This inspection took place on 20 December 2016 and was unannounced. Canwick Court provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 31 people who require personal and nursing care. At the time of our inspection there were 23 people living at the home.

There was 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.

Staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to support staff if they were concerned about the safety and welfare of the people in their care.

Medicines were administered safely. Medication documentation was not always completed consistently which created an increased risk to people’s safety.

We saw that staff obtained people’s consent before providing care to them. The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were usually sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision. People were encouraged to enjoy a range of social activities. They were supported to maintain relationships that were important to them.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified. Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

This inspection took place on 10 December 2014 and was unannounced.

Canwick Court specialises in the care of older people who have mental health needs including people living with dementia. It is registered to provide accommodation for people who require nursing and personal care for up to 26 people in two units. At the time of our inspection there were 26 people living at the home.

At the time of our inspection there was 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.

On the day of our inspection we found that staff interacted well with people and people were cared for safely. People were safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe.

The provider did not act in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).If the location is a care home Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find. At the time of our inspection there was one person who was subject to DoLS.

We found that people’s health care needs were assessed, and care planned and delivered

to meet those needs. People had access to other healthcare professionals such as a dietician and GP.

Although staff responded in a timely and appropriate manner to people there were not always sufficient staffing to meet people’s needs. Staff were kind and sensitive to people when they were providing support. Staff had a good understanding of people’s needs. People had access to activities and excursions to local facilities.

People had their privacy and dignity considered.

People were supported to eat enough to keep them healthy. People had access to drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs.

We saw that staff obtained people’s consent before providing care to them.

Staff felt able to raise concerns and issues with management. We found people and relatives were clear about the process for raising concerns and were confident that they would be listened to.

Audits were carried out on a regular basis and action plans put in place to address any concerns and issues.

During our visit we spoke with two people who used the service, three members of staff and the registered manager. We observed the care people received and looked at four people's care records in detail.

To help us to understand people's experiences we used our Short Observational Framework for Inspection (SOFI). SOFI allows us to spend time observing and helps us to record how people spend their time.

A relative said, "It is very good here, they look after my mum well.”

Overall we observed that people were supported by sufficient skilled and experienced staff who understood their roles and responsibilities. We observed care and saw staff were responsive to people's needs.

We saw from the care plans and observations people received care which was appropriate to their needs.

People told us the staff were caring and looked after them well.

When we looked at the records we found they detailed the care people required and care was delivered safely to meet people's needs.

We saw people received appropriate nutrition in order to meet their needs.

We looked at the process for administering medicines and saw it was safe and effective.

During our visit we spoke with one person, two staff and a two relatives. We observed the care people received and looked at records.

We found medicines were administered and stored safely.

Overall we observed people were supported by skilled and experienced staff who understood their roles and responsibilities.

We observed care and saw staff were responsive to people and interacted with them positively.

We spoke with a relative. They told us the staff were caring.

We observed staff supporting people and saw they were caring and responsive to people's needs.

We saw staff explained the care they were giving to people. For example when they offered medicines to people they explained what they were.

When we looked at the records we found they accurately reflected the care people were being given or required.

We found the service was well led and staff received appropriate training to support them to effectively provide care to people.

We did not speak to people about their care during this visit.

At our last inspection of Canwick Court Care Centre on 19 July 2012 we issued a compliance action,. We issues the compliance action because we were concerned people were not protected from the risks of unsafe or inappropriate care and treatment as records were not completed fully.

We found there were numerous gaps in fluid, food and positioning charts and records did not reflect the care people should have received according to their care plans.

Following this visit we received an action plan from the provider to address the issues. In the action plan the provider said they would audit all positional, fluid and food charts randomly on a daily basis.

During this visit we spoke with the registered manager and deputy manager. We looked at three care records and six fluid and food charts. We also checked on the progress the manager had outlined in their action plan.

We found that overall records were being completed in a timely and accurate manner and reflected the care outlined in the care plans.

Many of the people that used the service at Canwick Court Care Centre had dementia and therefore not everyone was able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

Many of the people that use the service at Canwick Court Care Centre had dementia and therefore not everyone was able to tell us about their experiences.To help us to understand the experiences people had we used our Short Observational Framework for Inspection (SOFI) tool.The SOFI tool allowed us to spend time watching what was going on in a service and helped us to record how people spent their time, the type of support they got and whether they had positive experiences. Some people using the service were able to tell us about their experiences and we also spoke with staff and other health professionals.

We carried out the SOFI for an hour which included the lunchtime period. We observed a mixed response to people’s privacy and dignity.

We observed a member of staff taking time to explain to a person that it would soon be dinnertime and asked them what they would like for dinner. However we also observed staff calling out to people as they passed them without having a meaningful conversation with them.

We saw staff responded to people in a sensitive way but we also saw people left without support for periods of time.

People were spoken with in a sensitive manner and some of their wishes were responded to promptly although at other times they may be asked to wait. One person told us, “They (the staff) like to make sure we are content.”

We asked people for their views on the care provided and they told us that they felt well supported. One person told us, “I didn’t want to go into a care home, but it has been very good here.” We also saw people joking with staff and discussing their care.

People told us they felt safe in the home and one person commented, “they are all so kind to us.”