This inspection took place on 9 November 2016 and was unannounced. The Swallows is a residential care home for older people. The home accommodates up to 19 people, and provides care and support to people with dementia. At the time of the inspection there were 18 people using the service.

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.

The service was last inspected on the 7 June 2016, where we carried out a focused inspection. We found the service had made improvements and was meeting the regulations we inspected. These related to safe. At this inspection we found the service was meeting the regulations we inspected.

People were protected against the risk of harm and abuse. Staff were aware of the different types of abuse and how to recognise and report their concerns of suspected abuse. Staff received on going safeguarding training. People were protected against identified risks. The service had devised risk assessments that identified the risk to people and how staff would minimise those risks. Risk assessments were reviewed regularly to reflect people’s changing needs. People were supported to live in a safe environment that was regularly assessed. The service carried out regular safety audit checks of the environment. Where risks were identified, action was taken in a timely manner to make the environment safe.

People received their medicines in line with good practice. Identified errors were responded to in line with good practice to ensure the risk of poor management of medicines was minimised. Staff received training in safe management of medicines.

People were not deprived of their liberty unlawfully. Staff were aware of their responsibilities in line with the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Staff received on going MCA and DoLS training and were aware of the correct procedure if they suspected people’s capacity was fluctuating. At the time of the inspection 12 people were subject to a DoLS authorisation.

People received care and support from sufficient numbers of suitable staff. The service carried out robust recruitment processes to ensure staff were suitable to work at the service. Records showed staff had supplied two references, photo identification and a Disclosure and Barring Service [DBS] certificate prior to being employed. A DBS is a criminal check employers undertake to make safe recruitment decisions. The service employed sufficient numbers of staff to ensure people’s needs were met.

People’s consent to care and treatment was sought and respected. Staff encouraged people to make decisions about the care they received. Where people were unable to make these decisions action was taken in their best interests and in line with good practice. Staff respected and encouraged people’s privacy and dignity.

People received care and support from staff that reflected on their working practices. Staff received on-going supervisions and appraisals whereby staff looked at what they did well and areas they required additional support and guidance.

People were supported to access sufficient amounts of food and drink that met their preferences and nutritional needs. People’s dietary requirements were adhered to in response to guidance from health care professionals. People had their health and wellbeing monitored and were supported to have access to health care services when required.

People received personalised care that was tailored to their individual needs and preferences. The service had devised care plans that documented people’s likes, dislikes, life history and medical and health needs. People and their relatives were encourag

This inspection took place on 7 June 2016 and was unannounced.

The Swallows is a residential care home for older people, which provides accommodation and support for up to 19 people, some of whom have dementia. At the time of the inspection there were 19 people living at The Swallows.

The service was last inspected on 23 and 25 February 2016 and was given an overall rating of Inadequate. At the last comprehensive inspection, the provider was placed into special measures by CQC. We undertook a focused inspection at 4am to look at the areas of significant concern identified at the last inspection. This report covers our findings at the inspection on 7 June 2016. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Swallows on our website at www.cqc.org.uk

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.

We found there were insufficient numbers of staff on duty at night to safely evacuate the building in the event of a fire.

Staff did not always have access to an up-to-date fire risk assessment and fire policy. Not all staff we spoke with were aware of where the current risk assessment and fire policy were located. The service had a file in the staff office area, which contained out of date paperwork relating to the fire safety.

The service carried out fire safety checks, fire alarm drills, emergency lighting checks and other checks relating to the fire safety. However checks were not always undertaken when senior staff were absent. We found three weeks checks were missing, which correlated to times when senior staff were on leave.

The service had carried out Personal Emergency Evacuation Plans [PEEPS]. These documents provide guidance to staff and emergency services on how to safely evacuate someone from a building in an emergency.

The service put in place new window restrictors, which ensured all windows were restricted in line with good practice. The service had updated signage relating to fire exits. Designated fire exit doors were in place and free from obstruction. Fire exits doors were linked to the fire alarm and upon the alarm sounding would automatically open.

Staff were aware of the correct procedure to follow in the event of an emergency and had received fire safety training.

This inspection took place on 23 and 25 February 2016 and was unannounced.

The Swallows is a residential care home for older people which provides accommodation and support for up to 19 people, some of whom have dementia. At the time of the inspection there were 19 people living at The Swallows. 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 were placed at significant risk of harm as the provider did not take reasonable steps in relation to fire safety management. The service did not have fire risk assessments, Personal Emergency Evacuation Plans (PEEPs), fire safety audits or functioning fire escapes in place. The service did not have enough staff to meet people’s needs at night. The service did not have sufficient staffing at night to ensure people could be evacuated from the building safely in the event of an emergency. People were at risk of harm as the provider did not have adequate audit systems in place to monitor the safety of the premises and equipment. Records showed electrical hardwiring checks, portable appliance testing [PAT] and legionella water tests were out of date.

People had their liberty restricted without authorisation. Staff had inadequate knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These aim to make sure that people in care homes, hospitals, and supported living services, are looked after in a way that does not deprive them of their liberty and ensures that people are supported to make decisions relating to the care they receive.

People were not always protected against the risk of harm and abuse. Staff were not always clear on the correct procedure in reporting alleged abuse. Staff were unclear of the provider’s whistleblowing procedure. The service did not have an ‘easy read’ complaints procedure in place to support people who found written documentation difficult to understand. People received their medicines in line with their prescriptions. However, the service demonstrated unsafe medicine management in relation to the storage and disposal of medicines.

People were protected against known risks, such as the risk of falling. The service had in place risk assessments which identified known risks and provided staff with guidance on how to mitigate these risks.

People’s consent to care and treatment was sought before care was delivered. Staff were aware of the importance of ensuring consent was obtained prior to giving care. Staff were respectful when consent was not given. Care plans were person centred and detailed people’s likes, dislikes, preferences, history and health care needs. People had access to health care professionals to maintain their health and wellbeing. Records showed people received support and guidance from staff that followed health care professionals’ advice. People’s privacy and dignity was promoted. Staff were aware of the importance of maintaining people’s privacy and dignity at all times.

People were given sufficient amounts to eat and drink throughout the day. The chef provided people with nutritious food that met their nutritional needs. People were able to request additional food that was not available on the menu.

We identified that the provider was not meeting regulatory requirements and was in breach of a number 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken imm

People using the service and their representatives were involved in decisions about their care. The service involved people in care plan development, they were supported to express their views and their choices were respected. However, people using the service and relatives we spoke with said there was a lack of activities organised in the home.

People using the service and their relatives we spoke with made positive comments about The Swallows. They told us they had no concerns about the care and support they received. One person told us, "It's nice here. People are kind. I must admit the staff are very, very good. They're excellent." A relative told us, "The move here has been the best thing that's happened to her. They have done a lot of work to encourage her to look after herself." Another relative told us, "All the staff seem to be really good - they're attentive."

Our last inspection of 26 September 2012 found there was a lack of suitable arrangements to ensure the staff team had up to date training and supervision to enable them to deliver care and treatment to service users safely and to an appropriate standard. When we inspected the service on 30 April 2013, we found that staff training was up to date, and staff supervision had improved.

The provider monitored the quality of the service by obtaining feedback through residents' meetings and staff meetings, monitoring incidents relating to people using the service and carrying out audits.

During our inspection, we observed that people were treated with consideration and respect by the staff team.

Lunch was well organised during our inspection and people received a prompt service and support with eating their meals. However we noted improvements were needed in the way that support was provided to some people who needed additional support.

The staff were supported through regular staff meetings. However, there was a lack of suitable arrangements to ensure the staff team had up to date training and supervision.