Ladydale Care Home

At the previous five inspections we identified that improvements were needed to the quality of care and to governance systems in place to monitor care. This inspection was to check that improvements had been made. We found improvements had been made and sustained.

There was no 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 2008 and associated Regulations about how the service is run. The deputy was acting as the manager until a permanent manager who would apply to the CQC to become registered could be found.

People told us they felt safe and we saw that measures had been taken, such as risk assessment and staff following these to ensure people were kept safe. When things had gone wrong the service had learned and action was taken to reduce reoccurrences. Staff were recruited safely and there were sufficient amounts of staff to meet people's care needs.

People's medicines were managed safely. There were effective systems in place to ensure people had their oral medicines as prescribed and improvements were made to the documentation of topical medicines following feedback.

People were protected from the risk of infection. The building was appropriately maintained and plans were in plan to help people evacuate in the event of an emergency arising. The building was also appropriately adapted to cater for the needs of the people living there.

The service was working within the principles of the Mental Capacity Act 2005 (MCA) to ensure people's rights were protected. Decision-specific assessments were carried out with best interest decision being recorded and appropriate referrals were made to the Deprivation of Liberty Safeguards (DoLS) authority.

People enjoyed the food and had a choice of food and drinks which we saw staff catering for.

People were supported to access other health professionals where necessary and health professionals felt referrals were appropriate. The service carried out assessments to ensure they could effectively support people.

Staff had appropriate training and support to be able to care for people well.

People felt they were treated with dignity and respect. Where possible people were supported to retain their independence and make decisions about their care. Staff supported people in a way that suited the person.

Staff knew people well and plans reflected people's needs. People's diverse needs and end of life choices had been considered. Activities were arranged for people to partake in.

People and relatives were able to complain and feedback was acted upon and responded to, overall.

Effective systems were in place to help identify improvements required and taken was taken to resolve any concerns identified. Further improvements were planned with the introduction of an electronic system. People, relatives and staff felt the acting manager was approachable and they could feedback their opinions of care. Notifications were submitted to the CQC as required and the previous rating was being displayed.

The five questions we ask about services and what we found