We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

An unannounced comprehensive inspection took place at Palace House Care Home on 30 and 31 October 2018. The inspection was carried out by an adult social care inspector and an expert by experience on the first day, and by one adult social care inspector on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

In preparation for our visit we checked the information we held about the service and the provider and included this in our inspection plan. We considered the previous inspection report and obtained the views of the local authority safeguarding team and local commissioners. We analysed information from previous complaints and safeguarding alerts and incorporated the themes into the planning of this inspection. We reviewed information from statutory notifications sent to us by the service about incidents and events that had occurred at the home. A notification is information about important events, which the service is required to send us by law.

We did not ask the provider to send us a Provider Information Return. This is information we require providers to send us at least once annually to give us some key information about the service, such as what the service does well and improvements they plan to make.

During our inspection visit, we spent time observing how staff provided support for people to help us better understand their experiences of the care they received. We spoke with five people living in the home, four visitors, four care staff, the activities coordinator, a bank nurse, the clinical nurse lead and the manager. We also spoke with a visiting healthcare professional.

We had a tour of the premises and looked at a range of documents and written records including four people's care plans and other associated documentation, three staff recruitment and induction records, staff rotas, training and supervision records, minutes from meetings, customer survey outcomes, complaints and compliments records, medication records, maintenance certificates, policies and procedures and records relating to the auditing and monitoring of service. We also looked at recent reports from the local commissioning medicines optimisation team (April and October 2018), the community pharmacist (March 2018), the fire and rescue service (October 2018) and the local commissioners.

Following the inspection visit, we asked the manager to send us additional information; this was promptly provided.