This unannounced comprehensive inspection took place on 23 November 2017. The last inspection took place on 7 October 2015 when the service were meeting the legal requirements. The service was rated as Good at that time. Following this inspection the service remains Good.

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. St Clair House is a care home which offers care and support for up to 25 predominantly older people. At the time of the inspection there were 22 people living at the service. Some of these people were living with dementia. The service occupies a detached house over two floors with a passenger lift for people to access the upper floor.

There were systems in place for the management and administration of medicines. However, the systems for supporting people who self-administered their own medicines was not always appropriate. It was clear that people had received their medicine as prescribed. Regular medicines audits were being carried out on specific areas of medicines administration and these were effectively identifying if any error occurred such as gaps in medicine administration records (MAR).

The premises were well maintained. There was redecoration in progress at the time of this inspection. Whilst the service was not registered for dementia care, there was no pictorial signage at the service to support some people, who may require additional support with recognising their surroundings.

The premises were regularly checked and maintained by the provider. Equipment and services used at St Clair were regularly checked by competent people to ensure hey were safe to use. However, there were no recent records available to demonstrate necessary Legionella water checks had been completed at St Clair. The Health and Safety executive states that care homes should check hot and cold water temperatures monthly and shower heads should be cleaned quarterly. We have made a recommendation about this in the Safe section of this report.

We walked around the service which was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes. People were treated with kindness, compassion and respect.

Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.

Staff were supported by a system of induction training, supervision and appraisals. Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. People were supported by staff who knew how to recognise abuse and how to respond to concerns. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The registered manager had a record which provided them with an overview of staff training needs.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had no staff vacancies at the time of this inspection.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. Although capacity assessments had not always been completed before restrictions had been put in place in order to keep people safe. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff on an electronic

We carried out this unannounced inspection of St Clair House on 7 October 2015. St Clair House is a care home that provides residential care for up to 25 people. On the day of the inspection there were 23 people using the service. The service was last inspected in July 2013 when the requirements of regulation were met.

The service had a registered manager 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.

We inspected the home over one day. The service comprised of a main house with an extension wing comprising of individual rooms leading onto the enclosed garden area. There was a choice of spacious areas where people could spend their time. The main house was an older property but well maintained with plans for future refurbishment in place.

The service had safe arrangements for the management, storage and administration of medicines. It was clear from the medicine records that people received their medicines as prescribed. Regular medicines audits were taking place to identify if any errors occurred.

There was a calm and relaxed atmosphere in the service and staff interacted with people in a kind and sensitive manner. Staff had time to support people and call bells were answered promptly. People told us, “They are good at answering the intercom. They will tell me if I have to wait” and “I like to do crosswords and they [staff] often take the time to pop in and help me”.

Staff working at the service understood the needs of people they supported, so they could respond to them effectively. We observed care being provided and spoke with people who lived at the service. All spoke positively about the staff and the registered manager and felt they were meeting people’s needs. Comments included, “The staff are all kind and patient, I wouldn’t want to live anywhere else” and “Staff are very good and they are all very cheerful”.

Staff supported people to maintain a balanced diet appropriate to their dietary needs and preferences. People were able to choose where they wanted to eat their meals, in either a lounge, dining room or in their bedroom. People were seen to enjoy their meals on the day of our visit. One person said, “I enjoy my meals very much and there is a choice”.

People were protected from the risk of abuse because staff had a good understanding of what might constitute abuse and how to report it. All were confident that any allegations would be fully investigated and action would be taken to make sure people were safe.

The service had an effective recruitment process in place to ensure new staff were safe to work with people requiring care and support. Pre-employment checks had been completed to help ensure people’s safety.

Staff were supported by a system of induction training, supervision and appraisals. Staff meetings were held regularly. These allowed staff to air any concerns or suggestions they had regarding the running of the service.

People told us they knew how to complain and would be happy to speak with the registered manager if they had any concerns.

There were a variety of methods in use to assess and monitor the quality of the service. These included a satisfaction surveys for people using the service and their relatives as well as the staff team. Overall satisfaction with the service was seen to be positive and results of the most recent survey were available for people to view at various entry points to the service.

St Clair House provided care and support to a maximum of 25 people. There were 20 people using the service at the time of our inspection. We spoke to three people during the inspection and observed staff supporting and assisting a number of other people.

We saw care plans were detailed and gave direction as to the care and support people needed. They had been regularly reviewed. We saw they were developed and reviewed with the person using the service and /or their relatives where appropriate.

There were robust systems in place for the storage, administration and disposal of medications.

We saw the house was well maintained and provided a homely atmosphere.

There were robust staff support systems in place and regular training opportunities. Meaning people were looked after people who were confident and trained to do their job.

We saw the quality of the service provided was monitored and the registered manager sought people’s views about the service they received regularly.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practicing professional.

People who lived at St Clair House told us that they were happy living at the home.

They said that the staff respected their privacy and dignity.

People told us that they liked the food they were provided with and that there was a varied menu that offered them choices at each meal time. Comments made included “the food is pretty good here”, “there is plenty to eat, a good choice and I get a snack at bedtime if I want it”.

We spoke with eight people who used the service. We were told the staff were kind and caring towards them. One person added that they felt safe and well cared for at St Clair House

People told us that there were enough staff on duty to meet their needs and that if they rang their call bell it was answered promptly by the staff.