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Inspection carried out on 31 October 2017

During a routine inspection

The inspection took place on 31 October 2017 and was unannounced.

Margaret House provides accommodation for up to 42 people. It is not registered for nursing care. On the day of this inspection 36 people were living at Margaret House.

The home did not have a registered manager in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 a person to register with CQC to manage Margaret House, they were in the process of preparing their application.

When we last inspected the service on 14 July 2015 we found that the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 at that time.

People felt safe living at Margaret House. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider’s recruitment processes helped to ensure that staff employed to provide care and support for people were fit to do so. However, the provider undertook to implement some improvements to strengthen the process further. People's medicines were managed safely.

Staff received regular support and guidance from the management team which made them feel respected and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.

People and their relatives complimented the staff team for being kind and caring. Staff and the management team were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The provider had arrangements to receive regular feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to. People were provided with a variety of opportunities for engagement.

There was an open and respectful culture in the home and people who used the service, relatives and staff were comfortable to speak with the provider and management team if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

Inspection carried out on 14/07/2015

During a routine inspection

This inspection was carried out on 14 July 2015 and was unannounced.

Margaret House is a care home which provides accommodation and personal care for up to 19 older people with residential needs. At the time of our inspection there were 16 people living at the home. 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 and associated Regulations about how the service is run.

When we last inspected the service on 21 June 2013 we found them to be meeting the required standards. At this inspection we found that they had continued to meet the standards.

People living at the home and their relatives were positive about the home, the manager and the staff. Their feedback was sought and any suggestions were acted upon.

Staff were kind and caring and people’s privacy and dignity was promoted. The care provided was outstanding and staff were knowledgeable about people’s needs. Staff had received appropriate training and supervision.

People’s safety was promoted and there were robust risk assessments in place to maintain this. However people were supported to take positive risks and be in control of their life. Care plans and care practices were reviewed regularly and people were involved to ensure their needs were met the way they wanted. Accidents and incidents were reviewed by the manager to ensure any action needed was taken. Medicines were managed safely and people received their medicines in accordance with prescriber’s instructions. Staff knew how to recognise and respond to allegations of abuse.

People were offered a choice of nutritious food in accordance with their needs and preferences.

People had access to activities that complemented their interests and hobbies. There were links with the outside community.

Health and social care professionals were very positive about the staff team at Margaret House and the service they provided.

Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection nobody had been deprived of their liberty, people had capacity and the freedom to leave the home as they pleased. The manager and staff were familiar with their role in relation to MCA and DoLS.

The management team was dedicated to provide an outstanding service to people. Their ethos and values were well known to staff who had good knowledge about their own responsibilities and job roles. We received very positive comments about the management team from people who used the service, their relatives, staff team and health care professional. The provider and manager closely monitored and sought feedback about the services provided to identify areas for improvement and drive forward improvements in the home.

Inspection carried out on 25 June 2013

During a routine inspection

We spoke with nine people who received care in Margaret House and one person’s relative. People told us they were happy. One said, “The staff are wonderful and we have no complaints.” The relative told us they have always been made to feel welcome and that there mother is extremely happy with the care and support provided.

Care records contained detailed information for how staff support people and maintain their independence as much as possible.

Procedures were in place, and staff were trained in how medicines were handled safely. Staff recruitment ensured that only staff who were suitable to work with people who used the service were employed. Staff felt well supported. One staff member said, “This is a lovely job and I enjoy working here. Team work is excellent.” Another told us, “It’s made such a difference that we can now do care.”

The provider had systems in place to monitor the quality of the service being provided to people.

Inspection carried out on 21 September 2012

During a routine inspection

During our inspection on 21 September 2012, we spoke with 12 people who lived at Margaret House, they were all very complimentary about the care they received and could not fault it in any way. All the people we spoke with told us they felt safe living at the home, they were able to make choices about whether they wished to participate in activities. One person told us that they regularly took the bus into the local town and very much enjoyed being independent.

They told us the staff are fantastic and are always happy to help and provide support for them. We observed and talked with staff who were very knowledgeable about the people who lived at Margaret House and they were able to understand their needs. Care records and the training offered by the provider enabled staff to meet people’s health and care needs.

Reports under our old system of regulation (including those from before CQC was created)