At our previous inspection in February 2013 we found people were not protected against the risks associated with the administration of medicines. This was because there were shortfalls in the way medicines were being recorded. The provider sent us an action plan describing how they intended to improve.

At this visit we found the provider was monitoring the administration of medicines on a daily basis to ensure they could act immediately if needed. We saw staff had received supervision and refresher training with regards to the management of medicines.

We looked at systems for enabling people to self administer their medicines and saw improvements had been made. We saw accurate records had been maintained in relation to the administration of medicines.

People who lived in the home told us they were looked after well by the manager and the staff team.

We observed that people were well supported and treated respectfully by staff. We looked around the home and saw bedrooms, communal areas, bathrooms and toilets were clean and odour free.

We looked at people's care plans, personal care needs, risk assessments and daily routines and found that they encompassed the safety and well-being of people who use the service.

Training records showed that staff had received all relevant training. We noted that staff received regular supervision with annual appraisals in place.

People who use the service and staff told us they knew how to raise a concern or complaint and felt confident in doing so. They said if they had any issues or concerns they were able to discuss "with the manager."

We reviewed the medication process and found shortfalls in the way medication was being recorded which may have an impact on the people who use the service.

The quality of the service was monitored and people who use the service, staff and professionals for example GP's were provided with the opportunity to give feedback and influence the way the service was.

People who lived in the home told us they were well cared for by the manager and the care staff. They said they were treated with dignity and respect.

People said it was a friendly and comfortable place to live and that their privacy was respected. People told us they were satisfied with the care and support they received and that the staff were competent and caring.

People said they enjoyed the food and were provided with a choice of activities.

We were told that people felt safe and were able to raise concerns or issues if the need arose.

Relatives we spoke to said people were well cared for and that they were made to feel welcome when they visited the home.

Staff said they were well supported by the manager and provided with the appropriate training.

Outside professionals who visited the home told us they found the service well organised and providing a homely and caring environment.

One inspector visited the home and answered our five questions, is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with all four people using the service, their relatives, three staff, the manager and the provider. We reviewed the four care plans, three staff files and other relevant records.

Is the service safe?

Care plans instructed staff how to meet people’s needs in a way which minimised risk for the individual. They were detailed and ensured staff cared for people in a safe way.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home had trained their staff with regard to DoLS and understood when a DoLS referral may be necessary. The type of care the home provided and the needs of the people who lived there meant that it had never been necessary to deprive people of their liberty.

We found that food was of good quality, nutritious and served in a hygienic and safe manner. Staff were trained in food hygiene and people’s dietary requirements.

Staff were trained to recognise all forms of abuse and had a clear understanding of how to protect the people in their care. People told us they felt safe and family members said they were always absolutely certain their family members were safe in the home.

The home had enough staff to provide safe care to the people who lived there.

Systems were in place to make sure that the manager and staff continually monitored the quality and safety of care offered to people.

Health and safety was taken seriously by the home and all the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.

Effective?

People’s health and care needs were assessed with them, and/or their relatives, as appropriate. Care plans were detailed and clearly identified people’s needs and how they should be met. We saw that staff gave support as described in individual’s care plans.

One relative gave us an example of how the home had improved a person’s health condition.

Caring?

People were supported by kind, caring and patient staff. We saw that care staff were attentive, encouraging and positive. They responded appropriately to people’s needs. Staff communicated with people at all times and encouraged social interactions.

People described staff as ‘‘very, very kind’’. One person said: ‘‘it’s wonderful, you couldn’t get a better place to live’’. Relatives of people who lived in the home described staff as: ‘‘very respectful, kind and understanding’’.

People's diversity, values and human rights were respected. Care plans were individualised and person –centred. We saw that people were treated with respect and dignity by the staff.

Responsive?

Care plans were reviewed regularly and amended, as necessary, to meet people’s current needs. We saw that health care was sought in a timely way.

The home had made changes and improvements as a result of ideas and discussions with people who lived in the home and their relatives.

The home had received three compliments and no complaints since January 2014.

Well led?

Staff members told us that they were supported to do their job well. They said that they felt valued and their views were listened to. People who lived in the home and their relatives told us that the manager and provider were in the home all the time. They said they would listen to anything they had to say and take action, as necessary.

The service had a formal quality assurance system. We saw records which showed that any shortfalls were identified and actions to be taken to address them. Several examples of changes made as a result of the annual quality questionnaires were provided by the manager. As a result the quality of the service was being maintained or improved.