This inspection took place on 22 March 2018 and was unannounced. At the last inspection completed on 6 June 2017 we rated the service as good. At this inspection we found the service remained good.

Kerria Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Kerria Court accommodates up to 47 people in one adapted building. At the time of the inspection there were 39 people living in the care home.

There was a registered manager in post, however they were not at work at the time of the inspection, there was however an appointed manager to oversee the home. 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 protected from avoidable abuse. Risks were assessed, identified and managed appropriately. Premises and equipment were maintained to minimise the risk of infection. Staff were recruited safely and staffing levels were sufficient to meet people’s needs. Medicines were managed safely. The manager had systems in place to learn when things went wrong.

People had their needs assessed and had effective care plans in place. Staff were trained to meet people’s needs and were able to offer consistent support to people. People had a choice of meals and they were supported to eat and drink safely. The environment was adapted to meet the needs of people and people were supported to access health professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by kind caring staff. Peoples communication needs were assessed and care plans supported people to make choices and retain their independence. People were treated with dignity and respect.

People’s preferences were understood and their diverse needs were assessed and planned for. People were supported to access activities and had their needs and wishes for end of life care considered. People’s complaints were investigated and responded to.

People and their relatives were involved in discussions about the service and their feedback influenced developments. We found systems in place to check on the quality of the service people received and the provider used information from these to make improvements. The manager had systems in place to monitor the delivery of people’s care.

Kerria Court is registered to provide care and support for up to 47 older people who have needs relating to their age or dementia. Ten places at the home are reserved for people on a short stay basis. Nursing care is not provided. On the day of our inspection there were 41 people at the home.

There was a registered manager in the home. 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 July 2016 the service was rated Good. At this inspection we found the service remained Good.

People and their relatives told us they felt safe at the home. Staff were aware of the provider’s processes for reporting any concerns and understood their responsibilities to keep people safe from harm.

There were enough staff to support people safely and recruitment checks were in place to help ensure staff that were employed were safe to work with people. We reviewed the systems for the management of medicines and found that people received their medicines safely.

Staff had been trained to support people effectively. This included learning about the specific needs the person lived with. Staff told us that they received regular supervision and felt supported.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they were offered meals which they enjoyed. People were supported to eat enough food and drink by staff who understood their nutritional needs. People's health was supported by access to a variety of health professionals.

Staff were caring in their interactions with people. The staff we met knew people well, and were able to tell us about people including their needs, preferences and people who were important to them. Staff maintained people's privacy and dignity whilst encouraging them to remain as independent as possible.

There were enough staff to support people to participate in the activities they chose. People's visitors were welcomed and there were no restrictions on when they could visit.

There was clear and visible leadership in place and the staff team felt supported by the management team.

There were effective systems in place to monitor and assess the quality of service being delivered.

This inspection took place on 12 and 13 July 2016 and was unannounced. The home was last inspected in February 2015 and found to be requiring improvement in two areas. The inspection team comprised of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Kerria Court is registered to provide care and support for up to 47 older people who have needs relating to their age or dementia. Nursing care is not provided. On the day of our inspection there were 43 people at the home.

The home had a registered manager in post who was available throughout 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.

We observed people looking relaxed and at ease within the home, and with the staff who were supporting them. People and their relatives told us they felt safe at the home. Staff were aware of the provider’s processes for reporting any concerns. Staff understood their responsibilities to keep people safe from harm but had not ensured incidents of behaviour were recorded to ensure strategies to manage behaviour were suitable and effective.

We were informed by the deputy manager of concerns that had been raised by the coroner since our visits took place. We were informed these concerns related to an incident prior to our inspection where a person needed to be taken to hospital in an emergency. Staff had only shared verbally important information about risks to the person rather than in a written format. We were informed that at the time of this incident the home was in the process of introducing 'transfer records' but at the time, these had not been completing for everyone. We were given assurances that these had now been completed and reviewed following the coroner inquest. We were informed that the provider would be completing a 'lesson's learnt' report, which would be shared with us, once completed.

There were enough staff to support people safely and recruitment checks were in place to help ensure staff that were employed were safe to work with people.

Staff had been trained to support people effectively. This included learning about the specific needs the person lived with. Staff told us that they received regular supervision and felt supported.

We reviewed the systems for the management of medicines and found that people received their medicines safely. The registered manager had identified and was taking action to further improve the administration of prescribed topical creams and ointments.

Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions.

People told us that they were supported by staff who were kind, caring, attentive and compassionate. People were able to make decisions about how they wanted their care provided. Staff maintained people's privacy and dignity whilst encouraging them to remain as independent as possible.

People told us they were offered meals which they enjoyed. People were supported to eat enough food and drink by staff who understood their nutritional needs. People's health was supported by access to a variety of health professionals.

People told us that they played an active part and contributed to the planning and reviewing of the care they wished for. A variety of activities were provided to meet the interests of individual people. We saw people were engaged and were consulted about the activities programme.

People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality

This inspection was undertaken as part of our scheduled plan of inspections, however we also followed up on concerns we had received. None of the concerns named specific people, dates or times of incidents for us to be able to track specific events.

During our visit we spoke with ten people who lived at Kerria Court. Not all of the people were able to tell us in detail about their views of the home. We spoke with the registered manager, district manager, six members of staff, and a student on placement at the home. We also spoke with two relatives of a person living at the home.

The support we observed was delivered with kindness and respect. One person told us, ‘’It’s very nice here, I would not want to go anywhere else.'' However, we found that some people did receive the support they needed to meet some aspects of their care. There were omissions and their care plans did not explain the care and support each person needed as fully as they should.

People were protected from the risks of inadequate nutrition and dehydration and usually received their medication in a safe way.

People who used the service may not be protected against the risk of unlawful or excessive control or restraint because suitable arrangements were not in place.

There were not always enough staff to meet people’s needs.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received.

We talked with four people who lived at the home, they told us they were happy at the home and with the care they received. One person told us ‘’Staff meet all my needs, I can have a shower when I want one and I choose when I go to bed and get up’’. Another person said ‘’ they look after you here, they are very good’’. We spoke with two people at the home who told us that they felt safe living there. Both people told us they would feel able to tell staff if they were not happy about something. One person told us ‘’I would feel okay telling staff if something was not right’’.

The Inspection took place over two days on 23 and 25 February 2015. The inspection was unannounced.

We last inspected Kerria Court in June 2014 when we found the provider had breached the Health and Social Care Act 2008 in relation to the care and welfare of people who used the service and record keeping. Following that inspection the registered manager sent us an action plan informing us of the action they would take to address the breaches we found. At this inspection we found that improvements had been made and that there were no breaches of regulation. Further improvement was needed to ensure people consistently received a good service.

Kerria Court is registered to provide care and support for up to 47 older people who have needs relating to their old age or dementia. Nursing care is not provided. On the day of our inspection there were 42 people at the home.

A registered manager was in post but was on annual leave at the time of 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. In the absence of the registered manager the home was being managed by two care managers.

People we spoke with told us they felt safe in the home and the staff made sure they were kept safe. People were supported by staff who had received training on how to protect people from abuse.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with people. Improvement was needed to the staffing arrangements to make sure there were enough staff to meet people’s needs. This had been recognised by the provider prior to our inspection and action was being taken to recruit additional staff.

We reviewed the systems for the management of medicines and found that people received their medicines safely but we were unable to establish if people had received their prescribed creams and ointments when they needed them.

The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The associated safeguards to the Act require providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We looked at whether the service was applying the safeguards appropriately. The care managers and staff we spoke with understood the principles of the MCA and associated safeguards. They understood the importance of making decisions for people using formal legal safeguards.

People told us they were supported to eat and drink sufficient amounts to maintain their health but we found systems to monitor that people were getting enough to drink needed improvement. Risks to people’s nutrition were minimised because staff understood the importance of offering appetising meals that were suitable for people’s individual dietary needs. People had access to healthcare professionals when this was required.

People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality of the service. We saw that the provider had a system in place for dealing with people’s concerns and complaints.

We found that whilst there were systems in place to monitor and improve the quality of the service provided, these were not always effective in ensuring the home was consistently well led. We found that some improvements were needed.