The inspection of The Radcliffe took place on 6 February 2017 and was unannounced. The previous inspection had taken place during November 2015, where breaches of regulations were identified in relation to safe care and treatment and good governance. Following the previous inspection, the registered provider submitted action plans to show how they would address these breaches. We found the areas identified had been addressed and we found improvements during this inspection.

The Radcliffe is registered to provide personal care and accommodation for up to 34 older people; some of whom are living with dementia. The home is made up of two buildings, connected by a covered walkway. One building has 17 en-suite bedrooms and the other building has 17 bedrooms, of which five are en-suite. The home has three communal lounges, two communal dining areas, five communal bathrooms and an enclosed garden and outdoor seating area. There were 33 people living at the home at the time of the inspection.

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.

People told us they felt safe living at The Radcliffe. The registered manager and staff were aware of relevant procedures to help keep people safe and staff could describe signs that may indicate someone was at risk of abuse or harm. Staff had received safeguarding training.

Risks to people had been assessed and measures put into place to reduce risk. However, more detailed information and guidance for staff to ensure safe moving and handling of people would further ensure people’s safety.

Some improvements were required in relation to fire safety. The registered manager and registered provider were aware of this and had begun to take action.

Medicines were stored and administered appropriately.

Staff told us they felt supported and had received appropriate induction, training and ongoing support and supervision.

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 supported this practice.

People received appropriate support to meet their nutritional and hydration needs. A variety of drinks and snacks were offered to people throughout the day.

We observed staff to be kind and supportive and people told us staff were caring. We observed people’s privacy and dignity was respected.

Care records were person centred and reviewed regularly. Care and support was provided in line people’s care plans. Appropriate information was shared between staff to enable continuity of care.

The registered manager was visible throughout the service during our inspection and they knew people’s needs well. Regular quality assurance audits were undertaken and the registered manager ensured that, where actions were identified, these were logged and monitored. There was a service action plan which identified who was responsible for specific actions.

We spoke with eight people living in the home and five members of staff. These were some of the things they told us:

“They (the staff) do everything for you, what more could you want.”

”The staff are all very nice.”

“People come in to entertain us. I like the singers that come.”

“The meals are good and we get a choice of food.”

“I enjoy working here, the staff turnover is low and generally we work well as a team.”

We found that people’s care plans were easy to follow and gave staff the direction to offer appropriate care and support.

The home was clean and tidy and infection prevention guidance was being followed.

The medication system was being managed safely and people received their medication at the right times.

People knew how to raise any concerns and there was a complaints procedure in place.

All of the people were spoke with were very complimentary of the care and service they received.

One person told us that staff "always come quickly when I need them" and another said of staff "They are always for us"

Examples of what people had written in quality assurance questionnaires include:

"I think the Radcliffe is a wonderful place. I have always found management and staff very easy to talk to"

"Any problems or queries I have rung up about have always been dealt with promptly"

One person who lives at the home had marked each section of the questionnaire as "Excellent"

The inspection of The Radcliffe took place on 24 and 26 November 2015 and was unannounced. The previous inspection had taken place on 5 November 2013. The service was not in breach of the health and social care regulations at that time.

The Radcliffe is registered to provide personal care and accommodation for up to 34 older people; some of whom are living with dementia. The home is made up of two buildings, connected by a covered walkway. One building has 17 en-suite bedrooms and the other building has 17 bedrooms; of which five are en-suite. The home has three communal lounges, two communal dining areas, five communal bathrooms and an enclosed garden and outdoor seating area.

The service had a registered manager in place. 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.

People told us they felt safe and staff had received training in relation to safeguarding vulnerable adults.

Risk assessments were in place to help reduce risks to people.

Appropriate health and safety checks were completed regularly, in order to help keep people safe. However, there were no emergency procedures in place to keep people safe in the event of a major incident or emergency situation. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We had some concerns regarding the way in which medicines were administered. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s consent to care was sought. Where people lacked capacity to make specific decisions, a mental capacity assessment had been undertaken and decisions were made in people’s best interest. Where people were deprived of their liberty, authorisation had been granted by the local authority.

The environment was not always conducive for people living with dementia.

People and their families told us staff were caring. We observed staff being caring and respectful to people. People were supported to practise their faith.

Although the care plans we looked at were person centred, we found they were sometimes lacking in information and some contained contradictory information.

There was an activities coordinator and we saw people had a range of activities to choose from. People told us they felt they had choices.

Some policies and procedures were in need of updating.

The registered manager had identified some areas for improvement and had developed an action plan with a view to making improvements at the home. However, there were other areas which required improvement that the registered manager had not recognised prior to our inspection. This was a further breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.