We carried out an unannounced inspection on 11 September 2017. The service provides care and support for up to 21 people with needs relating to old age.

At the time of the inspection, there were 20 people being supported by the service. There was a registered manager in post; the registered manager was on annual leave when we inspected the service. 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 were safe and the provider had effective systems in place to safeguard them. There were risk assessments in place that gave guidance to the staff on how risks to people could be minimised. People’s medicines were managed safely and administered in a timely manner by skilled and trained staff.

The provider had effective recruitment processes in place and there was sufficient staff to support people safely. Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had supervision, support and effective training that enabled them to support people well.

People were supported to have sufficient food and drinks and were supported in a caring and respectful manner. They were also supported to access other health and social care services when required.

People’s needs had been assessed, and care plans took account of people’s individual needs, preferences, and choices.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people or their representatives. The provider acted on the comments received to improve the quality of the service.

The registered manager provided stable leadership and managerial oversight to staff who felt supported in their roles.

The provider’s quality monitoring processes had been used effectively to drive improvements.

This inspection took place on 13 August 2015 and was unannounced.

St Margaret’s Residential Home provides care and support for up to 21 older people, some of whom are physically frail and maybe living with dementia. There were 18 people living at the service when we visited.

The service has 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 felt safe living at the service and staff had been trained to recognise signs of potential abuse and to keep people safe.

Processes were in place to manage identifiable risks within the service and to ensure people did not have their freedom restricted unnecessarily.

The provider carried out recruitment checks on new staff to make sure they were suitable to work at the service.

There were systems in place to ensure people were supported to take their medicines safely and at the appropriate times.

Staff had been provided with essential training and support to meet people’s assessed needs.

People’s consent to care and support was sought in line with the Mental Capacity Act (MCA) 2005.

Staff supported people with eating and drinking and to maintain a balanced diet.

People were registered with a GP. If required, they were supported by staff to access other healthcare facilities.

Positive and caring relationships had been developed between people and staff.

People were encouraged to maintain their independence and staff promoted their privacy and dignity.

Pre-admission assessments were undertaken before people came to live at the service. This ensured their identified needs would be adequately met.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.

There was a positive, open and inclusive culture at the service.

There was good leadership and management demonstrated at the service, which inspired staff to provide a quality service.

There were quality assurance systems in place to monitor the quality of the service provided and to drive continuous improvements.

When we visited St Margaret’s Residential Home on 26 June 2013, we spoke with five people about the care and support they received from staff. People told us they were happy with the home environment and the support they were offered. One person said, "I really like it here." Another told us, "It's good here. The staff are all excellent. I like the staff and they care for me very well."

Due to the complex needs of some people, we also spent some time observing people and saw that they were engaged in activities of their choice and at a level that was appropriate to them. Although no formal activities were taking place during our visit, we observed staff interacting with people and supporting them to listen to music, read the newspaper or watch television. One person told us, "It's my home. I like to watch the television."

We noted that staff were friendly in their approach to people and treated them with dignity and respect. They addressed them in a manner that was appropriate to them and which corresponded with their preferred method of address.

People appeared content in the presence of staff and there was a friendly and calm atmosphere. Care records showed that relatives were encouraged to participate in people's care reviews and were kept updated with any changes in condition.

We reviewed the medication records and saw that people received prescribed medication on time and that the medication was stored safely.

During our visit on the 19 October 2012 we spoke with four people using the service and a visiting relative.

People we spoke with told us that they liked living at the home and said staff were very kind.

We were told by two people that the food was very good and they had plenty of it. We observed one person with complex needs who was being supported at lunch time by a staff member. This was carried out discreetly, in an unrushed manner and the staff member spoke respectfully to the person at all times.

Everyone spoke positively about the care they received and said staff spoke with them in a kind and respectful way.

One person told us that staff ensured their privacy and dignity was respected at all times.

A visiting relative told us they were happy that their relative was living in the home and said they were well cared for. The relative said the staff “Don’t just care for my mum, they care for me too. She always has a drink beside her and she only need to ask if she wants something.”

During our visit one person took hold of the manager’s hand and told us, “She’s a good one. She always joins in with everything and always sorts out our problems.”

Another person told is if they had any worries or concerns they would talk to the manager without hesitation.

During our visit on 28 December 2011, we spoke with three people who received a service at St Margaret’s. They all told us they were happy with the care provided. We also spoke with the relatives of two people who had lived at the home. They told us they were very satisfied with the care their relatives had received. One relative particularly praised the end of life care their relative had experienced at the home.

People told us that the staff knew how to support them and understood their needs. We looked at one persons care plan and risk assessments with them. They told us these were accurate and reflected their needs.

People made positive comments about the staff who care for them and said that staff treated them with respect. We heard staff speak in a kind, friendly and respectful manner. Staff addressed people by their name and explained what they were going to do before providing care.

The people we spoke with were confident the manager would address any concerns they raised.