We completed a follow up inspection of Syrena House on 18 November 2014 because at our last inspection we had minor concerns about medicines management. These concerns included gaps (no signatures) on some of the medication administration records and no formal internal medication audit.

At this inspection we found that the Syrena House had made improvements.

We talked with three members of staff including the manager. We reviewed all of the medication records and seven care records. Medication records were completed appropriately. Medicines were ordered and stored safely and the pharmacists completed regular medication audits.

The provider may wish to note that the pharmacy audits were not kept on site. This meant that staff did not have immediate access to them.

On the day of our visit we were told that there were nine people staying at Syrena House. We spoke with three people and eight staff members, which included an occupational therapist and members of the management team. We looked at three people’s care files in detail, observed care and reviewed information provided to us by the management team.

Before people received any care or treatment they were asked for their consent and staff acted in accordance with their wishes.

People we spoke with who were staying at Syrena House said that their care and welfare needs were being well met. Comments included: “It’s nice here. I am happy. I go out, do yoga and the food's nice”; “I am fine” and “Off to the cinema this afternoon.”

No formal audits of medicines were carried out. This posed a risk that medicine management was not robust enough to ensure the safe storage, dispensing, recording and disposal of medicines at Syrena House.

Staff confirmed that they received training on an ongoing basis to enable them to carry out their roles confidently.

Care records were stored securely in order to protect people’s confidentiality.

On the day of our visit we were told that there were six people staying at Syrena House of which two people were on extended leave in view of their imminent discharge. We spoke with three people and eight staff members, which included an occupational therapist, student nurse and the management team. We looked at three people’s care files in detail, observed care and reviewed information provided to us by the management team.

People who used the service understood the care and treatment choices available to them. People told us how they were helped to understand the care and treatment choices available to them. Comments included: “I have seen my care plan and have a copy in my bedroom”; “I have my own privacy in my bedroom” and “I am involved in decisions about my care and treatment.”

People we spoke with who were staying at Syrena House said that their care and welfare needs were being well met.

People confirmed that they felt safe and supported by staff at Syrena House and had no concerns about the ability of staff to respond to safeguarding concerns.

People informed us that staff met their needs in a timely manner. Everyone we spoke with was confident in the ability of staff to provide the care needed. Comments included: “I think there is enough staff”; and “The staff are really helpful.”

People were made aware of the complaints system. This was provided in a format that met their needs.