We carried out an inspection on the 20 and 28 December 2017. The first day was unannounced.

This was the first inspection of the service since it was registered in June 2016.

Stone House 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. Stone House accommodates up to 35 people in one adapted building over two floors. There were 26 people accommodated at Stone House at the time of this inspection.

The service 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. The registered manager was not present when we visited the service although arrangements had been made for a temporary manager to run the service to ensure continuity.

We have made a recommendation about care records. Records outlining the daily fluid intake of some people were maintained yet did not indicate daily targets for people to be achieved. While there was no evidence that this had a negative impact on people.

People told us that the felt safe living at Stone House and that they always received their medication when required. People told us that there was always staff around to assist them. Medication was well managed and promoted the health of people who used the service.

People lived in an environment that was clean and hygienic. The premises were well maintained with equipment being checked to ensure it was safe to use. The environment was designed to enable people to move around independently and remain safe.

People were further protected by the robust recruitment of new staff. The registered provider demonstrated that staff received up to date training on topics which related to the needs of people.

Staff were sufficient in number to meet the needs of people who used the service. Where shortfalls in staffing were identified, efforts were made to ensure that continuity could be maintained by using exiting staff to cover shifts.

Accidents and incidents were recorded and analysed to prevent future re-occurrence or identify future trends.

Staff received training and supervision which was suitable for their role. A structured induction process was in place enabling new staff to become familiar with their role and the needs of people who used the service.

The registered provider took the requirements of the Mental Capacity Act into consideration and ensured that the best interests of people were served.

The nutritional needs of people were met with people’s preferences respected. Food was well prepared in clean and hygienic facilities.

People felt that staff cared about them. Observations of care practice noted that people were treated in a respectful and dignified manner. Staff gave practical examples of how the privacy of people could be maintained.

Advocacy services were in place for individuals and consideration was given to ensuring that communication between staff and people whose first language was not English enabling their needs and preferences to be known.

Staff were aware of the likes and dislikes of people and individuals were able to personalise their rooms to their own tastes.

People’s care plans were checked on a regular basis to ensure they were accurate and up to date. Care plans included an acknowledgement of the health needs of people but also placed emphasis on their social history and interests. We saw that care practice matched the information included within care plans.

An activity programme was in place and ensured that people had the opportunity to join in if they wished.

People were provided with the opportunity to remain