About the service:

Arncliffe Court Care Home is a care home that provides personal and nursing care for up to 150 people in four buildings. Accommodation was on ground level. At the time of this inspection 92 people were living at the service.

Improvements had been made since the last inspection so that people’s rights under the Mental Capacity Act 2005 were managed appropriately and that care was planned and managed in a way that promoted people’s health, safety and well-being. In addition, improvements had been made to the overall governance of the service.

We have made two recommendations in relation to the management of medicines and the quality monitoring systems in place within the service.

People’s experience of using this service:

Peoples' needs and wishes were assessed and planned for. Care plans identified the intended outcomes for people and how their needs were to be met. This was an improvement from our previous inspection. People received care and support from appropriately trained staff. People were offered a nutritious and balanced diet and their healthcare needs were understood and met.

Systems for assessing and monitoring the quality and safety of the service were not fully effective in identifying areas of improvement within the service. However, there had been improvements from our previous inspection. People and their family members described the staff as approachable and supportive. Systems were in place to gather people’s views on the service.

People were protected from abuse and the risk of abuse and staff understood their role in relation to this. People and their family members told us that the service was safe. Risks to people and others were identified and measures put in place to minimise harm. Good infection control practices were followed to minimise the risk of the spread of infection, this was an improvement from our previous inspection. Regular safety checks were carried out on the environment and equipment.

Staff knew people well and were knowledgeable about individual's needs and how they were to be met. People and their family members knew how to raise a concern or make a complaint about the service. People were treated with kindness by staff. Staff provided care and support with positive outcomes for people.

Details are in the key questions below.

Rating at the last inspection: The service was rated as Inadequate on 25 September 2018 and was placed into Special Measures.

Rating from this inspection: Requires Improvement. The service is no longer in Special Measures.

Why we inspected: This was a planned inspection to assess what improvements had been made by the registered provider following its previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on the 7 and 8 August 2018. The visit on the 7 August 2018 was unannounced and the visit on 8 August 2018 was announced.

This was the first inspection of the service under the registered provider Advinia Care Homes Limited.

Arncliffe Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Arncliffe Court accommodates up to 150 people across five separate houses, each of which have separate adapted facilities. Two of the houses specialises in providing care to people living with dementia. At the time of this inspection 91 people were living at the service.

A registered manager was not in place. 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.

At this inspection we identified breaches of the regulations in relation to the need for consent and the implementation of the Mental Capacity Act 2005, safe care and treatment and good governance.

Risks to people’s health, safety and welfare were not always fully considered. Not all identified risks to people and others had been fully assessed and where possible, minimised. This related to infection control practices and the management of medicines.

The service had failed to ensure that appropriate action was taken quickly to assess and mitigate any risks in relation to the telephone system within the service not working. For a period of four days, no calls could be made to or from the service. No risk assessment had been completed to inform others of the current situation. After a four day period we contacted the registered provider who took immediate action to ensure that phones were accessible to staff.

The service had failed to informed others of any potential risk in relation to the identification of a water bacteria being present in the service. Although the bacteria had been assessed as a low risk, and was being regularly checked, no information had been made available to advise people of its presence.

Systems were in place for the recording and monitoring of accidents and incidents. However, effective reports were not always maintained.

Systems and procedures were in place in relation to the Mental Capacity Act 2005. Records demonstrated that more knowledge was required around the implementation of the Act to ensure that people’s rights were promoted and maintained.

Each person had their own individual care plan. However, not all of the care planning documents to support people’s needs contained detailed, up to date information. In addition, alternative approaches to how to support people were not always considered. This could put people at risk of not receiving the care and support they required.

The quality assurance systems in place were not effective. The provider failed to identify and act upon a number of issues which we identified during the inspection. These were in relation to health and safety, care planning and supplementary care records.

Personal records relating to people were not always stored to protect people privacy.

We have made a recommendation about the environment. The environment lacked wayfinding and orientation for people living with dementia.

People had freedom of movement around the service and told us that they had a choice where they spent their time, and what time they went to bed and got up. However, people’s personal choices and preferences were not always respected in relation to their planned care.

Policies and procedures were in place and available to all staff. The new registered provider had a service level agreement with the