Churchfield Court provides accommodation and personal care to a maximum of 37 people who People had a range of conditions relating to old age. At the time of our inspection 33 people lived at the home.

At our last inspection, in October 2015, the service was rated good. At this inspection, the rating remained good.

The manager was registered with us as is required by law and was present on the day. 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.

Staff delivered safe care to people and supported people to take their medicines safely and as they had been prescribed. Staff had received training in how to protect people from abuse and harm. Risks to people’s safety and well-being were assessed and instruction was available for staff to follow to prevent people being at risk of accidents and injury. Staffing levels met people’s needs and kept them safe.

People received effective support from staff who knew how to meet their individual needs and wishes. People were supported to have choices in their daily lives. Staff ensured that people were supported in the least restrictive ways. People were offered food and drink they enjoyed and had access to appropriate healthcare services.

People received support in a kind and caring manner. People were encouraged and enabled to be involved as much as possible in making decisions about how their support needs were met. Visitors were made to feel welcome and people were enabled to have contact with their family.

People and their relatives were involved in the assessment and review of their needs. People were offered activity sessions they enjoyed. Arrangements were in place to obtain the views of people and their relatives. A complaints procedure was available for people and their relatives to use if they had the need.

The service was well-led. Checks and monitoring of the quality of the service were undertaken regularly to ensure that the service was run in the best interests of the people who lived there. People and staff confirmed the registered manager and provider led the service well. The registered manager was visible within the service and had a good insight of people’s needs.

Churchfield Court provides accommodation and personal care to a maximum of 37 people who People had a range of conditions relating to old age. At the time of our inspection 33 people lived at the home.

At our last inspection, in October 2015, the service was rated good. At this inspection, the rating remained good.

The manager was registered with us as is required by law and was present on the day. 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.

Staff delivered safe care to people and supported people to take their medicines safely and as they had been prescribed. Staff had received training in how to protect people from abuse and harm. Risks to people’s safety and well-being were assessed and instruction was available for staff to follow to prevent people being at risk of accidents and injury. Staffing levels met people’s needs and kept them safe.

People received effective support from staff who knew how to meet their individual needs and wishes. People were supported to have choices in their daily lives. Staff ensured that people were supported in the least restrictive ways. People were offered food and drink they enjoyed and had access to appropriate healthcare services.

People received support in a kind and caring manner. People were encouraged and enabled to be involved as much as possible in making decisions about how their support needs were met. Visitors were made to feel welcome and people were enabled to have contact with their family.

People and their relatives were involved in the assessment and review of their needs. People were offered activity sessions they enjoyed. Arrangements were in place to obtain the views of people and their relatives. A complaints procedure was available for people and their relatives to use if they had the need.

The service was well-led. Checks and monitoring of the quality of the service were undertaken regularly to ensure that the service was run in the best interests of the people who lived there. People and staff confirmed the registered manager and provider led the service well. The registered manager was visible within the service and had a good insight of people’s needs.

At the time of our inspection 36 people lived at Churchfield Court. We spoke with ten of those people, two relatives, seven staff and the provider. All of the people who lived there and their relatives were fairly positive about the home and the services provided. One relative said, “It is ok here. They look after them”. Another relative told us, “It is good. I do not have any concerns”. One person who lived there said, “I like living here. I was in another home before but this one is much better”. A second person told us, “I think it is a good place. I am happy”.

The summary is based on our observations during the inspection, discussions with people who lived at the home, their relatives, the staff supporting them, and by looking at records. If you wish to see the evidence supporting our summary please read the full report.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found;

Is the service safe?

All people we asked told us they felt safe. All people and relatives that we asked told us that they had not seen anything of concern. One person told us, “The staff are not unkind”. One relative said, “No, I have not seen heard shouting or treating people badly”.

Staff we spoke with had a basic knowledge of Deprivation of Liberty Safeguard (DoLS) processes. DoLS is a legal framework that may need to be applied to people in care settings who lack capacity and may need to be deprived of their liberty in their own best interests to protect them from harm and/or injury. We were told by the assistant manager that there had been no need to date for an application to be made to the local authority regarding a DoLS issue.

We determined that the management of day to day risks and safety was not adequate. This included the temperature control of the environment. People told us that the living areas were too hot. One person said, “It is terrible in here”.

We found that medication systems were not safe. They placed people at risk of harm and ill health. Two people had not been given their medication as it was not available. Another person had been given the incorrect dose.

We identified that weight monitoring processes did not protect people from the risk of ill health. We found that one person had lost weight yet no action had been taken to address this.

We have asked the provider to tell us what they are going to do to meet the regulations to ensure that the service is safe.

Is the service effective?

People’s health and care needs were assessed but they were not always included in detail in their care plans. Some people’s needs had been overlooked by staff and had not been included in the care plan. This meant that care plans were not able to consistently support staff to meet people’s needs.

We found that staff had not followed polices and protocols regarding the management of medication which did not demonstrate that the service was effective.

We have asked the provider to tell us what they are going to do to meet the regulations to ensure that the service is effective.

Is the service caring?

We determined that staff showed people respect and promoted their dignity. We saw that staff showed patience when supporting people.

All of the people and their relatives we spoke with were very complimentary about the staff. They described them as being, “Caring”, and “Kind”. One person who lived there said, “The staff are friendly and kind”. A relative told us, “I feel welcome when I visit. The staff are pleasant”.

We found that the provider had adequate processes and systems in place to meet regulations to ensure that the service was caring.

Is the service responsive?

People who lived there and their relatives had been given the opportunity to complete satisfaction surveys. As a result some changes had been made. This showed that the provider was willing to listen to the views of the people who lived there, and their relatives, to improve the overall service provision.

We found that the provider had taken note of the findings from our previous inspection and had taken action to address issues to improve for example, meal choices and the activities provided.

We found that the provider had processes and systems in place to meet the regulations to ensure that the service was responsive.

Is the service well-led?

Prior to our inspection and to the registered manager taking leave we had not identified, or been made aware of any concerns, about Churchfield Court. However, during this inspection we found non-compliance in a number of areas that placed people at risk. (Non-compliance is when we find that the provider is not meeting the law or staff practice or processes are not adequate). We were told by the assistant manager that some of the non-compliance was due to staff not doing what they should. Which showed that the service was not well led.

We have asked the provider to tell us what they are going to do to meet the regulations to ensure that the service is well led.

No one knew we would be visiting that day as our inspection was unannounced.

At the time of our inspection 34 people lived at Churchfield Court. At least two of those people were receiving respite care. Respite care is when people receive care for a short period of time people for various reasons. This could be to give their relatives a break.

During our inspection we spoke with ten people who lived there, five relatives/ visitors, and seven staff. As the manager was not on duty during our inspection we telephoned them at the end of our inspection to give feedback regarding our initial findings.

Everyone we spoke with was complimentary about the overall service provided, their care, and the staff. One person who lived there told us, “I was in another home before I came here. The building was wonderful but the care was not there. Here we get the care and everything that we need”. Another person said, “I have lived here for over ten years. I am happy here. I have got no complaints”. A relative told us, “I have got a lot to thank this place for. They look after everyone so well”.

We saw that people's needs had been assessed by a range of health care professionals including specialist doctors and the optician. This meant that staff had enabled people to have their health care and safety needs monitored and met.

People had been provided with varied food and drink options to prevent malnutrition and dehydration.

We saw that the premises were adequately maintained and were safe.

We determined that staffing levels were adequate to ensure that people’s needs were met and that they were safe.

We saw that complaints processes were in place for people or their relatives to use if they were not happy with the service provided.

On the day of our inspection we spoke with four people who lived at the home and four relatives. We also spoke with four members of staff and the registered manager. We spoke briefly with a visiting professional and the registered provider.

A number of people were unable to verbally communicate their views due to health conditions. We used a 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. We used SOFI with five people living at the home.

We also looked at other areas for evidence to support people’s experience such as sampling a set of care records, speaking with relatives as well as staff.

People reported that they felt respected and their privacy and dignity was maintained. We saw staff spoke with people in a caring and considerate manner. We saw that people were encouraged to be independent and staff provided assistance when necessary.

People told us there were activities they could participate in like games and trips outdoors to keep them occupied. People said they enjoyed their meals and they were offered choice, one person told us the food was “Very nice". We saw that staff ensured people received an adequate meal.

All the staff we spoke with knew the people they were caring for well. We saw care plans and risk assessments were in place but there were inconsistencies in updating risk assessments.This could mean risks may not always be identified and managed.

Staff understood what constituted abuse and said that they would be able to recognise and report poor practices. People who use the service and relatives that we spoke with on the day were happy with the standard of care.

Infection prevention and control procedures were in place to reduce the risk of infection. Staff we spoke with were able to explain good infection prevention and control practices.

We saw evidence that a large number of staff had received mandatory training in areas such as fire safety and safeguarding. Staff felt trained and supported to provide good care. This demonstrated people were cared for by appropriately trained staff.

We saw evidence that regular audits were undertaken in areas such as medication. Systems were in place to record and monitor accidents and incidences.The home was monitoring the quality of service and improving as a result of findings.

Our inspection was unannounced and took place on 5 and 16 October 2015. The inspection was carried out by one inspector and a pharmacy inspector.

The home is registered to provide accommodation and personal care to a maximum of 37 people. On the day of our inspection 34 people lived at the home. People who lived there had a range of conditions, the majority of which, related to old age.

The manager was registered with us. 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.

At our last inspections in May and October 2014 the provider was not one of the regulations we inspected. This related to medicine safety. During this, our most recent inspection, we found that improvements had been made regarding medicine safety.

People felt safe living in the home. Systems were in place to protect people from the risk of harm and abuse.

People were happy with the meals offered. People were supported to have a nourishing diet and drinks were offered throughout the day to prevent the risk of dehydration.

People and their relatives felt that the staff were kind and caring. Interactions between staff and the people who lived at the home were positive. Staff were friendly, polite and helpful to people.

People received care in line with their best interests and processes were in place to ensure they were not restricted unlawfully.

Staff felt that they were provided with the training that they required to ensure that they had the skills and knowledge to provide safe and appropriate care to people. Staff also felt that they were adequately supported in their job roles.

A complaints system was available for people to use. Relatives felt that if they raised issues they were addressed satisfactorily.

We found that quality monitoring processes had improved to ensure that the service was run in the best interests of the people who lived there.