Lock provides long term and respite care for adults with a range of physical nursing needs, including palliative and end of life care and respite care for adults. The service is registered to accommodate up to 40 people. At the time of the inspection 31 people were using the service.

The last inspection took place in September 2015 before BUPA (The provider) changed their legal entity to BUPA Care Homes Limited. This was the first inspection of the service since the legal entity changed on 31 January 2017.

Shelton Lock had 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.

People’s and staff comments found staffing levels were not always sufficient to consistently meet the needs of people using the service. We have identified this as an area of improvement as to how staffing levels are determined in the detailed findings of this report.

Staff were able to demonstrate a good understanding and knowledge of people's specific support needs, so as to ensure theirs and others safety. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow.

People’s safety was promoted as potential risks were assessed and regularly reviewed. Measures to reduce risk were implemented which included the use of equipment to support people safely and promote their independence.

We observed that staff followed safe procedures when giving people their medicines. Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

The provider had robust recruitment processes in place. Staff understood their roles and responsibilities and would seek people's consent before they provided care or support. Staff received supervision and support, and had been trained to meet people's individual 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. We observed examples of good practice where staff offered people choice, and people told us they did not feel restricted.

The dining experience for people was positive and people were in the main complimentary about the quality of meals provided. Catering staff responsible for the provision of people’s meals were knowledgeable about people’s individual dietary requirements and their diets were catered for.

People's healthcare needs were effectively managed and kept under review. Staff were observed to refer to and speak with health care professionals on both urgent and routine health care matters. People told us they had access to health care services and people’s records confirmed this.

People’s needs were assessed prior to their moving into Shelton Lock and were used to develop care plans which were reviewed and updated. Assessments were also used to gather information about people’s life histories. We found this information whilst gathered was not used to support people’s social interaction and engagement. People’s access to activities and stimulation was inconsistent, and further measures were needed to reduce the risk of social isolation. We have identified this as an area for improvement within the detailed findings of this report.

Systems were in place to seek and act on feedback from people using the service, which included the complaints policy and procedure. People referred to resident meetings; however they said these were not reg