This was an unannounced inspection that took place on 12 and 15 January 2018.

Cecil Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cecil Court provides care for up to 45 people including people with dementia and is located in the Kew Gardens area of west London.

The home had a registered manager. 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 and associated Regulations about how the service is run.

At the last inspection in January 2016 all the key questions of safe, effective, caring, responsive and well-led were rated good and there was an overall rating of good.

The home had participated in the ’My Life’ project that researched the effectiveness of biographical reminiscence films for people with dementia. We saw first-hand the positive effect these film biographies had in greatly enriching people’s quality of life and reducing their anxiety.

People and their relatives said that Cecil Court provided good care and support in a friendly atmosphere. Staff were available in suitable numbers to meet people’s needs and they did so in a kind, friendly and skilful way.

The home kept thorough and comprehensive records that were up to date and regularly reviewed with information recorded in a clear and easy to understand way.

The registered manager and staff encouraged people to discuss health needs and they had access to community based health professionals if required. People were protected from nutrition and hydration associated risks by being provided with balanced diets that also met their likes, dislikes and preferences. People and their relatives told us the meals provided were of good quality and there were plenty of choices. Staff prompted people to eat their meals and drink if this was required whilst enabling them to eat at their own pace.

The home was clean, well-furnished and maintained and provided a safe environment for people to live and staff to work in.

Staff had appropriate skills and training, were competent and knowledgeable about the people they supported. They were focussed on providing people with individualised care and support and this was provided in a professional, friendly and supportive way. Staff were aware of their responsibility to treat people equally and respect their diversity and human rights. They treated everyone equally and fairly whilst recognising and respecting people’s differences.

Staff said the registered manager and organisation provided good support and there were opportunities for career advancement.

People and their relatives thought the registered manager and staff were approachable, responsive and encouraged feedback from people.

The home had systems that consistently monitored and assessed the quality of the service provided.

This was an unannounced inspection that took place on 22 and 26 January 2016.

Cecil Court provides care for up to 45 people including people with dementia.

The home had a registered manager. 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 and associated Regulations about how the service is run.

In October 2014, our inspection found that the home met the regulations we inspected against. At this inspection the home met the regulations.

People and their relatives told us the home provided a good service, an atmosphere that was enjoyable and they liked living there. They were satisfied with the staffing arrangements and said the staff team were caring, attentive and provided the care and support they needed in a kind and friendly way.

The records were kept up to date and comprehensive. There was clearly recorded, fully completed, and regularly reviewed information. This meant people were well supported by staff who could perform their duties well. People and their relatives were encouraged to discuss health needs with staff and had access to community based health professionals, such as GPs as required. They were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. People and their relatives were positive about the choice and quality of food available.

The home was well maintained, furnished, clean and provided a safe environment for people to live and staff to work in.

The staff were knowledgeable about the people provided a service for and care field they worked in. They had appropriate skills, training and were focussed on providing individualised care and support in a professional, supportive and friendly manner. Staff said they had access to good training, support and career advancement.

People and their relatives said the management team were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

During our visit we spoke with people who use the service, relatives and members of staff. We saw the staff treat the people using the service with respect and dignity and enabled them to make a range of choices including how they spent their day, food and entertainment. People using the service we spoke with said "I like the food, there is always enough" and "The staff are nice and we have a laugh".

A relative said they felt that "The general care is good, there is never a smell and it is always clean and tidy". A member of staff said "The staff have a good awareness of the needs of all the residents" and "It's a homely home".

The relatives we spoke with felt there was enough staff to provide care but one commented that staff often moved between areas as people with dementia need to see the same faces. A relative said "I am very satisfied with the care my relative is receiving, we feel the staff are part of our family. Everyone is very friendly and helpful".

People told us what it was like to live a this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective) and a practising professional.

To help us to understand the experiences people have, we used our SOFI (Short

Observational Framework for Inspection) tool during this visit. 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.

People made positive comments about the home and the care and support they received, saying staff maintained their privacy and dignity and that they were involved in planning the care they received.

People's comments about the food were positive and included "I like the food", "the food is very good", "the meal was tasty" and “the desserts are delicious”. People told us they had enough to eat and drink.

Other comments about the home included “I spend time in the gazebo, when the weather is fine, it is a feature this home offers, which I particularly enjoy”, “my relative lives outside of London and we have regular conversations on the phone which is of great comfort to me”, “ I was allowed to bring my favourite armchair and other bits of furniture and I made my room homely”, "the atmosphere is a happy one” and "I can have visitors at any time".

The people who we spoke with told us that they were happy with their care and treatment at Cecil Court. One person said, ‘’I have lived here for many years and I could not wish to be in a better place’’. They told us that the staff were kind and caring. Some people told us that they felt the variety and quality of food could be improved. We met some people who were visiting relatives at the home. They told us that the home met the needs of people living there, that they were well informed and always welcome.

The staff we spoke with told us that they were well supported. They said that they had a good range of information and training to help them care for people living at the home.

This was an unannounced inspection over two days on 14 and 15 October 2014. During the visit, we spoke with 14 people who use the service, two relatives, eight care staff, the deputy manager and two members of the organisation’s management team.

The home had a registered manager who was on annual leave. 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 and associated Regulations about how the service is run.

In April 2013, our inspection found that the service was compliant with the regulations we inspected against.

Cecil Court is a care home registered to provide accommodation for up to 45 people who require personal care and may also have dementia. The service is located in the Kew Gardens area.

We found one area that required improvement. A small proportion of the medicine records for people using the service was incomplete without a written explanation provided for creams administered. The management team were aware through their monitoring and auditing systems and had taken steps to address this. You can see what action we told the provider to take at the back of the full version of the report. The other records we looked at were up to date and well kept.

We recommend that the home reviews Good Practice Guidance D: Medicine administration records (MAR) in Care Homes

.

We sampled eight care plans that were clearly recorded, fully completed, regularly reviewed and underpinned by risk assessment. We saw that there were enough staff at all levels of seniority who were well trained, knowledgeable, professional and accessible to people using the service and their relatives.

People using the service and their relatives said they were happy living at Cecil Court, with the service they received, the staff who delivered it and way it was delivered. They said staff were caring, responsive to their needs and the home was well managed. This matched our observations during the inspection visit. We saw that staff had appropriate skills, were familiar with people using the service, understood their needs and care and support was given in a supportive, patient and compassionate way.

We saw that the home provided a safe environment for people to live and work in. The provider had a clear and transparent care philosophy and values that were reflected in the good care practices that we saw staff following.

People told us, we saw and records showed that the management team and organisation were approachable, responsive, encouraged feedback from people who use the service and their relatives and consistently monitored and assessed the quality of the service provided. Staff said they felt well supported by the management team and organisation.