Agincourt Care Home is residential care home registered to provide care for up to 31 people in a residential area of Weymouth. At the time of our inspection there were 29 older people living in the 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 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.

Systems and processes were in place to maintain people’s safety and protect them from avoidable harm.

Where management spot checks or feedback had shown staff needed to improve their practice evidence showed they had been given coaching.

Staff had a good understanding of how to safeguard people from abuse and knew what signs to look for and how to raise a concern. The home had robust recruitment processes to ensure that people were supported by staff who were suitable to work with vulnerable adults. Medicines were managed safely. Staff were confident with this task and had regular observations to check their competency. The home conducted audits to ensure there was learning from incidents or issues and the chances of them reoccurring was reduced.

People’s needs and choices were assessed with their involvement. This included listening to them and noting aspects of their lives that were important to them and made them unique. This diversity was acknowledged, respected and supported. Reviews of the support people required were completed and included evidence that they were included in these discussions. People were supported by staff that had received training that gave them the skills and confidence to meet their specific needs.

People were supported to have a balanced and varied diet. People were supported to maintain their health and wellbeing. This included support to attend routine appointments or with visits from health and social care professionals. Improvements were being made to the home environment to make it more dementia friendly.

Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people living there particularly when they lacked capacity to make certain decisions affecting their life. The MCA 2005 provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. Records showed that people who required these safeguards had them in place and, where conditions were attached, they were being met.

People were supported by kind and caring staff who supported them to express their individuality and celebrate what they had done so far in their life. People were given the time and support they needed to express their views and wishes. Staff understood the importance of helping people to maintain their privacy and dignity. People were encouraged to maintain contact with their rela

Agincourt Care Home is registered to provide accommodation and personal care for up to 31 older people. Nursing care is not provided. On the day of our inspection there were 25 people living in the home.

The service 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.

The risks people took were understood by staff and in general terms had guidance on reducing those risks. However we found that the recorded guidance to staff in relation to supporting a person with unwanted behavior required to be clearer. The registered manager addressed this at the time of the inspection.

The home was clean but some areas of infection control needed to be improved upon. The laundry area needed cleaning and the storage of dirty clothes needed to be reconsidered. The registered manager addressed this at the time of the inspection.

The arrangements made for the dispensing of medicines in the home was safe but in one case required some further oversight. We looked at medicines records and found that the recording was generally safe but there was insufficient evidence of one person receiving their medicine. The registered manager acknowledged our observations and began to plan how best to improve the systems in place.

There were some outstanding maintenance work that required attention. However the provider told us about the plans they had in place to address these and that they hoped to complete some of the work in the new year (2017)

People were valued and well cared for by staff. The interactions between people living at the home and staff was observed as friendly and compassionate. People and their relatives told us staff were friendly and caring. Staff demonstrated a high commitment to their work and had built up positive relationships with people. People were treated as individuals and their diverse needs respected and met. One member of staff said “just to be able to combe their (people’) hair and make them feel good makes me feel good”.

People were cared for by staff with the appropriate skills and experience. Some staff had worked in the home for a number of years and told us they enjoyed their work. Staff were provided with opportunities to learn how to care for people with enduring mental health illness’. Staff told us about how they felt supported by the management and felt valued by the provider Agincare.

People and those important to them told us about how they felt included in their care plans. One relative told us about how well the staff had responded when they had concerns; another told us about being involved in planning the Christmas activities. This demonstrated that the service tried to include all people with regards to areas of running of the home.

People were provided with support to access health care services. When people became unwell staff made arrangements for a health care professional to visit.

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People’s individual needs were assessed and care was delivered to meet their needs. We spoke with three people and four people’s relatives. All spoke positively about the home and the care provided to them. One person told us, “They (the staff) do everything I need here.” Another person said “The staff are good, there are no faults.”

The provider had effective systems to monitor pre-employment checks and recruitment procedures for staff.

The home had suitable systems to monitor the quality of service provided.

We spoke with people who used the service who told us “the staff were brilliant” and said “they really look after me here.” One person told us that their needs were met and that the home would meet any changes that they had in their daily living, for example, changing a meal time or location.

People who lacked mental capacity did not have their decisions or choices that they may have had when they had mental capacity explored or recorded. This did not comply with current legal requirements.

People’s needs were assessed and daily care was delivered in line with their wishes. Staff had received training in safeguarding and knew how to report or respond to any concerns within the home.

We saw the home was clean and hygienic with an effective system to monitor cleanliness. Medicines were appropriately stored, administered, recorded and audited.

We saw that staff were supported by the provider through regular training and that staff were encouraged in their professional development.

The home had suitable systems to monitor the quality of the service provided and to assess and manage risks to the health, safety and welfare of people using the service and others.