We inspected Stratford Bentley Care Centre on 7 March 2017. The inspection visit was unannounced. When we last inspected the service we found the service was rated as Good overall.

Stratford Bentley is arranged on a single floor and provides personal and nursing care for up to 30 older people, including people living with disabilities and dementia. There were 22 people living at the home when we inspected the service.

A requirement of the service’s registration is that they have 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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection visit.

People received medicines as prescribed to maintain their health and wellbeing. People were supported to access healthcare from a range of professionals inside and outside the home and received support with their nutritional needs. This assisted them to maintain their health.

People were protected against the risk of abuse as the provider took appropriate steps to recruit staff of good character, and staff knew how to protect people from harm. Safeguarding concerns were investigated and responded to in a timely way to ensure people were supported safely.

There were enough trained and supervised staff to care for people effectively and safely, and meet people's individual needs. Staff treated people with respect and dignity, and supported people to maintain their privacy and independence.

The provider, manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made applications to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA requirements. Decisions were made in people’s ‘best interests’ where they could not make decisions for themselves.

Staff knew people well and could describe people’s care and support needs. Care records were up to date and provided staff with the information they needed to support people responsively.

People made choices about who visited them at the home. This helped people maintain personal relationships with family and friends who were important to them. People were supported to take part in social activities and pursue their interests and hobbies.

People knew how to make a complaint if they needed to. Complaints received were investigated and analysed so that the provider could learn from them. People who used the service and their relatives were given the opportunity to share their views about how the service was run.

Quality assurance procedures were in place to identify where the service needed to make changes; where issues or improvements were identified the manager took action to continuously improve the service.

This inspection took place on 29 & 30 March 2016 and was unannounced.

Stratford Bentley is a nursing home which provides care to older people including some people who are living with dementia. Stratford Bentley is registered to provide care for up to 30 people. At the time of our inspection there were 22 people living at the home. Stratford Bentley is also registered to provide a personal care service to people living in five individual bungalows situated next to the home. At the time of our visit, these bungalows were unoccupied so no care provision was provided.

There was no registered manager in post. The registered manager left the service on 17 March 2016 and the home was being managed temporarily by a senior nurse. 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 provider is currently recruiting for a registered manager.

Staff knew how to keep people safe from the risk of abuse. People told us they felt safe living at Stratford Bentley and relatives agreed their family members felt safe and protected from abuse or poor practice.

The provider assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks. However, some care plans and risk assessments required updating to make sure staff provided consistent support that met people’s needs.

There were enough staff on duty to meet people’s health needs. However, if personal care was provided to people living in the bungalows, the provider would need to reassess staffing levels to ensure people living at the home, continued to receive a responsive and effective service. The premises were regularly checked to ensure risks to people’s safety were minimised.

People’s medicines were managed, stored and administered safely in line with GP and pharmacist prescription instructions.

People were cared for by kind and compassionate staff, who knew their individual preferences for care and their likes and dislikes. Staff understood people’s needs and abilities and they received updated information at shift handovers to ensure the care they provided, supported people’s needs. Staff received regular training and support that ensured people’s needs were met effectively. Staff were encouraged to develop their skills and knowledge, which improved people’s experience of care being delivered.

Nursing staff and care staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). No one had a DoLS in place at the time of our inspection. The temporary manager acknowledged people’s care plans did not always record information to make sure, where they lacked capacity, staff knew how to support and encourage them. Records showed consideration had been made if a persons’ liberty may be deprived, as the provider had made six applications to the local authority.

People were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs, which minimised risks of malnutrition. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health, and when their health needs changed.

People and their representatives felt involved in care planning reviews and said staff provided the care required. Care was planned to meet people’s individual needs and abilities and care plans were reviewed although some information required updating to ensure staff had the necessary information to support people as their needs changed. People were supported to pursue their interests and hobbies and live their lives how they wished, and staff