We carried out this inspection on 14 December 2017. Our inspection was unannounced.

Eccleshare Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and nursing care for up to 46 people, including older people and people living with dementia. There were 37 people living in the home at the time of our inspection.

The service was run by a company who was the registered provider. The home had a registered manager in post. The registered manager was not available at the time of this inspection but the registered persons area manager was present and they provided the information we required. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’) 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. In this report when we speak both about the company the area manager and the registered manager we refer to them as being, ‘The registered persons’.

At our last inspection on 4 October 2016 we found that there was a breach of the regulations that had reduced the registered persons' ability to consistently provide people with care that was being well-led. We also said that other improvements needed to be made to ensure that the service was safe, caring and responsive. We rated each of these parts of the service as ‘requires improvement’. Overall, our assessment of the service was ‘requires improvement’.

Shortly after our inspection visit the registered persons told us that they had made the improvements that were necessary to address each of our concerns. The registered persons also provided us with subsequent monthly updates about how they were addressing and making further improvements to the concerns we had raised at our last inspection. In addition they said they had reviewed the arrangements in place for the way the home environment was set out and that they had changed the name of the home from Eccleshare Court 1-39 to Eccleshare Court. They said these changes were made to help more clearly distinguish the home from another home the registered persons owned which was located next to Eccleshare Court.

At the present inspection we found that suitable arrangements had been introduced to ensure that the service was well managed. The breach of the regulations for well-led had been addressed and resolved and as a result people were receiving safe, caring and responsive care which was well-led. Given the progress made we revised our assessment of each of these aspects of the service to ‘good’ and also changed the overall assessment of the service to ‘good’.

We carried out an unannounced inspection of Eccleshare Court 1-39 on 4 October 2016.

The home is located near to the centre of the city of Lincoln. It provides personal and nursing care for up to 46 people, some of whom live with dementia. People live in their own individual rooms which are self-contained. Three of the rooms are suitable for double occupancy. Each room has its own lounge and bed area as well as a kitchenette and en-suite bathroom. There is a wheelchair accessible lift to use between floors and communal areas for people to meet. As well as each room having an en-suite bathroom there is also a communal bathroom with bathing facilities. In the centre of the building is a courtyard garden with seating provided for residents and families to use. There were 38 people living at the home at the time of our inspection.

There was an established registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

We found there was a breach of the Health and Social Care Act (Regulated Activities) Regulations 2014. This was because the registered provider had not ensured that quality assurance and audit systems were reliably managed so as to enable them to identify and resolve shortfalls in the services provided for people. This breach had reduced the registered provider's ability to ensure people were kept safe. You can see what action we told the registered provider to take at the back of the full version of this report.

During our inspection visit we found some other areas in which improvement was needed to ensure people were provided with care that was caring and responsive and that the provider’s regulatory responsibilities were met in full.

There were not always enough suitably deployed staff at the home to ensure people’s needs were always being met.

We found that the management of people’s medicines was not always conducted safely in line with good practice and national guidance.

People had access to a range of healthcare services and were supported to enjoy a varied diet in order to help them stay healthy. There was also a range of equipment available to meet their needs and encourage independence. However, care records did not always reflect up to date information about people’s needs.

People and their relatives were involved in planning their care and had been consulted about their individual preferences, interests and hobbies. Activities were available for people to take part in, however, the activities available did not always enable people living with dementia to be stimulated or maintain and further develop their interests and hobbies.

People living at the home were invited to comment on the quality of the services provided. However, the arrangements for receiving feedback about the way the home was run were not always effective.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection the provider had submitted DoLS applications for 10 people living in the home and was waiting for these to be assessed by the local authority.

Staff were recruited appropriately in order to ensure they were suitable to work within the home and were provided with training to develop their knowledge and skills.

There were systems in place for handling and resolving formal complaints and the provider and registered manager took action to address concerns when they were raised with them.