Belper Views Residential Home

Belper Views is a residential care home providing personal care to up to 25 people. The service provides support to older people. Accommodation is provided over two floors and people have access to communal lounges, a dining room and secure outdoor space. At the time of our inspection there were nine people using the service.

People’s experience of using this service and what we found

Since the last inspection, the service had made significant improvements to governance systems which reflected positively on people's experience. The management acknowledged further improvements were required to ensure these improvements were embedded and sustained.

Comprehensive assessments of people’s needs were completed, and staff understood people’s needs. People were referred to relevant healthcare professionals where appropriate and advice was followed. Staff had received training to carry out their role safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service generally supported this practice.

People felt safe using the service and there was a clear safeguarding policy and procedure in place. Risks to people were assessed and there was enough guidance for staff to support people safely. There were enough staff to meet the needs of people and to ensure effective cleaning of the service. People received their medicines as prescribed. When things went wrong, this was reported and investigated appropriately.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 20 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 12 November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 29 September 2021 and 5 October 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, governance, staffing, safeguarding and consent.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Belper Views Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Belper Views Residential Home is a residential care home providing personal care to 18 people aged 65 and over at the time of the inspection. The service is registered to support up to 25 people. The home is set over two floors, with bedrooms and bathrooms located on each floor. There are two communal lounges, a dining area and a secure garden.

People’s experience of using this service and what we found

There were not enough staff to support people’s needs. There was no dependency tool in place that calculated the number of staff required to meet people’s needs. Staffing levels were not reviewed when the number of people using the service changed. Infection prevention and control was not always well managed to ensure people were protected from the risk of infections.

The service lacked provider and management oversight. Required audits were not always completed. Where audits were undertaken, follow up actions were not always identified or actioned. The provider did not always ensure staff and people were engaged with the running of the service.

Staff had not received the required training to support their roles or people’s needs. New staff and established staff did not receive required supervision to review their ongoing support or training needs.

The provider had not ensured good oversight of the home to maintain people's care and safety. Risks to people were not always assessed and actions taken to mitigate the impact were not always completed.

Safeguarding concerns were not always reported to local authorities to protect people from harm and staff did not always demonstrate an appropriate understanding of safeguarding. There was no safeguarding policy in place specific to the service.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People received enough to eat and drink and people shared with us that they enjoyed their meals .

The provider worked in partnership with other professionals and referrals had been made appropriately to support ongoing health needs. Medicines were administered safely.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 31 January 2020).

At this inspection enough improvement had not been made and the provider was in breach of regulations.

Why we inspected

We received whistle-blower concerns in relation to management and staffing. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led to examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Belper Views Residential Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, safe care and treatment, governance, training, need for consent and safeguarding at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Belper Views is a residential care home providing personal and nursing care to 13 people aged 65 and over at the time of the inspection. The service can support up to 25 people. The care home accommodates people across two floors. The upstairs consists of bedrooms and a communal bathroom. Downstairs there are further bedrooms and communal toilets or bathing facilities. There were also two communal lounges, a dining room and open access to a secure garden with seating area.

People’s experience of using this service and what we found

The culture of the home had made changes, providing a more open approach and this had shown in the improvements made. Audits had been completed, however some areas still required adjustment and the need to embed the changes made. Other changes needed to be made in respect of consistent risk assessments and the sharing of information on changes to care when people were unwell. When people had anxiety a more formalised approach needed to be considered to ensure consistent was provided.

We saw many improvements within the home and the way support was provided by the staff. People told us they felt safe and staff felt confident actions would be taken if needed to address any concerns.

Risks to people’s care were monitored and measures put in place. Medicines were managed safely, however the recording needed to be improved in relation to stock and topical creams. Any risk to infections had been reduced and the home had a good food hygiene rating. There were enough staff to support people’s needs and the required checks for recruitment completed.

Staff had received training in a range of areas to support their roles. Their skills and competency had been checked and any support provided. People had a choice of meals and their nutritional and dietary needs had been catered for. Health care needs were monitored and liaison with health professionals to promote good health and well-being was in place.

There was a homely atmosphere and the environment had been adapted to ensure suitable space for people’s needs. Staff provided care in a kind and friendly manner. People felt their dignity was maintained and their wishes respected.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice.

The care plans were detailed and included all aspects of care and people’s preferences. They had been reviewed and supported by relatives were relevant. The provider had ensured some information was in an accessible format and was working to develop this area further. People were supported with their interests and some activities were available.

There was a complaints policy and people felt able to raise concerns. We saw any which had been raised were addressed in line with the policy. People’s views had been sought and their requests included in the home or their own care needs. Staff felt supported by the new management and the changes throughout the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The last rating for this service was Inadequate (published 7 August 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and we now rate the service as Requires Improvement. The provider was no longer in breach of any of the regulations.

This service has been in Special Measures since 3 April 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

About the service

Belper Views is a residential care home providing personal for up to 25 people aged 65 and over. At the time of the inspection the home was supporting 18 people. The care home accommodates people across two floors. The upstairs consists of bedrooms and a communal bathroom. Downstairs there are further bedrooms and communal toilets or bathing facilities. There were also two communal lounges, a dining room and open access to a secure garden with seating area.

People’s experience of using this service and what we found

There was no registered manager and the provider had limited oversight of the home. Audits had been completed, however they had not identified where things needed to be changed to drive the improvements. Staff did not receive the support they required to give them direction and guidance in ensuring people received person centred care. Notifications had not been completed to reflect events which had occurred within the home. Some partnerships had been developed, however further consideration needed to be made to reflect people’s religious or individual needs.

People had not always been protected from the risk of harm. Staff had received training however there was no clear structure to report concerns and ensure actions were taken. Risk assessments had not always been completed for all aspects of risk, leaving some areas of concern with no risk reducing measures. There were not always sufficient staff, and we could not be sure they were deployed to meet people’s needs. Medicines were managed safely, however the stock and use of topical creams needed to be monitored. Improvement’s had been made in protecting people from the risk of infection, however some aspects were not reflected in daily practice. Lessons had not always been learnt to ensure continued improvements.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We made a recommendation to the provider following current guidance in relation to this area.

Staff had received training; however, their knowledge had not been embedded into their practice., which meant people were at risk of not receiving care in a safe way. People’s dignity had not always been maintained or people’s choices considered.

Care plans had not all been completed to ensure that the care was person centred and reflected individual’s needs. Staff were not always responsive when people required care. Some care plans in relation to end of life had been completed and reflected choices at this time of people’s lives.

People enjoyed the meals they received and felt comfortable within the home. Relatives could visit any time and were made welcome. People had established positive relationships with the staff.

Complaints had been addressed.

When people required support with their health care, referrals were made in a timely way and the support was followed up by the staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Inadequate (published 3 April 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough, improvement had not been made or sustained and the provider was still in breach of regulations.

Why we inspected

The inspection was brought forward to review the concerns we had raised at our last inspection. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. We have identified breaches in relation to seven areas which relate to the good governance of the home, people’s care, dignity and ongoing safety at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

About the service:

Belper Views Residential Care Home is a care home that provides personal care for up to 25 people, some of whom are living with dementia. At the time of the inspection there were 23 people using the service. The accommodation is split across two floors. The ground floor provides communal space with two lounges, a dining area, conservatory and level access to a secure gardens There are bedrooms, toilets and bathing facilities on both floors.

People’s experience of using this service:

The overall rating for the service is inadequate and the service will be placed in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.

After the last inspection the provider had developed an action plan, however we found that the actions agreed to be completed by the provider and registered manager had not been done.

There was a lack of leadership, coordination and oversight which failed to drive the necessary improvement. We saw that audits had not been used to consider how the safety for people could be improved and risks reduced or mitigated. The rating from the last inspection was not displayed.

Staff did not receive the support they required to ensure they were competent in their roles. When they completed training, their knowledge was not checked to see if they understood how to implement their learning. Staff were not always responsive to people’s needs and we saw that the communal areas were frequently unsupervised. Lessons had not been learnt to drive improvements.

People were not safe and staff were not aware of how to raise concerns and we saw incidents which had occurred had not been reported. People’s risks had not been considered and measures put in place to reduce the risks.

Medicines were not managed safely. People had not always received their prescribed medicines, and stocks had not been regularly checked to ensure it was stored in accordance with guidance. When staff administered the medicine, they did not follow the national guidance and we saw this placed people at risk of not receiving their medicines.

People were not protected from the risk of infection. Measures were not in place to ensure cleaning schedules had been followed, to maintain cleanliness and hygiene at the home. People’s needs and choices had not been considered.

People are not supported to have maximum choice and control of their lives and staff had not supported them in the least restrictive way possible; the policies and systems in the service did not supported this practice.

People enjoyed the meals, however they did not always receive the support they required during the meal period. When people required support with their nutrition this had not been considered or a referral made to a health care professional for direction.

When people required support with their health care, referrals had not been made in a timely way to support people’s immediate or ongoing needs. This meant effective partnership working had not been developed for people’s care when needed..

The home had not considered people’s view when they embarked on a refurbishment of the home. No questionnaire or meeting had been held for people to comment on their care or the environment they lived in. People’s dignity was not always respected, we saw that staff did not always have the time to spend meaningful time with them.

People had not received a pre- assessment before they commenced their care at the home. There was not always care plans in place which detailed the care people required and their preferences.

Consideration had not been made in respect of information access or aspects of people’s equality or cultural needs. When people required support for their care at the end of their lives, this was not reflected in the care plans or the support which was available.

There had been no complaints made about the service since our last inspection, however there was no information to inform people how they could raise any concerns. When significant events had occurred at the home, notifications had not been completed to inform us of the event and the action which had been taken, to help us check people’s care at the service.

When staff were recruited this was done in line with current guidelines, obtaining two references and a police check. This ensures staff are safe to work with people.

Rating at last inspection: Rated as Requires Improvement, report published 25 July 2018

Why we inspected: This was a planned inspection based on the rating at the last inspection which was Requires Improvement. At this inspection we found the service had deteriorated to Inadequate and we have placed the home in special measures.

Enforcement We found eight breaches in regulatory requirements. You can see the action we asked the provider to take at the end of the report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: Immediately after our inspection, we wrote to the provider and asked them to take urgent action to address the most serious risks outlined in this report. In response, the provider developed an action plan detailing actions taken and planned, to make improvements and reduce risk. We have restricted admissions to the home and placed conditions on the home to support us to continue to monitor the progress being made.

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 19 June 2018 and was unannounced. At the last inspection we rated the home overall as ‘Requires Improvement’. There were also regulatory breaches in consent and good governance. Following the last inspection, the provider was asked to complete an action plan to show what they would do and by when to improve the key questions of effective to at least ‘Good’. The home had been rated as ‘Requires Improvement’ at the last three inspections. At this inspection we found that due to a range of breaches and the ‘Well-led’ domain not being consistently maintained the rating for the service remains ‘Requires Improvement’; with ‘Inadequate’ in the ‘Well-led’ domain.

Belper Views Residential Home 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 provided accommodation over two floors. On the ground floor there are two lounges, a conservatory and access to a secure garden.

The service was registered to provide accommodation for up to 25 people. At the time of our inspection 20 people were using the service.

Belper Views has 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.

Audits had not always been completed to highlight when changes were required to reflect improvements. Care plans were not always up to date to reflect the care being provided.

People were not supported to have maximum choice and control of their lives and staff did not supported them in the least restrictive way possible; the policies and systems in the service did not supported this practice.

Staff knew how to protect people from abuse. Lessons had been learnt from events following concerns in relation to infection control. This was now managed safety. People’s wellbeing had been supported by a range of health care professionals. The home was friendly and welcoming and people could personalise their space.

People felt the staff were kind and caring and provided support when they needed it to maintain their independence. Their dignity was respected and staff considered people’s needs. There was a range of activities on offer to provide interest and stimulation to people, which linked to their life history. There had been no complaints since our last inspection; however peoples and relative felt able to raise concerns if required.

People’s views were considered and partnerships had been developed with a range of partners to support wellbeing and ongoing health. Medicine was managed safety and there was sufficient staff to support people’s needs.

The provider had displayed their rating as required at the home. The provider currently had no website linked to this location. We had received notification about events and incidents relating to the home.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

At our last inspection on 8 March 2016 we found quality monitoring systems were inconsistent and ineffective and had failed to identify shortfalls within the service. The premises were not properly maintained and levels of cleanliness were inconsistent. Insufficient staff on duty at times meant people’s care and support needs were not consistently met and the opportunity to pursue meaningful person-centred activities was limited. This represented a continuing breach under the Health and Social Care Act (Regulated Activities) Regulations 2014. We issued a warning notice and advised the provider of the timescale within which these shortfalls would need to be addressed.

During this inspection we found some improvements had been made but further improvements were still required. Improvements had been made with regard to the quality assurance systems in place to ensure that people received high quality, safe and effective care and support. Whilst improvements had been made, further time was required for the new systems and processes to become fully embedded.

People were not consistently supported to make decisions in their best interests. The registered manager, deputy manager and staff demonstrated a limited understanding of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs). Staff required additional support to fully understand and implement the principles of the Mental Capacity Act 2005. This represented a breach of regulations.

A registered manager was 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 were happy, comfortable and relaxed with staff and said they felt safe. They received care and support from staff who were appropriately trained, competent and confident to meet their individual needs. People were able to access health, social and medical care, as required.

People’s needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were person centred and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

There were opportunities for additional staff training specific to people’s needs, such as diabetes management and the care of people with dementia. Staff received one-to-one supervision meetings with their line manager. Formal personal development plans, such as annual appraisals, were in place.

Up to date policies and procedures were in place to assist staff on how keep people safe and there were sufficient staff on duty to meet people’s needs. Staff told us they had completed training in safe working practices. We saw people were supported with patience, consideration and kindness and their privacy and dignity was respected.

Thorough recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

Improved quality assurance audits and a formal complaints process were in place. People were encouraged and supported to express their views about their care and staff were responsive to their comments. Satisfaction questionnaires were used to obtain the views of people who used the service, their relatives and other stakeholders.

At our last inspection, in March 2015, we found one breach of regulations relating to risks at the home that were not always well managed. We also found that guidance for the safe handling and administration of medicines was not always followed and meant medicines were not always managed safely. Following this the provider sent us their action plan telling us about the improvements they intended to make. During this inspection we looked at whether or not those improvements had been met. We found some improvements had been made and other improvements were still required.

During this inspection we found quality monitoring systems were inconsistent and ineffective and had failed to identify shortfalls within the service. The premises were not properly maintained and levels of cleanliness were inconsistent. Insufficient staff on duty at times meant people’s care and support needs were not consistently met and the opportunity to pursue meaningful person-centred activities was limited. We have made recommendations regarding staffing levels and personalised support.

A registered manager was in post and present on the day of the inspection. 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 received care from staff who were appropriately trained and confident to meet their individual needs. They were supported to access health, social and medical care, as required.

People’s needs were assessed and their care plans provided staff with guidance about how they wanted their individual needs to be met. Care plans we looked at were centred on the individual and contained the necessary risk assessments. These were regularly reviewed and amended to ensure they reflected people’s changing support needs.

Policies and procedures were in place to help ensure people’s safety. Staff told us they had completed training in safe working practices. We saw staff supported people with patience, consideration and kindness and their privacy and dignity was respected.

People were protected by thorough recruitment procedures. Appropriate pre-employment checks had been made to help protect people and ensure the suitability of staff who was employed.

People received their medicines in a timely way. Medicines were stored and administered safely and handled by staff who had received the necessary training.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals.

Staff received training to make sure they knew how to protect people’s rights. The registered manager told us that to ensure the service acted in people’s best interests, they maintained regular contact with social workers, health professionals, relatives and advocates.

There was a complaints process in place. People were encouraged and supported to express their views about their care and staff were responsive to their comments.

We identified one breach under the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the report.

We found people were supported in an unhurried way and helped to live as independently as possible. One person we spoke with told us, 'I like to feed the fish every morning, and the staff help me do that even though it takes me quite a while to do it.' A visitor told us, 'My relative is very happy here. They have a lot of fun and are supported well to be active. My relative was helped to deadhead the flowering plants outside the other day.'

We found that care staff were knowledgeable about how to safeguard people against abuse. However we found the provider did not have a policy on safeguarding that gave up to date information.This meant that care staff did not have access to current information on safeguarding.

We found that the provider needed to make improvements to the way they updated care plans so it reflected people's current care needs, to the way they recruited staff, and to the way they checked that the people that lived at the home received a quality service.

We found that the provider had taken steps to ensure that controlled drugs were stored in accordance with legal guidelines and that suitable arrangements had been made for record keeping.