Fountain Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC monitors the regulated activity which involves in this instance the premises and the care provided. Fountain Court accommodates and provides personal care to a maximum of 16 people. All living areas are on ground floor level and all bedrooms are single accommodation. People may also be living with moderate to severe dementia. There were 16 people living in the home when we visited.

There is a registered manager in post who was present at our inspection. 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 the last inspection in November 2015 the service was rated Good overall. At this unannounced inspection on the 02 May 2018 we found the service remained Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People received receive care that had improved so that it kept them safe and free from harm. Issues identified at our previous inspection in respect of medicine management had been addressed and people received medicines as required. Staff understood how they should protect people from abuse and harm. Risks to people were assessed and guidance as to how to manage these risks, while respecting people’s individual rights, was available to staff

People still received support from staff that was effective, as staff had appropriate skills and knowledge to ensure they could meet people’s individual needs. People were supported to have choice and control of their lives despite any loss of capacity due to living with dementia, with care provided with in the least restrictive ways possible.

People were able to access the healthcare support they needed based on individual needs. People’s dietary needs were assessed from a practical and cultural perspective and people received foods they chose. Staff promoted people’s nutrition and were aware of the risks to this due to people living with dementia.

People continued to receive input from staff that was caring. Staff were kind and friendly and we saw that they promoted people’s rights, privacy, dignity, choice and independence. People were supported to express and have involvement in day to day decisions consummate with their individual abilities. Staff recognised people have varied and diverse needs and provided care that reflected the individual, this detailed in their care records.

Staff were knowledgeable as to people’s needs and people were comfortable in the presence of and speaking with staff. The provider had systems for gaining people’s views and responding to these including meetings, surveys and a complaints, comments, compliments procedure.

The service continued to be well-led, with regular checks and monitoring of the quality of the service. People’s relatives were happy with the care people received and felt they were able to trust staff to look after their loved ones.

While people had access to the provider’s CQC rating for Fountain Court on the premises this information was not displayed on what may be constituted to be the provider’s website. The provider responded to concerns we raised and has now displayed the ratings for all their services on their website following our inspection.

Fountain Court is registered to provide accommodation for up to 16 older people who require accommodation and personal care. People who live there may have a range of needs which include dementia. At the time of our inspection 16 people were using the service. Our inspection was unannounced and took place on 12 August 2015. The last inspection took place on 17 May 2013 and all the regulations were met.

The manager was registered with us as is required by law. 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 told us they felt confident that the service provided to them was safe and protected them from harm. Staff we spoke with were clear about how they could access and utilise the providers whistle blowing policy.

We observed there were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People told us that were able to raise any concerns they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005.

People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration. People were supported to access a range of health and social care professionals to ensure their health needs were met.

Staff interacted with people in a positive manner and used a variety of communication methods to establish their consent and/or understanding. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

Staff were aware of how and when to access independent advice and support for people and assisted with this when required.

People were involved in the planning of care and staff delivered care in line with people’s preferences and wishes.

Information and updates about the service were made available to people in meetings and to relatives verbally. The complaints procedure was displayed in a clear and understandable format to maximise people’s knowledge and understanding of how to make a complaint.

People, relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective.

Quality assurance audits that were undertaken regularly by the provider. The registered manager had also ensured that checks on staff were undertaken periodically out of normal working hours.

People received their medicines as prescribed but improvements were needed for recording when medicines had been refused or omitted.

There were 16 people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with eight people who lived at the home, two relatives, five staff and the acting manager.

We saw good interactions between people living there and the staff team. The atmosphere was friendly and relaxed. We saw relatives visiting people and different activities taking place for people to join in with, if they wished to.

People we spoke with told us positive things about the home and the care and support they received. One person said the “staff are nice”. Visitors told us that they were happy with the care their relative received.

We saw that people’s privacy and dignity was respected and people received care in a way that met their needs. Arrangements were in place to protect people from the risk of abuse.

Staff had received training which included caring for people with dementia so that they had the knowledge to support the people living in there.

Some systems were in place for monitoring and improving the quality of the service for people living in the home.

There were15 people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with five people, three relatives and five staff.

Due to their health conditions or complex needs not all people were able to share their views about the care that they had received so we used other ways find out people's experiences including observation.

People we spoke with told us positive things about the home. One person told us "I am very happy here”. Another person said “It is good here”. Relatives complimented the home and the care that had been provided. One relative said “They are a different person since they lived here they are content and alert”.

We saw that staff had treated people with respect and dignity. People told us that choices had been offered and their views had been taken into consideration.

People's needs had been assessed by a range of health professionals including specialist doctors and the optician. This meant that people's health care needs had been monitored and met.

Staff had received a range of training which had included caring for people with dementia.This meant that staff had the knowledge to support the people who lived there and keep them safe.

Systems had been used to monitor how the home had been run to ensure that people had received a quality service.

The location is owned and managed by Sandwell Metropolitan Borough Council. It is registered to provide accommodation and personal care to a maximum of 16 older people who have a diagnosis of dementia. At the time of our inspection there were 16 people living at the location.

We spent the day observing people, their routines and interactions with staff. We spoke to three people living at the location. Because of dementia needs communication was difficult however; people indicated that they were happy with the care they received from the location.

Below are a few examples of what they said to us;

“I like it here”.

“The staff are kind”.

“They do look after us”.

We were fortunate as we were able to speak to two relatives during our inspection.

Below are a few examples of what they said to us;

“We like it here”.

“It is ‘five star’ as far as I am concerned”.

“The carers and managers are lovely”.

The staff team were happy in their work and were committed to provide a good service to the people who live at this location. Staff told us;

“I like working here. It is very rewarding”.

“Any concerns are open here, nothing is hidden. The manager is on the ball and knows what is going on all the time. They will not tolerate care that is not 100%.”

We found that medication processes need some improvement to prevent risk to people. More robust processes should be put into place to monitor medication safety and management.