Bankfield House Care Home

Bankfield House is a residential care home providing accommodation and personal care for up to 30 people aged 65 and over. At the time of the inspection there were 28 people living at the home. Bankfield House accommodates people in one adapted building over two floors.

We found the following examples of good practice.

Staff had received additional training on infection control, the safe use of personal protective equipment (PPE) and hand washing. Information posters were placed around the home and we observed staff wearing appropriate PPE.

The service had a safe system and procedure in place for allowing visitors to the home. Visitors were able to see their relatives either in the outside visiting area or in the designated inside area away from the main part of the home. Visitors had to undergo a rapid Covid-19 test and wear the home’s PPE before being allowed on the premises.

The service followed guidance on the admission of new people to the home. Staff ensured new residents did not feel isolated on admission by providing additional staff interactions, extra reassurance and ensured everyone had a television in their room.

The home was clean and each of the two floors had a housekeeper. Additional Covid-19 cleaning schedules were in place and hand sanitizer/PPE stations were placed around the building. The service had purchased additional antiviral and antibacterial cleaning products.

The service ensured a comprehensive testing programme was in place. All staff received weekly Covid-19 swab testing and were also required to have a rapid lateral flow test to ensure they were negative for Covid-19 prior to starting any shift.

The registered manager had comprehensive policies and procedures in place to manage the risk of Covid-19. They were supported by the provider and staff from the local authority and infection control teams.

About the service

Bankfield House is a residential care home providing accommodation and personal care for up to 30 people aged 65 and over. At the time of the inspection there were 26 people living at the home.. Bankfield House accommodates people in one adapted building over two floors.

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

People received support from caring and well-trained staff. Staff treated people with kindness, dignity and respect.

The home was clean and well decorated.

People had their needs assessed and regularly reviewed to ensure their current care needs were met.

The service benefitted from a good provision of activities and social stimulation. These included visits from several community groups.

Care plans were inclusive and person-centred and written with full involvement of people and those important to them.

People received care and support from other healthcare agencies when they needed it and in a timely manner. People were supported to live healthy lives.

Safeguarding systems were in place and staff were knowledgeable about protecting people from abuse.

The manager was relatively new; however, they were experienced and knowledgeable around their regulatory and legal responsibilities.

The safety and quality of the service was regularly monitored through a series of periodic checks and audits.

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 this practice.

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 requires improvement (published 16 November 2018) and there were three breaches of regulation. 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.

Why we inspected

This was a planned inspection based on the previous rating.

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

Bankfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 is based in the Woodley area of Stockport and can accommodate 30 people over two floors. At the time of our inspection the home was fully occupied.

The home was last inspected on 21 and 22 August 2017, when we rated the service as ‘requires improvement’ overall and in two of the five domains. We also identified two continued breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to safe care and treatment and good governance.

At this inspection we found the provider had addressed the previous regulatory breaches, however we identified four new breaches in three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These are in relation to staffing, safeguarding people from abuse or improper treatment and good governance. You can see what action we asked the provider to take at the back of the full version of this report.

At the time of the inspection the home had 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.

Staff had access to both e-learning and practical training sessions. Although staff spoke positively about the support and training provided, the training matrix revealed gaps in training provision and that some sessions completed were out of date.

The home was not consistently adhering to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. Applications to allow the home to legally deprive people of their liberty had not been submitted for all those who met the requirements, with no clear system in place for determining who required an application and who did not. The best interest process had not been used, where people lacked capacity to consent to care and treatment and did not have a legal representative to make decisions on their behalf.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service, however these had not identified the issues we noted during inspection. We also noted some gaps and inconsistencies in records and monitoring charts, which had also not been identified by the home or their governance systems.

People we spoke with told us they felt safe and enjoyed living at Bankfield House Care Home. They had no concerns about the standard of care provided, nor did their relatives or friends with whom we spoke. Staff were knowledgeable about the different types of abuse, how to identify these and report any concerns. The home had appropriate safeguarding policies and reporting procedures in place, and had submitted monthly reports to the local authority for any incidents which had occurred, as required.

Checks had been carried out to ensure staff were suitable to work in a care setting with vulnerable people. Enough staff were deployed to meet people’s needs. The home used a system to determine safe staffing levels, which although complex to use, tallied with the rotas.

The home was clean, well maintained with appropriate infection control processes in place. Staff had access to and wore personal protective equipment (PPE) to prevent the spread of infection. Checks and servicing of equipment, such as for the gas, electricity, fire safety, passenger lift and hoists were up-to-date.

Medicines were stored, handled and administered safely and effectively. Staff responsible for administering medicines were trained and had their competency assessed annually.

Meal times were observed to be a positive experience, with people being supported to eat where they chose. Staff engaged in conversation with people and encouraged them to eat throughout the meal. We saw drinks were available in communal areas throughout the home, as well as being provided during ‘drinks’ rounds. People who required a modified diet, such as soft or pureed received this in line with guidance from professionals, such dieticians or speech and language therapists.

We observed positive and appropriate interactions between the staff and people who used the service. Staff were reported and observed to be kind, caring and considerate. They knew the people they supported and how they wanted to be cared for. People were treated with dignity and respect and offered choice within the daily lives. Staff were mindful of the importance of prompting independence and encouraged people to do things for themselves.

Care plans contained personalised information about the people who lived at the home and how they wished to be cared for. Each file contained detailed care plans and risk assessments, which helped ensure people’s needs were being met and their safety maintained.

The home provided a range of weekly and monthly activities and events for people to participate in. Involvement was captured within activity records and suggestions for activities requested and welcomed, to ensure people had access to things they enjoyed.

People and their relatives were involved in the running of the home, through attendance of resident and relative meetings and completion of questionnaires.

We last inspected Bankfield House Care Home in December 2016. At that inspection we assessed the service as inadequate in well-led, requires improvement in safe, effective and responsive and too in caring. At that inspection we identified multiple regulatory breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014, which related to safe care and treatment, premise and equipment, good governance, staffing and fit and proper persons employed.

The overall rating for this service in December 2016 was ‘Requires improvement’. However, we placed the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures.

This inspection was to check improvements had been made and to review the ratings. At this inspection we found improvements had been made. However sufficient improvements had not been made in two areas and the service remained in breach of Regulation 12 safe care and treatment and regulation 17 good governance.

Bankfield House Care Home is a privately owned care home located in the Woodley area of Stockport. It is a large detached two-storey building. Accommodation is arranged over two floors accessed via stairs or a lift. The communal areas include the Jasmin lounge leading through to a conservatory and , the Bluebell lounge which are both at the front of the property. The Snowdrop lounge is a quieter lounge and dining area at the rear of the property. In addition to these there is a separate dining room area.

There are safe, well maintained, enclosed gardens to the rear of the property and car parking facilities are available. There are twenty four single bedrooms and three double bedrooms. Eight bedrooms have en-suite shower facilities and a further seven bedrooms have en-suite toilet facilities.

Bankfield House Care Home is registered to provide care and accommodation for up to thirty older people some of whom may also have a diagnosis of dementia. At the time of our inspection twenty eight people were living at the home. .

Since the last inspection a manager had been appointed and had successfully registered with the Care Quality Commission. 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 living at Bankfield House Care Home, their relatives, and staff spoke highly of the service. For example one relative stated “It gave me peace of mind that [My relative] is being well looked after and well fed, when [My relative] was at home it was a worry as they didn’t eat properly.” One person living at Bankfield House Care Home said “I feel safe as there are people around me who can help me.”

As stated above during this inspection we found improvements had been made since the last inspection. However we found that robust systems had not yet been fully implemented to monitor all aspects of the quality and safety of the service being provided.

We found gaps in the recording of cooked food temperatures prior to meals being served, in addition to this we found gaps in the fridge and freezer temperature recordings and saw that some food had been opened and stored in the fridge without a date opening being recorded. This meant that people could be at risk of possible food poisoning if food was not being stored or serviced at the correct temperature.

Attention was paid to people’s diet and people were supported to eat and drink in a way that met their needs. People living at Bankfield House Care Home who we asked were complimentary about the food provided and said there was plenty of it. One person said “The food is the best thing here, you can have a cooked breakfast and you get a choice of main meal and plenty of it.”

We saw other appropriate safety checks were undertaken. For example, lift and hoist servicing, water temperature delivery testing, emergency lighting, window restrictors and nurse call bells.

We saw improvements had been made to medicines administration and we found there were no gaps in the recording of prescribed creams which meant people were having creams applied in line with the prescriber’s instructions.

Since the last inspection recruitment processes had been improved to ensure only suitable staff were employed to work in the service.

We found improvements had been made to ensure staff were properly trained and future training had been planned. This was evidenced by looking at training records and speaking with staff.

Since the last inspection staff had received on-going supervision and an annual appraisal. This meant that staff were being appropriately guided and supported to fulfil their job role effectively.

Staff spoken with understood the need to obtain verbal consent from people using the service before a task or care was undertaken and staff were seen to obtain consent prior to providing care or support.

The home was clean and we saw staff had access to personal protective equipment (PPE) to help reduce the risk of cross infection for example disposal gloves and aprons.

Staff understood how to recognise and report abuse which helped make sure people were protected. People living at Bankfiled House Care Home, visiting relatives and staff spoken with said they thought safe care and treatment was provided.

People had access to healthcare services for example from the district nurse, dentist, optician and chiropodist. People were supported to attend hospital appointments as required.

We observed people receiving person-centred care and staff were able to describe the individual care needs of people. We observed staff giving kind and caring support to people. We saw that people’s privacy and dignity was respected and people were relaxed in the company of staff.

We saw that meaningful activities were provided by an activity co coordinator based on people’s personal preferences.

A notice informing people how to make a complaint was displayed in the main entrance of the home and details of how to make a complaint were also detailed in the home’s statement of purpose and service user guide. There was a system in place for receiving, handling and responding to concerns and complaints. None of the people living at Bankfield House Care Home, who we asked, had made a complaint but they told us they knew who they would go to if they had any problems. One person said “I would go to the manager.”

At the last inspection on 10, 11 and 12 May 2016 we rated the service as requires improvement overall. At that inspection we identified eight regulatory breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014, which related to medication administration, consent, staff training, recruitment, people’s safety and good governance.

This inspection was to check improvements had been made and to review the ratings. At this inspection we found that although improvements had been made in some areas sufficient improvements had not been made and the service remained in breach of the regulations. These were in relation to safe care and treatment, premises and equipment, good governance, staffing and fit and proper persons employed.

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures.

Bankfield House Care Home is a privately owned care home located in the Woodley area of Stockport. It is a large detached two-storey building. Accommodation is arranged over two floors accessed via stairs or a lift. The communal areas include the Jasmin lounge leading through to a conservatory, the Bluebell lounge which are both at the front of the property, and the Snowdrop lounge which is a quieter lounge and dining area at the rear of the property and a dining room.

There are safe, well maintained, enclosed gardens to the rear of the property and car parking facilities are available. There are twenty four single bedrooms and three double bedrooms. Eight bedrooms have en-suite shower facilities and a further seven bedrooms have en-suite toilet facilities.

Bankfield House Care Home is registered to provide care and accommodation for up to thirty older people some of whom may also have a diagnosis of dementia. At the time of our inspection twenty eight people were living at the home. .

The service did not have a registered manager in place. The home had been without a registered manager since August 2015. 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. We were told by one of the directors that recruitment procedures to the post were currently in progress.

During this inspection we identified multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

As found at the previous inspection in May 2016, some medicines continued not to be managed safely. We found there were gaps in the recording of some prescribed creams which meant there was a risk that creams had not been applied when required, which could have resulted in unnecessary discomfort to the person.

We found at the previous inspection in May 2016 recruitment processes required improvements to ensure only suitable staff were employed. During this inspection we saw in one file that a member of staff had taken up post since the last inspection and had commenced employment before all the necessary safety checks had been undertaken. This meant there was a risk of unsuitable people being employed to work with vulnerable groups of people.

Although we saw some improvements had been made we found that staff were still not receiving an annual appraisal and two supervision sessions as required by the home’s own schedule. This meant that staff were not being appropriately guided and supported to fulfil their job role effectively.

Following this inspection we were sent an overall training record for the staff employed. From looking at the training record we found there were some gaps in staff training. For example, not all staff had received safeguarding adults training, moving and handling training, end of life training and infection control training.

We saw that the home had its own induction checklist. However, we found that two staff members who had commenced employment since the last inspection in May 2016 had not had an induction.

We saw some appropriate safety checks were undertaken. For example, portable appliance testing, lift and hoist servicing and water temperature delivery testing had been undertaken. However, there was no evidence that emergency lighting or means of escape were being checked and it was not clear from records reviewed, which window restrictors had been checked. This meant the provider could not be sure people using the service were supported to remain as safe as possible at all times.

We reviewed a sample of people’s care files and found some shortfalls in the accurate recording. For example we saw that some parts of people’s plans of care were vague and did not clearly direct staff on how to meet some specific care needs.

During our previous inspection in May 2016 we recommended that the provider implemented the use of a staffing tool to determine the number of staff and range of skills required in order to meet the needs of people using the service and keep them safe at all times. This recommendation had not been implemented.

Staff spoken with understood the need to obtain verbal consent from people using the service before a care task was undertaken and staff were seen to obtain consent prior to providing care or support.

We saw that the home was clean and well maintained and we saw staff had access to personal protective equipment (PPE) to help reduce the risk of cross infection.

Since the previous inspection, some systems had been improved to monitor the quality and safety of the service. People’s care files were being audited on a monthly basis. Some parts of the administration of medicines were being audited and we found that accidents and incidents were being recorded and informally reviewed by the directors. However, due to the continued shortfalls found at this inspection, the audit systems required further development to fully assess and monitor the quality of the service provision and promote service improvement.

People had a personal emergency evacuation plan (PEEP) in place. These plans detailed the level of support the person would require in an emergency situation in order to safely evacuate the home.

People had access to healthcare services. For example, from the speech and language therapist, district nurse, dentist, optician and chiropodist. We found people were supported to attend hospital appointments as required.

As identified at the previous inspection in May 2016, there was a choice of food at breakfast and the evening meal but choices were not actively encouraged at the lunchtime meal.

From our observations of staff interactions and conversations with people, we saw staff had good relationships with the people they were caring for. The atmosphere felt relaxed and homely.

We saw that meaningful activities were provided by an activity co coordinator based on people’s personal preferences.

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.”

We last inspected Bankfield House Care Home on 24 September 2014. At that follow up inspection we found that the service was meeting the regulations we assessed.

Bankfield House Care Home is a privately owned care home located in the Woodley area of Stockport. It is a large detached two-storey building. Accommodation is arranged over two floors accessed via stairs or a lift. The communal areas include the Jasmin lounge leading through to a conservatory, the Bluebell lounge which are both at the front of the property, and the Snowdrop lounge which is quieter lounge and dining area at the rear of the property and a dining room.

There is safe, well maintained, enclosed garden to the rear of the property and car parking facilities are available. There are twenty seven single bedrooms and three double bedrooms, although at the time of this inspection only was being used as a double room. Fifteen bedrooms have en-suite facilities.

Bankfield House Care Home is registered to provide care and accommodation for up to thirty older people some of whom may also have a diagnosis of dementia. At the time of our inspection there were twenty eight people living in the home.

The service did not have a registered manager in place. The home had been without a registered manager since August 2015. 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.

During this inspection we identified eight breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

Some medicines were not managed safely. We found there were gaps in the recording of prescribed creams which meant there was a risk that creams had not been applied when required, which could have resulted in unnecessary discomfort to the person.

We had concerns in relation to staff supervision because staff were not receiving supervision on a regular basis, which meant that staff were not being appropriately guided and supported to fulfil their job role effectively.

Recruitment processes required improvements to ensure only suitable staff were employed.

We saw there was a risk of cross infection because hoists and hoist slings were not clean and there was inappropriate storage of the hoist slings.

Some of the routine safety checks had not been undertaken for example checks of the means of escape, window retractors and nurse call bells. In addition there was no evidence that fire evacuation drills had been undertaken. This meant the provider could not be sure the service was safe.

People's care records contained conflicting information and although they had been reviewed some plans of care had not been rewritten in over two years. This meant there was risk that people could receive inappropriate care.

Staff spoken with understood the need to obtain consent from people using the service before a task or care was undertaken. However there were gaps in the recording of consent and consent for some people had not been appropriately obtained.

Some systems were in place to monitor the quality of service people received however they we not robust and due to the shortfalls we found during our inspection they require improvements.

Just prior to this inspection it came to the attention of CQC that an allegation of abuse had been made which had not been referred to the local authority safeguarding team as set out in Multi Agency Policy for Safeguarding Adults at Risk but had been investigated internally and CQC had not been notified of this allegation. During this inspection it was identified that the provider had not complied with their duty to notify us of a further two allegations of abuse, one death, one serious injury and one deprivation of liberty safeguards authorisation. This is a failure to notify the Commission of required events.

We recommended that the provider implements the use of a staffing tool to determine the number of staff and range of skills required in order to meets the needs of people using the service and keep them safe at all times.

Although we saw some written signage around the home we recommend that the service considers current best practice in relation to the specialist needs of people living with dementia in respect to the signage to help orientate people to their surroundings and support them to remain as independent as possible whilst using the service.

We recommend that the service considers current best practice in relation to implementing and reviewing the plans of care that are designed to meet the individual needs and personal preferences needs of people who use the service.

People told us they enjoyed the food and there was plenty of it. However we saw that there was a choice of food at breakfast and the evening meal but choices were not encouraged at the lunchtime meal.

We saw evidence that staff had completed the homes own induction training. However from April 2015 new health and social care workers should be inducted according to the Care Certificate framework. This replaces the Common Induction Standards and National Minimum Training standards.

From looking at the training record and speaking with staff we found that staff had received appropriate training.

People living at Bankfield House Care Home and the visitors we spoke with told us it was a caring place to live and they felt well looked after.

Relatives spoken with told us they thought any issues raised would be dealt with to their satisfaction.

We saw the food looked and smelt appetising and was attractively presented with good size portions. However we recommend that choice is actively promoted at the lunch time meal.

We saw that meaningful activities were provided by an activity co coordinator based on people’s personal preferences.

During this inspection we spoke with the senior carer supervisor on duty, one of the providers and looked at records relating to medication administration.

We considered the evidence collected under this outcome and addressed the following question, is the service safe?

Below is a summary of what we found. Please read the full report for the evidence supporting our summary.

Is the service safe?

During this inspection visit we saw there were appropriate arrangements in place to manage people's medicines safely which were administered in line with prescribed treatments. However was saw there were gaps in the recordings of some prescribe creams.

The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them, a visitor, a healthcare professional and from looking at records.

Is the service safe?

During this inspection visit we observed that people were treated with respect and dignity by the staff and people told us they felt safe living in Bankfield House Care Home.

Each person had an individual care file that included risk assessments and a care plan that described how to meet people's individual care needs.

From information we hold on this service we know that the registered person had not referred concerns to the local adult safeguarding team in a timely manner. This meant that any investigation into such concerns may be delayed and people might be left at risk. During this inspection visit we saw that actions had been taken to address the shortfall and helped to ensure that this did not happen again. We know that further concerns had been appropriately referred since then. At the time of this inspection there were three on-going safeguarding investigations being investigated by the local authority.

All the medicines people needed were available in the home. The receipt and administration of medicines was recorded, allowing medicines to be accounted for. We saw a member of staff administer medicines in a kind and respectful way. However, records relating to medicines were insufficient to ensure people's safety. Medicines were not stored securely, allowing the possibility of mishandling or misuse.

Is the service effective?

Prior to people being admitted into the home the manager visited people to carry out an assessment of their needs to ensure the home could meet all of those assessed needs. The manager said that if possible people were encouraged to spend some time at the home having lunch and meeting staff and other people living at the home before a decision was made about moving in.

Staff told us told us that the staff team all worked well together and provided a high standard of care.

Is the service caring?

The atmosphere in the home felt relaxed and friendly. From our observations we saw that care staff had a good understanding of people's individual needs and personalities. We saw that staff were kind and sensitive in their approach to people.

We observed that people looked well cared for and were appropriately dressed.

All of the people we spoke with who were living at the home indicated that they were happy and had everything they needed.

Is the service responsive?

We saw that where appropriate the service had accessed advice and care from other health care professionals. For example we saw evidence of visits from the GP, chiropodist, optician and, the district nurse and we saw that people attended hospital appointments when required. This meant the provider sought relevant professional advice and guidance appropriately.

We saw there was a complaints procedure in place which was also included in the 'residents information pack and statement of purpose'. We were also told that each person using the service had received a copy of the procedure which was also included in the staff handbook. We also saw that a copy of the complaint procedure was wall mounted in the main reception and was next to the singing in book. The visitor we spoke with confirmed that they had not made a complaint but knew what to do if they felt a complaint was necessary.

We looked at the records of complaints made which showed that everything had been documented and investigations and responses to the complaints were carried out within the specified timelines. This meant that people could be confident that their complaints were listened to and dealt with effectively.

Is the service well-led?

The service was led by a manager that is registered with the Care Quality Commission.

The manager was described by staff as approachable and supportive.

We saw there were systems in place to monitor the service quality and identify risk. This would help to ensure that people received a safe and effective service.

During this inspection we looked at a sample of care plans. We saw that significant improvements had been made and peoples care plans contained sufficient, up to date, accurate information.

During our observations on the day of this inspection we saw staff providing care and support to people in a respectful way. We observed good interactions between the staff and people living in the home.

The atmosphere in the home felt calm and relaxed. We saw people living at the home chatting to staff and each other in a warm and friendly manner.

During this inspection we did have some concerns about the lack of detail in people's care plans. This meant that people's safety and well being may not always be protected.

The service had (CCTV) cameras in the building. The cameras showed people living at the home using the lounge and dining room monitored by televisions. The manager was on holiday and the staff on duty were unable to produce any records to show that people had been consulted about the ongoing use of (CCTV) cameras. People's rights regarding privacy are breached if they are being monitored without their permission.

We observed the support that was being given to people living at the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. Staff were friendly and respectful to the people they were supporting.

We had contacted the local authority contracts team for Stockport Social services. They gave updated information regarding the reviews carried out of medications at this service.