Catchpole Court Care Home is a care home for up to 66 older people some of whom live with dementia. The home is purpose built and comprises of two separate units, each on two floors of the home. There were 54 people living at the home at the time of our visit.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good …

Staff knew how to respond to possible abuse and how to reduce risks to people individually and from environmental risks, such as from equipment or through fire safety awareness. There were usually staff who had been recruited properly to make sure they were safe to work with people. Medicines were stored and administered safely.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. 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 received a choice of meals and staff supported them to eat and drink enough. They were referred to health care professionals as needed and staff followed the advice professionals gave them.

Staff were caring and kind and treated people with respect. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records guided staff in how to do this. There were not enough activities or things for people to do during the day and people did not always have enough social stimulation. Complaints were investigated and responded to and people knew who to go to, to do this.

Staff worked well together and felt supported by the management team. The monitoring process looked at systems throughout the home, identified issues and took the appropriate action to resolve these.

Further information is in the detailed findings below.

We inspected this service on 8 January 2015 and the inspection was unannounced. Catchpole Court Care Home provides personal care for up to 66 older people, some living with dementia.

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.

There were enough staff to support people safely and staff knew what to do if they suspected someone may be being abused or harmed. Recruitment practices were robust and contributed to protecting people from staff who were unsuitable to work in care. Medicines were managed and stored properly and safely so that people received them as the prescriber intended.

Staff had received the training they needed to understand how to meet people’s needs. They understood the importance of gaining consent from people before delivering their care or treatment. Staff were clear about their roles. Where people were not able to give informed consent staff and the manager ensured their rights were protected.

People have enough to eat and drink to meet their needs and staff assisted or prompted people with meals and fluids if they needed support.

Staff treated people with warmth and compassion. They were respectful of people’s privacy and dignity and offered comfort and reassurance when people were distressed or unsettled. Staff also made sure that people who were becoming unwell were referred promptly to healthcare professionals for treatment and advice about their health and welfare.

Staff showed commitment to understanding and responding to each person’s needs and preferences so that they could engage meaningfully with people. Outings and outside entertainment was offered to people and staff offered activities on a daily basis.

Staff understood the importance of responding to and resolving concerns quickly if they were able to do so. Staff also ensured that more serious complaints were passed on to the management team for investigation. People and their representatives told us that any complaints they made would be addressed by the manager.

The service had consistent leadership. The staff told us that the manager was supportive and easy to talk to. The manager was responsible for monitoring the quality and safety of the service and asked people for their views so that improvements identified were made where possible. The organisation also carried out quality assurance visits, set action plans and checked the actions had been undertaken.

The service had two units, one of which, the Gainsborough Unit, catered for people living with dementia. During our inspection we used the Short Observational Framework for Inspection (SOFI). This is a specific way of observing care to help us understand the experience of people who could not talk with us because of their dementia.

We also spoke with eight people who used the service and with six staff members. We looked at seven people's care records and other records including health and safety checks, staff and resident meeting minutes and the result of the satisfaction survey that had been carried out by the service. We also talked with the manager and the area manager.

We looked around the building and assessed it for cleanliness and safety.

During our inspection and in the analysis of our findings, we considered the questions we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found;

Is the service safe?

We did not find that all areas of the service were safe.

When we arrived our identification was checked and we were asked to sign the visitor's book. This showed that the staff took the security of the building and the safety of the people who lived there seriously.

We found that staff had received training in protecting vulnerable people from harm and how to make a referral to the local authority for further investigation under their safeguarding procedures. When we spoke with people they told us they felt safe living in the home and that they would speak with the staff if they had concerns.

Our records showed that the service had acted quickly if they had any suspicion of abuse and acted on if they considered people were at risk of abuse.

We saw that the staff were provided with training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were only deprived of their liberty when they needed to be so that they were kept safe, and if they were deprived it was only done in their best interest.

We saw records which showed that the health and safety and infection control checks had been carried out in the service regularly, but we found areas of the service that were unsafe, poorly maintained and unhygienic.

We saw that there were sufficient staff on duty, but that they could be better deployed to protect people’s health, safety and wellbeing. The staff rota and dependency level assessments showed that the service assessed people's needs to ensure that there were sufficient numbers of staff to meet them.

But at key periods sufficient numbers of staff were not available to support people with their meals. This was because staff left the floor to have their scheduled meal breaks during the main mealtime. Nor was it clear that the activity coordinators used their time effectively, and poor infection control and cleanliness in the service indicated that there were not enough domestic staff available to keep the home clean and safe.

People told us that the staff were available when they needed them. One person said, "I don’t have to wait long for help." Another person told us that, “They (the staff) are never far away if I need them.” Staff told us that there were times when they were busy and found it difficult to cope, especially at mealtimes.

We identified poor moving and handling practice on two separate occasions.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

However, during our observations we saw that people on the Gainsborough unit displayed agitated, distressed, bored, and disconnected behaviour. We saw that there was little evidence that the service provided activities specifically designed to engage people living with dementia. The staff were seen to be rushed and stressed, which meant that we could not be assured that the people who used the service had access to meaningful activities to enable them to remain engaged and motivated.

The provider had a quality assurance system in place and the records we examined showed that health and safety audits had been done. However, due to our concerns found during this inspection, it is not evident that these audits were effective in keeping people safe and ensuring that the service was meeting their needs.

Is the service caring?

We saw that the majority of staff interacted with people who lived in the home in a caring, respectful and professional manner. However there were times when we saw that staff did not interact with people in a way that would ensure that they felt well supported and safe.

People who spoke with us, mainly on the Constable unit, told us that the staff treated them with respect. One person said that staff were, "Kind people." Another person told us, "I couldn’t find anything to complain about."

Is the service responsive?

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including the doctor, district nurse and dietician.

The people who used the service, their relatives and other professionals involved with Catchpole Court who had completed the satisfaction questionnaires said that they felt that the service responded well to concerns raised with them. Where shortfalls or concerns had been raised they were dealt with quickly.

Is the service well led?

The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The manager also told us that they felt supported by the organisation and by their direct line manager, who visited the service regularly to offer support and to check compliance.

As part of this inspection process we spoke with the deputy manager, five members of staff, five people who used the service and one visitor.

Our observations suggested that people living at the service were happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them.

People's health and personal care needs were assessed and there were care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that there were sufficient numbers of staff available to meet people's care needs. We found that medication practices and procedures required minor improvement.

We found that there had been changes to the day-to-day management of the home and the service was currently being managed by the deputy manager.

We spoke with eight people who used the service, three relatives and five members of staff as part of this inspection. People who used the service told us that were very happy with the care they received and that they felt safe but some people were unhappy with the recent changes to the menus and the standard of meals provided.

People told us that they found the standard of meals was good with one person stating that “I always eat everything.” But another person stated that they found that all the food had an ‘underlying taste, not sure what it is but everything tastes quite similar.”

One person stated that "There is always someone to help me and have a laugh with." Another person commented that "There is a homely and welcoming atmosphere here.”

We found that the service was meeting the personal, emotional and healthcare needs of people using the service. We found that the environment was maintained safely and odour free and that all health and safety checks were up to date.

We found that all mandatory training was up to date.

We spoke with seven people living in the home and two relatives during our visit. The people with whom we spoke told us they were happy with the home and that the staff looked after the people who live there well. People described the staff as lovely and commented “we are all happy here” and "the staff are very nice, we have a good rapport” and “it is OK living here, I am looked after and fed very well”. One of the people spoken with told us, that they feel contented living in the home and that they receive good care, support and treatment as and when required. All of the people with whom we spoke confirmed that they have access to a doctor or other health professionals when they need them and confirmed they receive their medication when required and that they have not been aware of any issues or mistakes with their medication. They also told us their "medication has always been available". Another person spoken with told us they have lived in Catchpole Court for just under a year and that their relative had found the home and arranged for them to visit. They told us, “it is very nice here and very well run”. They also said that they are able to spend their time as they wish, if they do not wish to take part in activities, they do not have to and if they want company they will choose when and where. They told us, they like going into Sudbury town centre, however it is too far for them to walk, if they say they want to go into town, staff will take them in their wheelchair. They confirmed this does happen when they ask.

The people with whom we spoke told us they are happy with the standard of food, which is generally good. They also told us that they are able to make choices from a menu, which has a minimum of two choices daily. They confirmed they are able to decide where they wish to eat their meals, some elect to take all meals in the dining room where as others will take some or all of their meals in their own room. One person commented, “we have nice food and are able to have a drink whenever we want one”.

We were informed that people feel safe and comfortable living in the home and that they have nothing to complain about. People told us if they did have cause for complaint they would talk to the manager. They also described Catchpole Court as homely, comfortable and relaxing. People with whom we spoke told us they are able to choose where they spend their time and that they have access to a call bell to contact staff when they need to. A relative commented, "the home is nicely presented and clean" and that it has improved of late as there seems to be more money available. People living in the home and relatives told us some staff appear better skilled than others, but they mostly felt that the staff are knowledgeable and have the right skills for the job. During our visit we observed staff engage well with people with varying levels of dementia living in the home. People were clearly comfortable in staff's presence, smiling and sitting in a relaxed position and engaging in conversations. People told us, "the staff are smashing" and "the staff are very nice”. One person commented, "I have got used to staff now, they are pleasant, some more helpful than others, but I do not have any problems, if I did I would soon tell them".

People with whom we spoke, including visitors to the home told us they were aware that there have been recent changes to the management of the home; however they were not ware of who the manager is. One person commented, “I do not know who the manager is, but I feel this proves a point, the home is running alright, if it is not broke don’t mend it".