We found that the management of medicines had improved, with clear records and auditing processes.
Selection and recruitment processes were robust and staff received appropriate checks before they were employed. One person we spoke with said, "Staff are good."
Improvements had been made to ensure audits were completed to assess the quality of the service.
Records showed that people's consent was obtained and they were involved in their care planning. One person said, 'Yes, they ask me.'
Care plans were person centred and we found that the delivery of care was appropriate. We found that interactions between people and staff were positive. One person said, 'I am happy here.'
Arrangements around the safe handling of medicines were not robust to ensure that people received their medicines as prescribed.
We found that selection and recruitment processes were not sufficient to ensure that appropriate checks were in place before staff were employed.
Systems were not always in place to ensure that the quality of the service was monitored. We found that people were comfortable at raising issues and talking to the manager throughout the day.
We found that improvements had been made and people and their relatives were involved in making care and treatment decisions.
We saw positive interactions between staff and people living at the home. One person said, 'I like it here.' We found that people received advice from other professionals in a timely manner. This meant that people received care that met their needs.
We found that arrangements were in place to safeguard people.
We found that arrangements were in place to ensure that staff received regular support through training, supervision, and appraisals. One staff said, 'I feel that things have really improved.'
We found that the manager and staff had made improvements following the concerns we highlighted at the previous inspection. This meant that concerns were taken seriously and acted upon to achieve better outcomes for people living at the home.
We found that records were accurate, systematically stored, and accessible when needed.
We saw that people were well presented and wore clothes that reflected their own preferences, style, and gender.
We saw that people had a choice of whether they wanted to sit in the lounge, in the dining room or in their bedrooms. We saw that relatives had an opportunity to spend time with people in communal areas of the home or in people's bedrooms where their privacy was respected. People were happy with their rooms and the facilities that were available. One person said, 'I like my room, it's nice.' We saw that people's rooms were decorated individually to people's choice, taste, and preferences.
Records showed that people and their relatives were not involved in reviewing care plans and assessments. The manager told us that other health professionals were involved in these processes. However, the records were not signed to show which health professionals had been involved and when.
We saw that staff did not offer people choices throughout the day about food and drinks. One person told us, 'We do not get a choice here in anything, not even the food.' This meant that people were not encouraged to be independent and make choices where possible.
Records showed that staff did not receive formal supervision, take part in staff meetings, or have regular updated training. This meant that staff might not be appropriately supported to ensure they are competent to meet people's needs.
Most people and their relatives told us that they were not aware of the complaints process if the need arose to make a complaint.
We found that records were not an accurate reflection of people's current care needs and health conditions. One out of three care records were available for us to get an overview of people's care needs. We saw that people's confidentiality was not always maintained. This meant that there was a risk that people did not receive appropriate care in the absence of complete care records.