We inspected Whitbourne House on 11 September 2018. This was an unannounced inspection.

Whitbourne House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home accommodates up to 41 people. On the day of the inspection there were 39 people living at the service.

There was no 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 appointed an operations manager who was registering with the CQC to become the registered manager.

Before the inspection we had received concerns citing staff shortages and poor leadership and management of the home. A month prior to our inspection the registered manager had left. The provider implemented changes to address some of the concerns which the management team were working through.

We found the provider had taken action to improve staffing levels and staff deployment. A staff rota consultation was in progress and staff were already seeing the positive impact of the changes.

The provider had made significant improvements to the environment by redecorating the home. The whole home was undergoing redecoration and the provider was working through an on-going plan for further improvements.

People did not always receive activities that met their needs and preferences. The management team told us they had a plan in place to improve activities. We found people's records were not always complete. Some of the provider's quality assurance systems had not identified the concerns we found.

People told us they felt safe living at Whitbourne House. Risks to people’s well-being were assessed and managed safely to help them maintain their independency. Staff were aware of people’s needs and followed guidance to keep them safe. Staff clearly understood how to safeguard people and protect their health and well-being. There were systems in place to manage people’s medicines. People received their medicine as prescribed.

People had their needs assessed prior to living at Whitbourne House to ensure staff were able to meet people’s needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.

People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management team. Staff support was through regular supervisions (one to one meetings with their line manager), appraisals and team meetings to help them meet the needs of the people they cared for.

People living at Whitbourne House were supported to meet their nutritional needs and maintain an enjoyable and varied diet. Meal times were considered social events. We observed a pleasant dining experience during our inspection.

People told us they were treated with respect and their dignity was maintained. People were supported to maintain their independency. The home provided information including in accessible format to help people understand the care and support that was available to them. The provider had an equality and diversity policy which stated their commitment to equal opportunities and diversity. Staff knew how to support people without breaching their rights.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. The registered manager and staff had a good understanding of the MCA and applied its principles in their work. Where people were thought to lack capacity to

We inspected this service on 31 May 2017. Whitbourne House provides personal care and accommodation for up to 41 people. The home is located in central location in Swindon. On the day of our inspection 36 people were living at the service, most of whom were living with dementia.

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 and their relatives complimented the compassionate nature of staff and told us staff were caring. On the day of our inspection we saw examples of kind and compassionate interactions that demonstrated staff knew people well. People’s dignity, privacy and confidentiality were respected.

Feedback received from some people and staff reflected people did not always receive activities, stimulation or engagement which met people’s needs, preferences and interests. There was no designated activities co-ordinator in post and there was not always evidence available that the provider ensured people had opportunities to benefit from person centred and meaningful activities.

People told us they were safe. Staff knew what to do if they had safeguarding concerns and were aware of the provider’s whistle blowing policy. People were supported by sufficient staff to keep them safe and the provider ensured safe recruitment practices were followed. Staff training was ongoing and the records confirmed staff received supervisions.

People’s care plans contained risk assessments that covered areas such as falls, mobility or nutrition. Where people were at risk, their records outlined management plans on how to keep them safe. Staff knew how to keep people safe from risk of harm however we found on one occasion this was not followed in practice. The registered manager reassured us they were going to investigate this further.

People’s medicines were stored securely. However, the provider’s policy in relation to administration of medicines was not always followed by staff which presented a risk to people. The registered manager told us they would address this.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were supported to have maximum 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 were supported to maintain good health and access health professionals when required. We received very positive feedback from external professionals involved with the service. Staff ensured people were supported with their meals when required and people were referred to a dietician if there were concerns about their nutrition.

People were assessed prior to coming to live at Whitbourne House and people told us staff knew them well. People’s care files gave details of the level of support required and people’s wishes and choices. These also contained information about people’s personal histories, medical information, their likes and dislikes.

Information on how to complain was available to people and the provider had a complaints policy in place. The registered manager ensured when a complaint had been raised it had been investigated and responded to in a timely manner.

The registered manager ensured various audits were being carried out. We however, found a lack of consistency in how well the service was led. There was a lack of support and resources that empowered staff to develop and drive improvements and some staff did not always feel listened to. Staff were confident that as a team they were focused to deliver good care and they told us im