Menwinnion Country House

At this inspection we found the provider had taken action to improve all these areas.

Since the inspection in December 2020 the service had a registered manager in post. The provider had reviewed how the service was managed and increased senior roles. This included creating additional roles. For example, deputy manager and leadership roles. This had enabled the management team to focus on developing the service and meeting legal requirements. The operation of the service was overseen by the nominated individual who was responsible for supervising the management of the regulated activity.

The way people's medicines were managed had improved. Systems and oversight had been developed in order to ensure medicines were managed safely. We made a recommendation at this inspection for further information to be included in records were medicines were required as needed. This would support staff to understand why the medicines were being administered.

At the last inspection we found staff had not received training to support their knowledge and skills in managing behaviours which might challenge, understanding consent and how to safeguard people. At this inspection we found training had been reviewed and a system was now in place which showed all staff received the relevant training. This had helped to develop staff skills and knowledge to support people safely and recognise triggers which might affect people's behaviour. Our observations on inspection confirmed this.

At the last inspection people's capacity assessments had not been appropriately assessed under the principles of the Mental Capacity Act 2005 (MCA). At this inspection managers and staff had received training in the MCA and understood how to respond to issues around capacity and consent. At this inspection we found 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.

Previously we found care plans were not written in a way which supported staff to recognise some people's level of need and risks. They were not person centred. At this inspection we found the registered manager

had reviewed all care plans. They were person centred and included information to support staff to recognise and respond to individual needs and risks.

People were supported to eat balanced diet and drink enough to keep hydrated. Staff had an induction when they started their jobs; and they were supported through regular training and supervision to deliver their roles effectively.

People told us staff were kind and compassionate to them. People were treated with respect and dignity. People received care and support that met their individual needs. People's end-of-life wishes were documented in their care plans and followed. People were engaged in activities to occupy them.

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and social care professionals.

The systems in place to monitor the quality of care within the service were effective. The registered manager promoted a positive person-centred culture and fully understood their responsibilities.