About the service:

Blatchington Court is a residential care home that provides residential and personal care for up to 20 older people, all of whom are living with dementia. At the time of this inspection, 17 people were living at the home.

People’s experience of using this service:

People and their relatives spoke highly of the home and felt it was well-led and managed, with a high standard of care. Opportunities to drive continual improvement had been taken and a robust system of audits monitored and measured the service. An analysis of falls that people had sustained had resulted in an additional member of staff being employed during the early part of the day. This had brought about a reduction in the number of falls.

The use of technology had enabled people to share their views about the service they received in an accessible way. Feedback was positive. Staff enjoyed working at the home and were motivated by management to do their jobs well and to a high standard. For example, there was an ‘Employee of the month’ scheme, where a member of staff was nominated by their peers and could receive gift vouchers for exceptional work.

People felt safe living at the home and their risks had been identified and assessed, so that staff knew how to support people. There were enough staff to meet people’s needs and new staff were recruited safely. Systems were effective in ensuring people received their medicines as required. The home was clean and smelled fresh.

People’s needs and choices were met by staff who knew them well. Staff had the skills, knowledge and experience to deliver effective care and support and had completed a range of training. Staff had regular supervisions and attended staff meetings.

A choice of meals was available to people. Where needed, staff supported people to eat their meals. The home was comfortable and rooms were personalised. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported by a range of healthcare professionals and services.

People were looked after by kind and caring staff who were patient, warm and friendly. People were encouraged to be involved in all aspects of their care and were treated with dignity and respect.

Care plans provided staff with detailed information and guidance for staff about people’s support needs, their likes, dislikes and preferences. Activities were organised and musical entertainers were popular, visiting the home three times a week. People had the opportunity to have dedicated one-to-one time with a staff member and could choose how they wanted to spend a ‘Golden Hour’ with staff.

Rating at last inspection:

At the last inspection, this service was rated as Good (published in November 2016).

Why we inspected:

This inspection took place in line with CQC scheduling guidelines for adult social care services.

Follow up:

We will review the service in line with our methodology for ‘Good’ services.

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

This inspection was unannounced and took place on 12 October 2016.

Blatchington Court provides accommodation for up to 20 older people living with dementia who require personal care and support; they do not provide nursing care.

The last inspection of the service was carried out in September 2013. No concerns were identified with the care being provided to people at that inspection.

At the time of the inspection there were 19 people living in the home. There is a 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.

People were supported to take part in activities and a hobby of their choice. A full activities programme was advertised and people’s art work was displayed in the home. People were supported to express their views through one to one conversations with the activities person and staff.

The provider’s staff recruitment procedures helped to minimise risks to people who lived at the home. Training for all staff to made sure they were able to recognise and report any suspicions of abuse. People told us they felt safe at the home and with staff. One person said, “Yes, very safe and very happy.”

There were sufficient numbers of staff to keep people safe and to provide care and support in an unhurried manner. People told us staff were always kind and caring. Throughout the inspection there was a cheerful, relaxed and caring atmosphere. There was a consistent staff team with some staff working at the home for up to ten years. It was evident staff knew people well.

The management of the home was described as open and approachable and we were told by people who were able to comment and staff that they would be comfortable to raise any concerns. Where concerns had been raised within the home, appropriate action had been taken to make sure people were fully protected.

The registered manager’s philosophy for the way they saw the support they provided was, to provide, “…as much enjoyment as they could for people in the life they had left.” They also said they strived to make the service run as “…efficiently as possible.” Staff spoken with supported the registered manager’s philosophy talking about people in a very caring way. During the inspection people were supported at all times to do what they wanted when they wanted to and enjoyed the activities going on at the time.

People told us they received care and support from kind and caring staff. Throughout this inspection we saw people were supported in a friendly and gentle way. Personal care was provided to people in a way that respected their privacy and dignity.

People's health needs were monitored and they had access to healthcare professionals according to their individual needs. Incidents and accidents were analysed to ensure people received the support they required to maintain their health and well-being.

People had their nutritional needs assessed and received meals in accordance with their needs. Where people required physical assistance to eat this was provided in a dignified manner. People were complimentary about the food served in the home. One person said “Lunch is always good and worth waiting for.” A relative told us “The meals are fresh and well cooked.”

Medicines were administered safely. Medicines were administered by staff who had received suitable training. Safe procedures were followed when recording medicines. Medicines administration records (MAR) were accurate. There were no unexplained gaps in the medicines administration records. Audits of medicines had been completed and appropriate actions taken to monitor safe administration and storage.

People were always asked for their consent before staff assisted them with any tasks and sta

At the time of our inspection the service provided care and support to 19 people. We spoke with a number of people who used the service. Many were not able to tell us about their experiences of living at the home because of their complex needs. However, three people were able to provide feedback to us on the care and treatment they received.

We also spoke with three visiting relatives and five staff members. The registered manager and office manager were also working in the home and spent time with the inspector.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

To see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People had been cared for in an environment that was clean and hygienic. Risk assessments were in place to provide information to staff to help minimise the risk of any harm to people.

All feedback indicated that there was enough staff and they were competent in the work they undertook.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were able to describe when a DoLS had been put in place in the past and why this had been used. Staff had been trained to understand when an application should be made, and the manager knew how to submit and review one.

Is the service effective?

We saw individual plans of care were in place. There was evidence to confirm that these were reviewed and updated to reflect any changing need.

People and their relatives told us that the care provided was appropriate and met people’s needs. Discussion with staff confirmed that staff knew and understood people’s individual care and social support needs.

Training records seen confirmed staff had received appropriate training to meet the needs of people living at the home.

Is the service caring?

People were supported by kind and caring staff. We saw that staff were very kind and polite and gave people time when supporting them.

Our observations confirmed that people were encouraged to be independent but were helped when they needed any support.

Is the service responsive?

Individual care plans were developed for each person following admission. People were given choices and when they declined, this was responded to appropriately. People had access to activities and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

We saw that a number of quality assurance processes were in place. These included feedback from people who used the service and their representatives.

People, visitors and staff told us that if they had any concerns they would speak with the manager. Everyone spoken with told us that they had no reason to complain but felt that if they did any issue would be dealt with effectively.

Blatchington Court’s manager was also the provider. There was a designated head of care. Staff told us they were clear about their roles and responsibilities. Senior care staff worked in the home alongside more junior staff to lead and guide. Staff said they were kept up to date with any changes as required.

During our inspection we spoke with five people who used the service and two visiting relatives. We also spoke with five staff members; these were the registered manager, the care manager, a senior care worker and two care workers. We also took information from other sources to help us understand the views of people who used the service, which included a relatives' survey and meeting minutes.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us “The staff are good. They treat me well. I like it here.” Another person who used the service told us “It is considerably nice here. No complaints.” Staff we spoke with had a good understanding of the support needs of the people who used the service. One member of staff we spoke with told us “We try and take the role of family here and treat the residents as you would your own family.”

The people who used the service were provided with adequate nutrition and hydration. We saw that the service had properly maintained equipment which was used correctly by staff to ensure the privacy and dignity of the people who used the service. Staff we spoke with confirmed that they felt supported and had received relevant training, which included the safeguarding of vulnerable adults.

We also saw evidence that care plans, staff records and other records relevant to the management of the home were accurate and fit for purpose.

We spoke with 16 of the 19 people who used the service. People who were able to speak with us said they felt comfortable and the staff were very good. One person said “They look after us very well.”

We saw that staff treated people with respect and protected their dignity when offering support with personal care. We spoke with relatives and friends, they were all very positive about the care and support offered by the service. One visitor said “(Person who used the service) is much better physically and also much happier here.” However, two people remained in their rooms at all times and although staff told us how they cared for them there was no evidence to support this.

We looked at the care planning system, staff training and the support offered and the processes in place to protect people who used the service. We found that staff were not following the moving and handling training they had received and had put people at risk. Records kept by the home were not comprehensive enough to ensure that people were supported correctly.