The inspection visit took place on 13 July 2017 and was unannounced.

St Anne’s is a care home for up to 36 people, some of whom were living with dementia. At the time of the inspection there were 34 people living at the service. This was the first inspection of the service since a change in its legal entity, from a sole provider to a limited company in December 2016.

The service is situated in a rural area on the edge of the market town of Holsworthy, close to the town of Bude. The service has two floors reached by a passenger lift. It has been designed to accommodate people who may require specific aids and adaptations for their health and wellbeing. There are external grounds including a courtyard, which are private and not overlooked.

At the time of the inspection visit the manager had been in post for three months and was in the final stages of their registration with the Care Quality Commission (CQC). This has since been completed. 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.

Systems for the operation and management of the service were being reviewed and audited to ensure they were suitable to meet the needs of people using the service and supported staff in carrying out their roles.

The service had moved to an electronic system to record care needs and interventions. Staff used electronic tablets to record all interventions of care and support. Generally, staff were familiar with the operation of the system. However, while the information was in place it was, at times, difficult to find. When we discussed this with the manager they were aware of these issues and were currently carrying out regular audits to pick up these instances and address them. This was important to make sure necessary information about the person that might have impacted upon the rest of the care plan, remained up to date.

Where appropriate and when available, relatives were included in the reviews of people’s care. A family member told us, “We are very involved in putting the care plan together.” People had access to healthcare professionals and their healthcare needs were met.

We reviewed the systems for the management and administration of medicines. There were suitable storage systems for keeping medicines safe and secure. Only staff with responsibility for medicine administration had access to medicines. There were clear records of medicines administered to people or not given for any reason. There had previously been a number of medicine errors. In order to ensure this was reported to the manager and acted upon there was now a medicine error record. A staff member told us they felt this was a good way of making sure errors were being managed safely and changes made through additional training where necessary. By introducing this system meant regular medicines audits were consistently identifying if any errors occurred.

We found two creams which had not been dated when opened. This meant staff would not be aware of the expiration of the item when the cream would no longer be safe to use. When raised with the manager they assured us it would be addressed with immediate effect.

The service acted within the legal framework of the Mental Capacity Act (MCA) and Deprivation if Liberty Safeguards (DoLS). 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.

There were enough staff to help ensure people’s health and social needs were met. People were treated with kindness, compassion and respect. Staff showed affection for the people they cared for. People were relaxed and happy and moved around the service