The inspection took place on the 16 May 2017 and was unannounced. This meant that the provider and staff did not know we would be visiting.

The service had not been rated under the new registered provider of Burlington Care Limited so this was a first rated inspection for The Lawns Care Home.

The Lawns Care Home accommodates up to 62 older people, some of whom are living with dementia. There were 56 people living at the home at the time of the inspection.

A registered manager was in post. People, relatives and staff spoke positively about her leadership. A registered manager is a person who has registered with the CQC 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.

We saw issues addressed from an infection control nurses audit inspection on 3 March 2017 were being attended to in relation to a hand washing sink and window ledge on the day of the inspection visit. First thing in the morning we found the first floor bathroom contained clothes and continence products and was untidy. Staff were mainly using this bathroom as one other on this floor was temporarily out of use. We also found two fridges in the dining rooms on both floors contained ice and contained unlabelled food. It was acknowledged and the registered manager took immediate action on the day to rectify the fridges and sent us evidence they had met with night staff to review cleaning rotas and discussed bathroom tidiness.

There were safeguarding procedures in place. Staff knew what action to take if abuse was suspected.

People were safe because risks had been identified and managed. All the staff in the home had completed training to give them the skills and knowledge to carry out their roles and to ensure people in the home were safe.

Systems were in place for the safe storage, administration and disposal of medicines. Records showed people received their medicines as prescribed and in their preferred manner.

People received on-going healthcare support from a range of external healthcare professionals and people’s health and nutrition needs were effectively monitored and responded to in line with nationally recognised practice. People were supported to eat a well-balanced diet and those who were at risk of malnutrition and/or dehydration had their food and fluid intake monitored. We found some records in relation to personal care were disorganised and the registered manager addressed this straight away.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

There were sufficient staff deployed and we spoke with the registered manager to ensure staffing levels were reviewed in light of increasing numbers of people. Safe recruitment procedures were followed and staff had completed training in safe working practices and to meet the specific needs of people through face to face training. An effective induction process was in place which was linked to the Care Certificate for all new staff members.

There was an activities co-ordinator employed to help meet the social needs of people. A varied activities programme was in place although people fed back to us they would like more activities

The staff knew the people they were supporting well and treated them in a respectful and friendly way. We saw care plans identified people’s needs and wishes although some people we spoke with did not know about their plan of care.

The provider had a range of quality monitoring systems and had made improvements in response to people's feedback and audits. There was a commitment to deliver a good standard of personalised care and continued improvement based on the views of people who used the service and the enhancement of their lives. The s