What life is like for people using this service:

• People received a service which was primarily focused on promoting their independence levels and supporting their reablement goals.

• Feedback from people about the quality of care and support they received was overwhelmingly positive. They complimented the caring nature of staff and felt that they were treated with dignity and respect.

• People’s needs had been assessed and their support requirements and reablement goals had been comprehensively identified and recorded to provide staff with the guidance they needed to support people.

• People were supported to have maximum choice and control of their lives.

• Effective systems were in place to manage people’s medicines or support and encourage people when self-medicating as part of their reablement plan.

• Staff and the multidisciplinary team worked together to enable people to progress in their well-being, daily living skills and confidence.

• There were sufficient numbers of staff available to ensure people’s safety and well-being.

• New staff were suitably vetted before they supported people.

• Staff had a good understanding of people’s needs and had been trained to carry out their role.

• Staff understood their responsibility to report concerns, accidents and poor practices.

• Systems were in place to identify shortfalls in the service and drive improvement.

• People views were valued and acted if any concerns had been identified.

• The registered manager understood their regulatory duties to ensure people received a safe and effective service.

The service met the characteristics of Good in all areas. More information is in Detailed Findings below.

Rating at last inspection: Good (report published 14 May 2016).

About the service: Great Western Court is a residential care home registered to provide accommodation and personal care to people aged 65 and over. At the time of our inspection the service supported 14 people. The home provides people with the support and time to build up their confidence and level of independence in daily living skills before returning home

Why we inspected: This was a planned inspection based on the previous rating at the last inspection.

Follow up: At this inspection we have rated the service as Good. The rating of this inspection and the information and intelligence that we receive about the service will determine the timeframe of our next inspection.

This inspection took place on 18 and 19 April 2016 and was unannounced. Great Western Court provides a reablement, interim placement and community respite service to help people to return to their own homes where possible following a hospital admission or deterioration in their health and well-being. It is registered to provide accommodation with nursing or personal care for up to 30 people. The home is purpose built on the ground floor which consists of five separate units; although only three units were open on the days of our inspection. Each unit had six individual bedrooms (some with adjoining bathrooms) and a shared lounge and dining room. There were 17 people living at the home at the time of our inspection.

A registered manager was in place as required by their conditions of registration. 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 had been consulted in the decision to move to Great Western Court for a period of rehabilitation. They had been involved in planning their reablement goals. Their care plans reflected their levels of independence and support needs. People’s risks had been identified and managed well, however guidance for people with unstable medical conditions were not always in place. These were immediately implemented by the registered manager. A multi-disciplinary team of therapist and rehabilitation officers supported people to progress and reach their personal goals. The home had good links with community health care professionals. People were supported to maintain their health and well-being and access additional care and support from other health care services when needed.

People told us they enjoyed their stay at the home. Relatives confirmed that people’s time and rehabilitation at Great Western Court had been beneficial. People told us the staff were kind and compassionate. Their dignity and privacy was respected. People were supportive to regain their daily living skills and try out new skills and equipment to enhance their levels of independence. Reablement activities had been introduced. Activities were being provided which assisted people in their reablement goals. Plans were in place to improve people’s social, emotional and recreational goals.

Their medicines were managed and administered appropriately. However records of when people required medicines ‘as required’ or had received medicinal creams applied to their skin were not always consistently completed. This was immediately addressed by the registered manger.

Staff had been suitably recruited and trained to carry out their role. The provider’s head office supported the registered manager in recruiting staff. Plans were in place to ensure the registered manager viewed and checked all relevant recruitment documents to ensure staff were of good character. Staff were regularly supported and supervised. People were supported by staff who were knowledgeable in recognising the signs of abuse and the course of actions they would need to take to report any concerns.

The registered manager had a good understanding of their role and how to manage the quality of the care provided to people. They listened to people’s concerns. They acted on their suggestions to make improvements in the home. Quality monitoring systems were in place to check and address any shortfalls in the service.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

A registered manager was in place as required by their conditions of registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present during our inspection.

Great Western Court provides a re-enablement, rehabilitation, interim placement and community respite service to help people to return to their own homes where possible following a hospital admission.  Re-enablement provides people with the opportunity to relearn or regain some of the skills for daily living which may have been lost as a result of illness, accident or disability. It is registered to provide accommodation with nursing or personal care for up to 30 people. During our inspection there were 20 older people using the service. The home is purpose built on the ground floor which consists of five separate units; each had six individual bedrooms (some with adjoining bathrooms) and a shared lounge and dining room.

People generally moved to Great Western Court from hospital for a period of rehabilitation to develop their activities of daily living skills to enable them to return to their own home. People were fully assessed within 48 hours of their arrival which gave staff an understanding of a person’s level of independence.

Throughout the day people were encouraged to do as much for themselves as possible however there were limited opportunities for people to engage in social and meaningful activities other than those which involved their rehabilitation programme.

People’s physical needs were assessed and risk assessments were managed well and recorded. However people’s care records did not always reflect their personal goals and levels of mobility. This did not give staff the information they required to monitor the progression of people’s mobility or if people had aspirations or goals that they would like to achieve during their time at the home.  People and their relatives were not always fully communicated with regarding the purpose or the progress of their stay at Great Western Court.

People told us they enjoyed their stay at the home and that they felt safe. Staff were knowledgeable in their role and were able to recognise the signs of abuse and knew how to report any concerns. Staff were trained to carry out their role however they did not received regular formal support meetings with their line manager to reflect on their care practices and knowledge although they said they could always approach them informally.

Staff were recruited to ensure that people were supported by suitable numbers of qualified staff. People were supported to stay healthy and were referred to the appropriate health and social professionals as required. People’s support needs were continually reviewed and anyone who needed additional support in their own home was referred to the relevant community services before they went home.

People told us staff were caring and kind. Complaints and concerns were dealt with immediately to ensure people’s experience of the home was comfortable and met their needs at all times. The registered manager understood her role and responsibilities to manage a rehabilitation service to ensure that people made the most of their time at the home. 

We spoke to 10 people about their care who all said they had no complaints or concerns and all felt well looked after. Nine people were able to tell us about their future plans to go back to their own home. One person told us they were here as they had lost confidence in their walking as they had several falls at home. They said they were at this location several years ago for the same reason and they really helped them as they were able to go shopping alone. All people praised the staff for their help and support.

At the time of our inspection the provider did not have a registered manager in post.

We followed up on some concerns we found at our last inspection on 8 & 11 February 2013. This related to the levels of cleanliness and some staff practices in infection control were unsafe. At this inspection we found the cleanliness had greatly improved. New infection control procedures had been introduced and this was now being monitored.

A system was in place to make sure people were safeguarded from the risks of abuse. Before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes. If people did not have the capacity to consent, the service acted in accordance with legal requirements.