This inspection took place on the 23rd August 2018 and was unannounced. At our previous inspection on the 9th November 2015 we found the home required improvements under the heading of safe but that overall the home was rated as good. Following this inspection, we found that the provider had made improvements so safe was now rated as good. All other key questions were also rated as good, so the overall rating of the home remains good.

Weston House Residential Home provides accommodation and personal care to up to 38 people, some of whom maybe living with dementia. At the time of this inspection Weston House Residential Home was supporting 30 people. The home 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People told us that they felt safe living at Weston House Residential Home. People felt that there was sufficient staff to meet their needs and that staff were available to spend time with them throughout the day. People received their medication as prescribed and people were protected from the risks of ill treatment or abuse. The provider followed safe recruitment procedures.

People had their health needs assessed and effective care plans in place to meet identified needs. People's needs were reviewed on a regular basis and they were involved with decisions about their care. People had access to a balanced diet and the environment had been adapted to suit peoples needs.

People felt that the staff team was caring and that they were encouraged to be independent. People felt they were treated with dignity and that their privacy was respected.

People had access to activities throughout the day and people knew how to raise a concern or complaint if needed. There was no one in receipt of end of life care at the time of inspection

Staff understood their roles and responsibilities and felt supported by the registered manager. Processes were in place to enable the registered manager to review the care provision and quality of care being provided.

This inspection took place on 22 July 2015 and was unannounced. At our previous inspection on 4 October 2013 we found that they were meeting the Regulations we assessed them against.

Weston House provides accommodation and personal care for up to 38 people some of who may be living with dementia. There was a new manager in post that had applied to be registered with CQC. 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 felt safe in the home and relatives were confident that their relatives were cared for by staff who knew how to keep them safe. Staff identified any risks to people and took action to minimise harm.

Staffing levels and the skill mix of staff were sufficient to meet most of the needs of people who lived in the home and to keep them safe. The manager and staff considered the levels of staff on the dementia unit were reduced too early in the evening to ensure that everyone could receive personal attention. Staff recruitment was thorough with required checks completed prior to staff commencing work.

Medication was stored securely. People were prescribed medication that had to be administered ‘as and when required’. However, not all ‘as required’ medication gave full details of the circumstances in which it should be given. This could result in some medication being administered inconsistently.

Staff obtained consent from people before they provided care and support. The manager and staff had an understanding of providing care to people who lacked the capacity to make their own decisions so that people had their rights protected.

People were assisted to eat and drink enough to keep them healthy. People were supported to access a variety of healthcare professionals to ensure their healthcare needs were met and were assisted to see their GP as and when required.

People living at the home considered that staff were caring and kind and knew them well. People were supported to maintain their independence where possible.

The care plans detailed people’s healthcare needs and gave staff direction to provide care. Most people were confident that their care was provided in the way they wanted. People knew that staff kept formal records of changes to their care.

Staff were aware of the activities people enjoyed and what was of interest to them. People were supported to take part in activities both in the home and in the community. Activities were planned on a monthly basis and people were encouraged to tell staff what they would like to do and efforts were made to accommodate these requests.

People who had concerns about the care of their relative had known how to complain and felt able to do so. One person had not been confident that their concerns had been resolved yet. People were aware that there was a new manager in post and had found them welcoming and approachable. Staff enjoyed their work and felt supported and listened to. They spoke positively about the provider and the manager.

Regular meetings took place with people living at the home. Relatives were also consulted for their views about the service provided. Their views were listened to and taken on board. The provider had a number of quality audits in place in order to monitor the quality of care provided. When incidents occurred the outcome was reviewed so that staff could learn from mistakes.

We were shown around the building by the registered manager. The ground floor was being redecorated and new carpets were to be fitted to all the communal areas. We observed that people were cared for in a clean and hygienic environment. The registered manager told us the refurbishment of the bathrooms was currently being planned.

We saw that changes had been made to make more lounge seating space. The new small lounge area with TV was popular with people. This change had been made following discussions with people and families about extending the main lounge area which was not wanted by most people.

The bedrooms were all well-furnished with people’s belongings and TV’s. Some of the bedrooms were en-suite and others were very close to the bathroom facilities.

We were shown the well equipped kitchen where lunches were being prepared with a choice of two main and sweet dishes. The dining areas were all set out with menus and flowers.

The notice boards had activity timetables and pictures of the people enjoying activities. The activities included a reminiscence group, church services, entertainment and trips.

The people we spoke to were all very positive about the care and support they received at Weston House. We spoke to ten of the people who told us “I like my meals” and “the girls who look after us are so lovely”. One person told us how their special diet was catered for and the girls worked hard to ensure she had what she wanted. Several people said that the new manager had really made a difference to their lives.

A relative told us that they were very happy with the care provided at Weston House. They said that if there were any issues at all they always felt able to raise these with the manager.

We saw that the staff supported the people in a friendly and polite manner. The staff showed respect to the people and ensuring their dignity was maintained.

One member of staff we spoke to said “we work as a team”. We ensure dignity is maintained, we listen to them and respect their wishes”.

We were told by the staff that if they had any problems they could go to the manager and they would always help and support them.

There were 31 people living in the home when we visited the service. We met and spoke with over 20 people and three relatives who were visiting. We also spoke with four members of staff. We looked at selected care records, staff files and other records relating to the running of the care home. We spent time in the main lounge to carry out a short period of observation.

People told us that their privacy and dignity was always promoted and respected. Our observations supported this and we saw numerous examples of good care.

We saw people enjoyed a wide range of activities and therapies. People told us that there was always something to do and that they always looked forward to visiting local places of interest, “whatever the weather”.

People's needs were regularly assessed and care and treatment was planned and delivered in line with their individual care plan. Relatives told us that people received very good, safe care and support from the staff team. One person told us,” We are very happy with the staff, they are very good”.

People told us that they felt safe and risk assessments demonstrated how risks were identified and reduced as far as possible. Staff were aware of risks, and people's rights. Staff gave examples of their working responsibilities to make sure people received effective support.

People told us they were pleased with the cleanliness of Weston House.

We saw that the wear and tear to furnishings and bathroom areas were in the process of being dealt with as part of the ongoing maintenance and upkeep of the home.

People were supported by a stable, trained staff team who knew people’s care and support needs well. People were protected because staff were confident to recognise and report abuse. Staff were offered a range of training opportunities that were specifically designed to meet the needs of the people that they supported.

Weston House had systems in place to seek the views and opinions of people who received a service. Our findings confirmed the home management listened and acted upon people’s comments to improve their lifestyle in the home. We were aware that changes to management of the home have had an impact on the usually high standard of record keeping necessary for managing the home. We saw remedial action had been taken to restore these matters.