The inspection visit took place on 21 June and was unannounced.

West View Care Home is a registered care service providing personal care, nursing care and support for up to 19 older people. There were 16 people using the service when we visited, some of whom were living with dementia.

The service had a registered manager. 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 registered manager is currently on extended leave and the provider has made suitable arrangements to manage the service in their absence.

At the last inspection on 17 February 2016 the provider was failing to meet one regulation. This related to unsafe arrangements in place for the storage and management of medicines. During this inspection the provider demonstrated to us that improvements had been made.

Staff knew their responsibilities to help keep people safe from harm and abuse. The acting manager took action if an accident or incident occurred. Measures were put in place to try to minimise future risk.

Risks to people's health and wellbeing were assessed and monitored so that staff had the information they needed on how to help people to remain safe. Apart from one person the provider had safely recruited a suitable number of staff to provide care and support to people. We brought this to the director’s attention who made arrangements to make the necessary checks.

Staff were supported through supervision and training. People who used the service told us told us they felt staff were well trained and competent.

People were asked for their consent before care and support was undertaken.

People were supported in line with the Mental Capacity Act 2005. People's mental capacity had been assessed for specific decisions. Any decision made in a person's best interest involved important people in their life. The provider had made applications to the appropriate body where they had sought to deprive people of their liberties to make sure this was appropriate. Staff understood the requirements under the Act.

Staff understood the importance of people having healthy diets and eating and drinking well. Staff knew people's dietary requirements and where there were concerns about a person's eating and drinking, specialist advice was obtained. They also supported people to access health services when they needed them.

People's dignity and privacy was protected and staff offered their support in caring and compassionate ways. People's friends and family could visit.

People contributed to the assessment of their needs and to reviews of their care plans where possible. People's care plans were individual to their needs.

When people expressed preferences about their care and support these were acted upon by the service. Staff had information available to them about people's preferences and care needs.

People knew how to raise concerns if they felt they had to. They were confident the managers would take any concerns seriously.

People had access to activities that were important and relevant to them. People were protected from social isolation with the activities, interests and hobbies they were involved with.

The environment was monitored and checked regularly to make sure it was safe for people, relatives and staff. The provider also monitored the service by asking for people's feedback about the service as well as undertaking a range of checks and audits.

People told us the staff were friendly and the managers were visible and approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager. Staff told us they had good management and leadership from the acting manager.

We carried out our inspection on 17 February 2016, which was unannounced. We returned announced on the 22 February 2016.

The service provides accommodation for up to 19 people. At the time of our inspection there were 19 people using the service.

West View Care Home provides care and support to people with needs associated with age, physical disability and people living with dementia. Accommodation is on the ground and first floor, which is accessible using the stairs or the lift. People have their own bedrooms and use of communal areas and garden.

The service had a registered manager. 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 registered manager was registered for two services and spent part of the working week at the other service. Arrangements were in place for a care manager to manage the service in the registered manager’s absence. We found that although some arrangements were working well there were short falls in the on going monitoring of the service.

People received their medicines as prescribed by their doctor though the paperwork held was not always accurate. Protocols for medicines prescribed to be taken as and when required where not in place and medicines had not always been stored appropriately. Actions were taken following our visit to remedy these issues.

Although there was a maintenance plan in place, areas of the building were in poor repair and rubbish was stored in places where people would have access. Hot radiators in communal areas did not always have radiator covers on for protection.

Staff were able to explain how they kept people safe from abuse, and knew what external assistance there was to follow up and report suspected abuse. Staff were knowledgeable about their responsibilities and were trained to look after people and protect them from harm and abuse. Staff were aware of whistleblowing. This ensured people were safe from abuse in the home.

Staff were recruited in accordance with the provider’s recruitment procedures that ensured staff were qualified and suitable to work at the home.

People’s needs had been assessed prior to them moving into the service and care plans had been developed from these. The care plans seen during our visit included people’s personal preferences in daily living. However they did not always provide staff with information as to how a person’s care around nutritional needs should be met.

Staff received an appropriate induction and on going training for their job role. Staff had access to people’s care records and were knowledgeable about people’s needs.

People’s consent to the care and support they were to receive had been obtained when they first moved into the service and the staff team involved them in making decisions on a daily basis. For people unable to give consent, decisions had been made in their best interests by someone who knew them well. Following a previous incident where a person’s capacity to make decisions about where they lived had not been taken into consideration the registered manager is now working in line with the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards.

People using the service had access to the necessary healthcare services. They were supported to maintain good health and received on going healthcare support.

The majority of risks associated with people’s care and support had been assessed and actions had been taken to minimise these risks. However, not all of the risk assessments we looked at during our visit were effective or reflected people’s current situation. Particularly people’s nutritional needs.

Staff spoke to, and assisted people in a kind, caring and compassionate way. We saw that people’s digni

People using the service told us they were happy with the care and support they received and told us they received their medicines on time.

Medication administration records we reviewed were completed accurately to show people had received their medicines. There was suitable storage for controlled medicines and a secure medication fridge in place. Staff kept a record of the daily fridge temperature to make sure medicines were stored safely.

People’s personal confidential information were reviewed and kept up to date. Staff records and other records relating to the management of the service were also kept secure and up to date.

We spoke with five people using the service and observed how staff supported them. We also read four people’s care records. People told us they were satisfied with the care received and that staff always sought consent before they were helped. Comments received included: “I read the daily paper and there’s no rush” and “I’ve been here long enough to know the staff are lovely.”

The majority of people received their medicines on time. However, the arrangements for recording medication administered were unreliable and there was no protocol in place to support people with ‘PRN’ (taken as required) medicines. The medication fridge and storage for controlled medicines were also found to be unsuitable.

At the time of our inspection visit some bedrooms had been refurbished and decorated. Some improvements were still needed to the premises to make sure it was safe and adequately maintained.

Effective recruitment processes were followed and appropriate checks were carried before staff were appointed and commenced their new job roles.

The majority of records were accurate and kept up to date. Some improvements were needed in relation to the management of medicines and completion of relevant risk assessments in relation to the premises. The provider must ensure protocols were available for staff to refer to in order to meet people’s care and support needs.

People told us they were well cared for and satisfied with the support they received. People were treated with respect and involved to make sure their care and supports needs were met. One person said: “It’s very nice here and quite homely.”

The provider had made improvements with regards assessment of people’s care needs, care planning and management of risk. People’s views and where appropriate their family member was involved to ensure staff were aware of their needs and preferences. Records showed people’s health and care needs were met and monitored.

People told us they were well cared for and satisfied with the care received. People were treated with respect and involved to make sure their care and supports needs were provided in a manner that suited them. One person said: “It’s quite nice here, food is always good and staff are very good to me, what more do I need.”

People had a range of assessments in place that detailed their needs. Records showed people received timely health support from the doctor and community nurse. Care plans lacked information about how care and support needs were to be met and measures in place to ensure people's safety. This also meant people’s needs, welfare and safety could not be monitored effectively. Improvements were needed.

Policies and procedures were in place to ensure staff took appropriate actions to protect people from harm. Staff were aware of their responsibilities to ensure people’s safety and confident to raise concerns.

People were cared for and supported by trained staff who promoted people’s safety, independence and welfare. Staff maintained their knowledge and skills through regular training, updates, support and planned supervisions.

People had opportunities to make comment or complain about the service through the residents meeting, individually or using the complaints procedure. People were confident to raise concerns with the registered manager. One person said: “I’ve got no concerns but I would tell them if there was a problem.”

At our last inspection of the service on 19 October 2011 people told us they were happy with the care and support they received. Visiting relatives reported that they were involved in review meetings and had attended the residents meetings.

People told us they were satisfied with the care and support they received. They found they could approach staff if they had any concerns or needed medical support.

People said they liked the choice of meals provided.

People had the opportunity to take part in social events arranged by the home. They were asked for their views about the quality of care and support received.

People who use the service said they were satisfied with the care and support they received. They said arrangements are made for them to see the doctor and the district nurse as and when needed. They felt staff were kind, caring and understood what help they needed.

People told us that whilst they like to read and listen to music they would like to do more things. One person said “they used to have things that staff did like quizzes, sing songs but not much happens now.”

Visiting relatives were complimentary about the care provided to their family members and the found the staff were caring and looked after people well. They said, “staff do record when they wash her, change the bedding and how much she’s drank” and “when they call the doctor, they always let me know.”

People who use the service and their visiting relatives told us that they felt confident to tell staff if they were unhappy about any aspect of the care provided. However, at present there are no formal quality assurance systems in place, whereby people who use the service and their relatives can comment on the quality of service or influence improvements.