About the service:

Carrington Court care home is owned by HC-one and is situated near the centre of Hindley, Wigan. The home can accommodate up to 48 people who need care and support. At the time of the inspection the home was fully occupied.

People’s experience of using this service:

People felt they or their relatives were safe living at Carrington Court.

There were systems and processes in place to keep people safe from the risk of abuse.

Risk assessments were completed appropriately and updated as required.

Staff were recruited safely, with all relevant checks in place and staffing levels were sufficient to meet people’s needs.

Medicines systems were safe, and staff had appropriate training.

Staff had received infection control training and wore appropriate personal protective equipment (PPE), to deliver personal care.

Care files included assessments and documented health needs and routines.

Staff had a thorough staff induction programme, on-going training and refreshers and were knowledgeable and competent.

Staff supervisions were completed regularly and there were annual appraisals.

People enjoyed the food and there were plenty of choices.

Food and fluid and positional charts were completed as required.

GPs and other professionals were contacted when required.

The building had wide corridors and doorways to help people who had restricted mobility move around.

The service worked within the legal requirements of the Mental Capacity Act (2008) (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Staff interacted respectfully with people who used the service and spoke in a friendly manner.

Care plans clearly reflected respect for people’s diversity and equal treatment for all those who used the service.

Staff were seen to respect privacy and dignity.

Care plans were person-centred, and people were given as much choice and control over their lives as possible.

There was a range of activities and outings and people’s wishes were fulfilled where possible. There was a complaints log and the service had received a number of compliments.

End of life wishes were recorded in care files, where people had expressed them, and some staff had completed training in this area.

The registered manager and provider were aware of their responsibility regarding duty of candour.

The service had a manager in place, who was registered with the Care Quality Commission (CQC) as required.

CQC notifications of significant events that the service is required to tell us about, were sent in as required.

Safeguarding issues, accidents and incidents were reported to the relevant bodies and any incidents reviewed to look at lessons learned.

Previous ratings were displayed on the provider’s website.

Relatives felt management and staff were efficient and effective at liaising with external healthcare professionals and other external bodies.

The service analysed data for any trends and patterns to aid improvement. Working in partnership with others.

The service was involved in intergenerational project work with local college and primary school around facilitating activities.

Rating at last inspection:

At the previous inspection, published on 24 August 2016, the service was rated good.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Inspection timescales are based on the rating awarded at the last inspection and any information and intelligence received since we inspected. As the previous inspection was Good this meant we needed to re-inspect within approximately 30 months of this date.

Follow up:

We did not identify any concerns at this inspection. Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for services rated Good.

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

The inspection was unannounced and carried out on the 13 July 2016.

The service was last inspected on 12 August 2014, when we found the service to be compliant with all the regulations we assessed at that time.

At the time of the inspection there were 48 people living at Carrington Court. Carrington Court is a purpose built home in Hindley, which offers Nursing and Residential Care. The home is situated close to local amenities. The home had 48 bedrooms which were across two floors and could be accessed via a lift and stairs. The home is an accredited home with Gold Standards framework.

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.

People told us they felt safe living at the home. People had comprehensive risk assessments which were reviewed and updated in a timely way to meet people’s changing needs. People and their relatives told us they were well informed and had been involved in the assessments and planning of the care and support received.

The home had sufficient numbers of staff deployed which was formally calculated based on people’s dependency. We found staff were able to meet people’s needs efficiently and all the people spoken with confirmed their needs were met in a timely way.

The staff we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns. People were protected against the risks of abuse because the service had a robust recruitment procedure in place.

The management of medications, promoted people’s safety. Appropriate arrangements were in place to ensure that medicines had been ordered, stored and administered appropriately.

The service had a training matrix to monitor the training requirements of staff. Staff received appropriate training, supervision and appraisal to support them in their role.

People were supported in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

We saw staff assessed peoples’ nutritional needs and varied menu’s had been developed. People were offered choice and the dining experience was interactive and relaxed.

We observed frequent, appropriate physical contact between staff and people which were natural and symbolised the familiarity and relationships that had developed between people and staff.

People’s privacy and dignity was maintained and their independence was encouraged. People told us that staff were respectful of their wishes.

People’s care plans were reflective of their preferences and needs and reviewed regularly in conjunction with them and their relatives.

People and their relatives knew how to make a complaint. They told us they were confident in the manager and we saw complaints had been resolved in the required timeframes.

The home had a full programme of activities in place for people and their relatives were actively encouraged to attend. Relatives spoke of feeling part of a community.

The service had links with the local community and we were told some wonderful relationships had been formed between people living at the home and a local college.

A range of audits were undertaken to help monitor and improve the quality and safety of the service. We saw actions were implemented timely following any deficits identified. Management understood their legal requirements and notifications had been submitted to CQC.

This is a summary of what we found. We ask five questions.

Is the service safe?

Both the people who lived in the home and their relatives were pleased with the care provided and felt that their views were respected and listened to. The staff worked in a safe and hygienic way and used appropriate protective clothing. There were enough staff to meet the needs of the people who lived in the home and a member of the management team was available on call in case of emergencies. One person said: “I’m not frightened of anything here.” Another person said: “I do feel she’s safe here.”

Staff personnel records contained all of the information required by the Health and Social Care Act. This meant the provider demonstrated that staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home.

The staff we spoke with understood the importance of safeguarding vulnerable adults, could identify potential abuse and knew how to report any concerns.

Is the service effective?

People told us they were happy with the care that had been delivered and we saw their care records were up to date. One relative said: “She has put weight on and is far more independent.” Another relative said: “She is a lot better than she was. They are very attentive”

Care records confirmed people’s preferences and needs had been recorded and care and support had been provided in accordance with people’s wishes. One relative said: “I’m very pleased with it.”

We heard that information was shared effectively between staff. Several ways of sharing information included daily management team meetings, handovers, daily records, diaries and monthly reviews.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and encouragement when supporting people. One relative said: “I think the staff are lovely.” One person who lived in the home said: “All the carers are good. I wouldn’t wish to be anywhere else. ”

Is the service responsive?

People’s needs had been assessed before they were admitted to the home. Their needs for support and treatment were carefully described so that care workers knew exactly what tasks to undertake. Changes in people's care needs were reported to the senior carer and they briefed care staff. One person who lived at the home said: “They couldn’t do more for you.” Another person said: “If I’ve needed anything I just ask.”

Is the service well-led?

Staff had a good understanding of the culture of the home and quality assurance processes were in place. People told us they had received customer satisfaction surveys and had attended meetings for people who lived in the home which were held every month to seek suggestions for any improvements required. One relative said: “I have made complaints about clothes but the manager sorted it out.” Staff told us they were clear about their roles and responsibilities and were well supported.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences.

During our visit we met with eight of the people living at Carrington Court and two of their relatives. We also met with other people living there and observed the support provided to them.

In addition we spoke with the Manager and nine members of staff who held various roles within the home.

Relatives told us that in their opinion people had received the support they needed with their personal care.

People who lived in the home told us staff treated them well and with dignity and respect. One of the people living at Carrington Court told us, "I love it here, I've not been here long and I really like it, the staff are lovely, attentive and kind, they really do their very best for you."

Staff told us the manager was excellent and they felt supported in their roles and received lots of training to enable them to provide needs led services to the people who lived in the home.

During our visit to Carrington Court we spoke with twelve people who live on the ground floor and three who live on the first floor of the home. They told us they liked living in the home and staff provided flexible services. For example, one person told us they liked the place as it was nice and comfortable. Another person said staff talked to them all the time and told them what was going on. All gave examples of the things they did during the day including reading, watching television, socialising with other people living in the home, having visitors and taking part in activities organised by the activity coordinator such as a music quiz, board games, baking, sing a longs, playing cards and going out in the local community. People said they had been provided with details about the home, staffing levels and the services provided before admission

People also told us that the home: “is unique, you don’t find homes like this; everyone cares. Everyone thinks of it as home”, “Staff know everything about my daily routines, heath needs, choices and capabilities. They make sure wherever possible I can do the things I like to do”. ”Staff are perfect, food is very good, nothing needs improving this is an excellent home”.

People said that there was always plenty of staff on duty and people did not have to wait a long time if they need help. One person told us that staff were perfect and said “anything you want they will do for you”.

People we spoke with told us they were happy living at Carrington Court. They said resident meetings were held on a regular basis and people said they could air their views. Direct comments included; “All the staff listen to what we say and make changes if required”. “I feel safe, I like living here”. “I just feel at home here”. “The management and staff are so good that this place really does feel like home”.