This unannounced inspection took place on 12 October 2017. The Manse Residential Care Home provides accommodation and personal care for up to 39 people. On the day of the inspection, 32 people were using the service.

At our previous inspection of 30 June 2015, the service was rated good. At this inspection the service remained good.

There was a registered manager in post. 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.

Care records were not always updated and accurate to reflect people’s needs and circumstances. There were a range of systems in place to monitor and assess the quality of service provided but these had not identified issues with documentation and record keeping

People told us they were safe at the service. People and their relatives told us staff were caring and kind to them. Staff maintained their privacy and confidentiality. Staff knew them well and understood their communication needs.

Staff knew how to protect people from abuse. They knew the signs of abuse and how to report their concerns. There were sufficient staff recruited in a safe way to provide care and support to people. Staff administered and managed people’s medicines safely. People received their medicines as prescribed.

Risks to people’s health, safety and well-being were assessed and management plans devised to guide staff on how to protect them from harm. People’s needs were reviewed and evaluated regularly. Care records had guidance for staff on how to deliver care to people in a way that met their needs. People and their relatives were involved in planning for people’s care.

The registered manager and staff understood their responsivities and supported people in line with the principles of the Mental Capacity Act 2005. The registered manager ensured decisions were made in people’s ‘best interests’ if they were unable to do so. They involved people’s relatives and professionals as required in decision making process. The registered manager had obtained authorisation from appropriate authority as required under the Deprivation of Liberty Safeguards. The monitored the conditions to ensure the people’s rights were not violated.

People accessed health care services to maintain their health. The service worked in partnership with other services such as a local hospice to ensure people received appropriate care and treatment. People received appropriate end of life care in line with their wishes.

People had sufficient food and drink to meet their nutritional needs. People told us they enjoyed the meals provided at the service. They received the level of support needed to eat and drink well.

People took part in activities they enjoyed at the service and in the community. People were supported to follow their interests, maintain their cultural, religious and social values.

Staff received regular training, support and supervision that enabled them to deliver effective support to people. The registered manager held regular meetings with staff where they discussed concerns about people and reflected on their practices.

The registered manager sought the views of people and their relative’s about the service and used their feedback to make improvements if needed. People knew how to make a complaint. The service had investigated fully and resolved complaints received in line with provider’s procedures.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

People felt safe. There were procedures and risk assessments in place which staff implemented to reduce the risk of harm to people. Staff had been trained in safeguarding adults. They knew how to recognise the signs of abuse and how to report any concerns.

Appropriate checks were carried out on staff and they received an induction before they began to work with people. The staff were experienced care workers who had the skills, knowledge and experience to care for people safely.

There was a sufficient number of staff on duty to care for people safely and effectively. Staff understood their roles and responsibilities and were supported by the management through relevant training, supervision and performance reviews.

There were procedures in place to ensure that people received their medicines safely which staff consistently followed. People were protected against the risk and spread of infection.

Staff asked for people’s consent before delivering care. People were involved in their care planning and in control of the care they received. Staff understood the main provisions of the Mental Capacity Act 2005 and how it applied to people in their care.

People were satisfied with the care they received and told us they were treated with respect and kindness. Staff ensured people received a nutritious, balanced diet. People were happy with the quality of their meals and said they were given enough to eat and drink. There were a variety of activities for people to participate in.

People were supported to express their views. The management and staff used their learning from accidents and incidents to improve the safety and quality of care people received.

People’s healthcare needs were met by suitably qualified staff. Regular checks were carried out to maintain people’s health and well-being. People also had access to healthcare professionals and staff liaised well with external healthcare providers. People were supported to plan their end of life care.

The registered manager had worked in the adult social care sector for many years and knew what was required to provide high quality care. There were systems in place to assess and monitor the quality of care people received and these were consistently applied by staff.

People who we spoke to said that the staff were friendly and helpful. One person using the service told us ‘I like this home’ and ‘I do not want to move from here.’ Another person said ‘The staff are good, they look after me well’.

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People were supported in promoting their independence and community involvement. People were given opportunities to express their choices and to make decisions in their daily lives. We observed that staff were aware of people's preferences and routines so they could support people in their daily lives. From our own observations we saw staff treated people using the service with dignity and respect.

Due to their needs, many people that we met during our visit were unable to share their views about the standards of care. The views of people who were able to comment on their experience can be summarised as follows “the staff are very good” and “staff are kind”. All the people we met appeared to be happy and looked well cared for.

Comments from people using the service were generally positive, indicatiing that staff are kind and helpful in meeting their care needs. People were observed to be treated with respect by staff and to have their privacy and dignity respected.