This unannounced comprehensive inspection took place on 12 January 2017.

Church Court is a care home without nursing care for up to 16 older people. On the day we visited 12 people were living there. The home is a converted house and has a passenger lift to reach three floors where people are accommodated. There was 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 2008 and associated Regulations about how the service is run.

People were supported by sufficient staff but sometimes the deployment of staff could be improved to ensure people were always well supported in the communal areas. The registered manager was accessible and supported staff, people and their relatives through effective communication. People told us they felt safe in the home. Staff knew how to keep people safe and were trained to report any concerns. People were supported by staff that were well trained and had access to training to develop their knowledge.

Individual risk assessments were completed which minimised risk for people helping to keep them safe and as independent as possible. All accidents and incidents were recorded and had sufficient information to ensure preventative measures were identified.

We observed staff responding to people in a calm and compassionate manner consistently demonstrating respect. Staff knew people well and supported them to take part in activities they liked.

Staff were aware of the Mental Capacity Act 2005 (MCA) to protect people when they needed support for certain decisions in their best interest. Care plans included mental capacity assessments and ‘best interest’ decisions where applicable. Most people made everyday decisions and staff promoted their independence.

Social and healthcare professionals supported people. Medicines were well managed and given safely. Special diets were provided to maintain and improve people’s health and wellbeing. People had a choice of meals and special diets were provided.

Quality assurance checks were completed and examples told us that action plans identified where changes were made to address any shortfalls. People and relatives were asked for their opinion about the service and their comments were taken into account to improve the service.

A single inspector carried out this inspection. The focus of the inspection was to answer 5 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 using the service, their relatives and staff told us, what we observed and the records we looked at. This is a summary of what we found.

Is the service safe?

People told us that they felt safe living at the home. A person told us “I feel safe. I have a call bell in my room.” People’s privacy and dignity were respected by staff.

The service followed the local authority safeguarding procedure and staff understood how to safeguard the people they supported. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. This reduced the risks to people and helped the service to improve.

The home had suitable policies and procedures and training in place in relation to safeguarding, the Mental Capacity Act 2005 and accompanying Deprivation of Liberty Safeguards (DoLS). This legislation protects the human rights of adults who live in a care home or hospital and lack the mental capacity to consent to arrangements proposed for their care or treatment and for whom such arrangements may amount to deprivation of liberty. DoLS are not used for people detained or liable to be detained under the Mental Health Act 1983 (as amended by the Mental Health Act 2007). Relevant staff were trained to understand when an application should be made, and in how to submit one. This meant that people were safeguarded as required.

Is the service effective?

One person said “I think it’s good”.

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in writing them and they reflected their current needs.

Is the service caring?

One person told us they were “quite satisfied” with their care. People were supported by kind and attentive staff. We saw that care staff explained and encouraged when supporting people.

People’s preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided according to people’s wishes.

Is the service responsive?

People participated in activities inside the service regularly. People knew how to raise concerns or make a complaint if they were unhappy. We saw that a previous complaint had been investigated thoroughly. People can therefore be assured that complaints are investigated and action is taken as necessary.

People who used the service, their relatives and representatives involved with the service completed an annual satisfaction survey. Issues or concerns raised were addressed.

Is the service well-led?

The service worked in collaboration with other professionals and services to ensure that people received effective care.

The service had a quality assurance system. Records we reviewed showed that identified issues were addressed. As a result the quality of the service improved.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of their roles. Suitable quality assurance processes were in place. This helped to ensure people received a good quality service.

People we spoke with were complimentary about the care they received, food provided and the staff. Staff were happy working at the home and spoke about the good team working. A visiting health care professional spoke well about the helpfulness of the staff and how they carried out suggested treatments.

The provider produced guidance for staff on the Mental Capacity Act 2005 and consideration was given to whether people had the capacity to consent to care and treatment. We saw evidence that people had given consent where appropriate.

The home was clean and comfortable and we saw and heard evidence that people appreciated the care provided. There were a range of activities provided including the visiting services of a chiropodist and hairdresser. People's care needs were assessed and records showed that their needs had been reviewed and care plans updated as necessary. Ongoing daily records showed the care that people received.

People were provided with a varied and nutritious diet with consideration given to their particular likes and dislikes, special diets and the need for food supplements. Staff ensured good food safety and the home was recently awarded a 'five star' rating for good kitchen hygiene.

There were good arrangements in place to minimise the risk of infection that included good hand hygiene guidance along with arrangements for cleaning and wearing protective equipment.

The provider had systems in place to audit the quality of service provided.

One person told us they felt the home was “very good” with “nothing being too much trouble for staff” They said they enjoyed spending time in the garden and reading their daily newspaper. They told us they felt they “couldn’t be in a better home”.

People expressed their views and were involved in making decisions about their care and treatment. It was evident from care records that people had been involved in the planning of their care.

We looked at care records for three people. These were kept in bound books with an index at the start to enable staff to store and retrieve information. There were sections in the book for all aspects of care recording and they had developed over time so that risk assessments and assessment tools were in the relevant section.

People we spoke with told us they felt safe living at Church Court.

We spoke with staff who told us they felt supported by the manager. They told us they enjoyed their work some of them having worked at Church Court for many years. They told us about the training they received or completed on-line and spoke about the one to one supervision meetings they had with the manager.

A representative of the organisation conducted monthly quality monitoring visits. The reports included a comment on what was looked at action for the home to take if required and space for the manager to record the action they had taken.