London and Manchester Healthcare Limited

There were a range of effective provider and manager quality assurance processes in place, the provider had learnt lessons from the previous inspection and improved services.

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.

Risk assessments held appropriate information. Care plans and risk assessments were person centred and detailed how people wished and needed to be cared for; these were regularly reviewed and updated as required. We saw evidence of how the registered manager and staff ensured people beliefs, choices and rights were respected. This was supported in feedback we received from people and their relatives.

The recruitment of staff was safe and there were enough staff on duty on the day of inspection to meet people's needs. Risks to people's health and safety had been assessed and mitigated and equipment had been serviced and maintained. Accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence.

We observed support being provided in the home and saw this was done in a caring, responsive, and patient manner. We saw people were comfortable in the presence of staff and positive relationships had developed between people receiving support and staff. A visitor told us "There are always plenty of staff about and they always seem patient and kind with the residents. There seems to be more permanent staff about lately, they do use some agency staff, but they also seem genuinely nice. The home is always spotless with no nasty odours. I have no concerns about any other residents or the way anyone is treated. There is always a very pleasant friendly atmosphere when I visit."