When we inspected the service in January 2016, the provider was not meeting all the fundamental standards of care because people's medicines had not always been given in a way that promoted effective treatment. The environment was not conducive to the needs of people living with dementia, and people had not been adequately supported to pursue their hobbies and interests. The level of user satisfaction with the quality of the service and whether people lived full and happy lives at the home was low. We found improvements had been made during this inspection, although further improvements were needed in how the service supported people to pursue their interests, and to live active, happy and fulfilled lives.

This unannounced inspection was carried out on 8 and 13 March 2017, and was completed on 20 March 2017 when we received information we had requested from the provider.

Victoriana Care Home provides care and support for up to 33 people, some of whom may be living with dementia, mental health conditions and chronic health conditions. On the day of our inspection, 18 people were being supported by the service.

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 safe because the provider had effective systems to keep them safe, and staff had been trained on how to safeguard people. There were individual risk assessments that gave guidance to staff on how risks to people could be minimised. People’s medicines were managed safely and administered in a timely manner by trained staff. The provider had effective recruitment processes in place and there was sufficient numbers of staff to support people safely.

Staff received effective training, support and supervision that enabled them to provide appropriate care to people who used the service. The manager and staff understood their roles and responsibilities in ensuring that people consented to their care and support, and that this was provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). People had nutritious food and they were supported to have enough to eat and drink. They had access to healthcare services when required in order to maintain their health and wellbeing.

Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. People were happy with how their care was provided and they valued staff’s support. People’s relatives were complimentary about the quality of the staff who supported their relatives.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences and choices. Care plans had been reviewed regularly or when people’s needs changed to ensure that these were up to date. Staff were responsive to people’s needs and where required, they sought appropriate support from other healthcare professionals. The provider had an effective process for handling complaints and concerns.

The provider had systems to assess and monitor the quality of the service. They encouraged feedback from people, relatives, staff and external professionals to enable them to continually improve the service. People and staff we spoke with were complimentary about the improvements that had been made to the premises and the quality of care provided.

We carried out an unannounced inspection on 22 January 2016.

The service provides care and support for up to 33 people, some of whom may be living with dementia, mental health conditions and chronic health conditions. On the day of our inspection, 23 people were being supported by the service.

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.

The provider had effective systems in place to safeguard people. There were individual risk assessments that gave guidance to staff on how risks to people could be minimised. Although people’s medicines had been managed safely and administered by staff who had been trained, these were not always given to people in a way that promoted effective treatment. This could have resulted in adverse effects to people’s health and wellbeing.

The provider had effective recruitment processes in place and there was enough staff to support people safely. The manager and staff understood their roles and responsibilities in ensuring that people consented to their care. Where required, they ensured that the care of people who lacked mental capacity to make informed decisions about their care was in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Staff had received effective training and support, but staff supervision had not always been provided in a timely manner.

People’s needs had been assessed and they had person-centred care plans in place. They were supported to have sufficient food and drinks, but people were not complimentary about the quality of the food and choices provided to them. People had been supported to access other health and social care services when required in order to maintain their health and wellbeing. The provider had failed to follow current guidance on creating a dementia friendly environment.

Staff were kind and caring towards people they supported. They treated people with respect and dignity. As much as possible, they supported people to maintain their independence. There were not enough activities provided to keep people stimulated throughout the day.

The provider had a formal process for handling complaints and concerns. People had been given opportunities to provide feedback about the quality of the service provided.

The provider had effective systems in place to assess and monitor the quality of the service provided. Regular audits had been carried out and actions taken to make the required improvements.

The provider was not meeting the requirements to provide safe and person-centred care because people’s medicines had not always been given in a way that promoted effective treatment. Additionally, people had not been adequately supported to pursue their hobbies and interests.

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

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

During our scheduled inspection of Victoriana Care Home on 2 September 2013 we identified non-compliance regarding cleanliness and infection control and safety and suitability of premises. We found that the provider could not fully evidence that the service had effective systems in place which protected people who used the service from, both poor standards of cleanliness and hygiene and unsafe or unsuitable premises. We found evidence of poor standards of hygiene and cleanliness at that time and that the premises posed a potential risk for people. We imposed compliance actions with regards to these regulations and told the provider they needed to make improvements in this area. On 3 December 2013, we carried out an inspection to check that these actions had been implemented.

The provider submitted an action plan, which stated that affected areas of the home, such as mattresses, carpets were to be thoroughly cleaned or replaced with increased monitoring of the environment and that thorough spot checks would be completed. It also confirmed that areas of the property that needed work, would also be rectified. It confirmed that this work would be completed by 21 September 2013.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

When we inspected the Victoriana Care Home 2 September 2013, we spoke with six members of staff including the registered and deputy manager. We spoke with four people who used the service, one visiting relative and one visiting professional.

We found that there were effective systems in place to support their workers. We saw that staff received appropriate professional development. One person said, “They (carers) work very hard, not met one that’s not helpful.” We found an effective complaints system in operation. One person said, “I’m alright, happy, no complaints.”

However, the systems in place to ensure a clean and hygienic environment were ineffective. We confirmed that staff had received training on infection control but we found that this training was not consistently followed in practice. One staff member said, “Some of the rooms look a little bit tatty.” We also found that the décor and rear garden required attention.

When we visited the Victoriana Care Home on 11 December 2012, we found people were very happy with the care and support they received. They told us they felt safe and were well looked after by the staff. One person said “The staff are very nice. We're well looked after and have a good bit of fun here. It's A1".

We observed that people were offered care and support at a level which encouraged independence and ensured their individual needs were met. There was a relaxed atmosphere in the home and we noted staff interacted confidently with people and were friendly and courteous in their approach to them. We spoke at length with five people who lived at the Victoriana Care Home, all commented positively about the quality of care and the conduct of the staff. One said, "I love it here, I'm content. They got me walking again and this is where I want to stay".

We noted people were encouraged to express their views and were involved in planning their care and making choices and decisions about their care and support and how they spent their time. Within the care files we saw care documentation had been signed by the individual or their representative to confirm their involvement and agreement with their particular care needs.

There were robust systems in place to promote quality assurance in this home. The responses from the 2012 satisfaction survey included many comments which reflected that people were very satisfied with this service.

During our visit to The Victoriana Care Home on 09 November 2011 we spoke with seven people using the service. Some of the people that we met during our visit had problems communicating verbally; so we spent time observing how care was provided to them and how they were involved in that care.

People told us that they had the opportunity to make choices, for example when they got up, what they wore and how they spent their time. Our observations of care confirmed that people were given choices. One person said,” I like the late night TV and it is never a problem, I can stay up as long as I want to”.

During our visit we looked at one set of care notes with a person using the service. She told us that she was happy for us to look at the records but was not interested in what they contained. She said, “I am quite happy here, I can come back to my room anytime I want for a sleep”. Her care noted confirmed that this was how she chose to spend her time. People told us that they felt safe and happy in the home. We observed people moving around the home and interacting well with each other and members of staff. People told us that they were well cared for and if they were poorly the GP would be called. . One person said, ”the staff look after us so well I feel spoilt”. We asked people about how staff responded when they called them either verbally or by using their call bells, and no one reported having to wait for a long period or being ignored.