Perran Bay Care Home

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

As part of this comprehensive inspection we checked to see if the provider had made the required improvements identified at the inspection of 24 April 2017. In April 2017 we found some people did not have a current accurate accessible care plan or risk assessment in place to guide and direct staff on how to meet people's needs. Some specific guidance in people's care plans was not being followed by staff. Some people had been assessed as being at risk from pressure damage to their skin and the service had provided pressure relieving mattresses for them. However, the correct settings for these mattresses were not being effectively monitored. The risk associated with accidents and incidents were not robustly managed. The processes for managing medicines were not robust. The management team were not able to easily access electronically held information relating to people's care needs. Quality assurance systems were not satisfactory. The service was not regularly auditing areas such as care plans and medicines management therefore had not identified the areas of concern found at this inspection.

At this inspection we found improvements had been made in all the areas identified at the previous inspection. This meant the service had met all the outstanding legal requirements from the last inspection and is now rated as Good.

Since the last inspection the registered manager had ensured all care plans had been reviewed and reflected the current needs of people using the service. Risk assessments were regularly reviewed with evidence of changes in people's needs and how staff should respond to them.

The electronic care planning system was fully operational and all staff were using this system effectively. Where people's risks involved the need for pressure relieving mattresses they were being checked regularly to ensure they were accurate.

Auditing procedures took account of all areas of operation within the service to ensure systems were effective. Accidents and incidents were being reported and recorded as they occurred. These were audited to ensure any trends or patterns were evident and the service learned from them to make changes to mitigate risks to people.

Medicine procedures had been reviewed with changes made to some of the processes. For example, consent and risk assessment for people choosing to self-administer their medicines. Medicine audits were identifying where errors had occurred and stock control of medicines had been reviewed. There were no medicines or creams which were out of date. This meant the service was meeting the requirements of regulations.

People received care and support that was responsive to their needs because staff had the information to support them. Staff supported people to access healthcare services. These included, social workers, psychiatrists, general practitioners (GP) and speech and language therapists (SALT).

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. There was a wide range of training available to all staff which met the diverse needs of people being supported.

Staff were supported through formal and informal group supervision.

The atmosphere in the service on the day of the inspection was relaxed, friendly and calm. Staff responded promptly when people asked for help and support was provided at a relaxed pace. Throughout our inspection we observed staff providing support with respect and kindness. People told us they felt safe and comfortable living at Perran Bay Care Home. Comments included, "Overall the move to the care home has been a great success and the biggest thing is it's a very safe place for them to be" and "All the staff are lovely. They check I'm okay and ask if I need help with anything. Nothing is too much trouble for them."

People's legal rights were protected because management understood the legal requirements of the Deprivation of Liberty Safeguards (DoLS). Nobody living at the service had any current restrictive practices or continuous supervisions required to protect them from the risk of harm and keep them safe. The registered manager was aware of the requirements for assessing people who would need their human rights protected. This was through an assessment process to decide if it was necessary to make a DoLS applications to the local authority, in order to seek the legally required authorisation to have these restrictions in place.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse.

There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.

The provider had systems in place to monitor the quality and safety of the service.

The five questions we ask about services and what we found