Kibworth Court is a residential care home that provides care and support for up to 45 older people. At the time of our inspection 41 people were using the service and many were living with dementia.

At the last inspection on 10 December 2016 the service was rated Requires Improvement. We rated the safe, responsive and well-led domains as requiring improvements. We asked the provider to make the necessary improvements. At this inspection we found that the required improvements had been made and the service was rated Good overall.

There was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe. Staff understood their responsibilities to keep people safe from avoidable harm. There were a suitable number of staff deployed and the provider had followed safe recruitment practices. Where risks were identified for people while they were receiving support these had been assessed and control measures put in place. People received their medicines in line with their prescription.

Staff had access to the support, supervision and training that they required to work effectively in their roles. Where agency staff were used, induction was provided to make sure that they were able to meet people's needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People had enough to eat and drink to maintain good health and nutrition. People were supported to access health professionals when required.

People were treated with kindness and compassion. Dignity and respect for people was promoted.

People had care plans in place that focused on them as individuals. This enabled staff to provide consistent care in line with people's personal preferences.

The service had a positive ethos and an open culture. The providers and registered manager provided positive leadership to all staff.

The provider had sought feedback from people and their relatives about the service they received. They had taken action based on this feedback.

The provider's complaints procedure had been followed when a concern had been raised and people felt able to make a complaint if they needed to.

The provider had quality assurance systems to review the quality of the service to help drive improvement.

We inspected the service on 10 November 2016 and the visit was unannounced.

Kibworth Court provides care and support for up to 45 older people. At the time of our inspection 36 people were using the service and many were living with dementia.

At the last inspection on 8 and 9 June 2015 we asked the provider to take action to make improvements. We asked them to improve their practice in relation to making sure that people had the equipment in place to meet their safety requirements. We had concerns that people’s care plans did not have all of the information required to guide staff on how to meet people’s individual needs. We found that people’s care records were not always safely stored. We also had concerns that the provider had failed to act in accordance with the Mental Capacity Act 2005 (MCA) and that staff did not understand the requirements of this law. Further, we required the provider to make improvements to their quality assurance systems which we found had not adequately assessed, monitored and mitigated the risks to people that used the service. Following that inspection the provider sent us an action plan setting out what they were going to do. At this inspection we found that the provider had made most of the required improvements in these areas.

There was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risks to people’s health and well-being were assessed including where people were at risk of falling. Some assessments did not detail the equipment people required and the registered manager told us they would make improvements. We found that people had the equipment they required to remain safe. There were risks within the home that people could have been exposed to. For example, laundry obstructed a fire door and partially covered a fire extinguisher. The provider told us they would take action to make improvements. Where some areas of the home required upgrading, the provider had a refurbishment plan in place.

People’s care plans did not always contain information and guidance for staff to follow. For example, where people required assistance to move using equipment, detailed information and guidance was not always recorded. However, staff knew about people’s preferences and support needs and people received care that was based on these. People or their relatives contributed to the planning and review of their care requirements.

People received their medicines when they required them from staff who understood their responsibilities. Where people required as and when required medicines such as pain relief, the provider did not have written guidance for staff on the circumstances of when these should be offered to people. They told us they would review their policy and practice in line with national medicines guidance.

The provider had a range of checks on the quality of the service to make sure it was of a good standard. For example, checks on people’s medicines took place. However, the quality checks did not always identify areas for improvement that we found. This included incomplete information within people’s care plans and some unclean areas of the home. The provider had sought feedback from people, their relatives and staff about the quality of the service. They took action where feedback was received.

Staff had mixed views about how well the service was managed. They told us that the registered manager and proprietors were not always approachable. People and their relatives told us that they felt the home was managed well. We found that the registered manager was available and gave time to people and staff during ou

Prior to our inspection we reviewed all the information we had received from the provider. We spoke with nine people who used the service and three relatives for their views and experiences. We also used observation to understand people’s experience, as some people had communication needs and were unable to tell us their views and experiences.

During our inspection we spoke with the acting manager, two directors, a senior care worker, a care worker, two kitchen staff and the activity coordinator. We looked at some of the records held in the service, including the care files for five people who used the service.

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. This is a summary of what we found.

Is the service safe?

People told us that they felt safe and that staff supported them appropriately.

We saw people had received a pre-assessment, and care plans and risk assessments were in place and reviewed regularly. These meant risks had been identified, and measures were in place to reduce risks and keep people safe.

People had their dependency needs assessed which informed the level of staff required, to meet people’s needs and keep people safe. We saw the staff roster showed there was sufficient staff employed and deployed appropriately.

We, the Care Quality Commission (CQC) monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. This means that when people have their liberty deprived in order to keep them safe, this was only done following a best interest assessment carried out by the local authority DoLS team. We saw an authorisation was in place for one person. This showed the provider had acted appropriately and within the legislation.

Is the service effective?

The provider told us, and records confirmed, changes were in place to formally gain people’s consent to care and support.

We saw people’s preferences, routines, health and welfare needs had been assessed. We saw examples of referrals and joint working with health professionals in meeting people’s needs. This showed person centred approaches to care delivery.

People received balanced and nutritional meals that met their dietary requirements. People received sufficient food and fluid that kept them hydrated.

Is the service responsive?

The provider had a complaints policy and procedure that supported people to know their rights, and what action to take should they wish to complain about the service.

An activity coordinator was employed who provided activities for people. We observed people participated in activities. Activity plans were on display that showed various activities were provided should people wish to participate.

Is the service caring?

We found staff knowledgeable about people’s needs, preferences and routines.

Staff were observed to be kind and attentive towards the people they cared for. We observed people who used the service appeared relaxed and at ease with the staff supporting them.

Is the service well-led?

Staff were aware of their roles and responsibilities, this showed good leadership and accountability.

We saw the provider had quality assurance processes to monitor the quality of services provided to people. We found these were up to date in accordance to the provider's systems and processes in place.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

One person who used the service told us, "I'm very comfortable here. All of the staff are very kind to me." Another person told us, "I have a nice big room. It's nice to be waited on. I feel comfortable and save." Both people told us that they were able to exercise choices about how they spent their time. One told us, "I spend my time how I want. I go to bed when I want. I get a choice of what I'd like to eat at mealtimes." Another told us, "I can eat in my room if I want. the food is excellent. it couldn't be better." Both people knew about social and individual activities that were available. A relative told us, "I'm happy with the care my mother receives. The staff obviously care for her as an individual and that is very important to her."

A social care professional told us that their client had told them that they "couldn't have wished for a better place." They told us that they saw that staff treated people with respect and dignity. They added, "The home is a pleasant environment. My client is happy here. They wouldn't stay here otherwise."

We saw found that people were supported in a caring and courteous manner by staff who had received relevant training.

We spoke with five people who used the service. All of those people expressed that they had a positive experience of living at the home. One person explained that they had been able to "enjoy my life to the full." Other people told us that they had been well cared for. One person told us that they were, "not missing out on anything." Another person told us, "I can't think of anything that could be better." We spoke with relatives of two people who used the service. One relative told us they had seen care workers acting with dignity and respect when supporting her mother. Another relative told us that they had been involved in care planning and had "good open communication" with the manager. People's positive comments were borne out by what we saw in care plans which showed that people's care, treatment and support had been planned and delivered with the involvement of people and their relatives.

People told us that they knew about activities that were available to them and that they had always had a choice of whether to participate in activities. We saw that people had exercised choices about how they spent their time and many people had engaged in meaningful occupation either alone or with other people.

People were supported by suitably qualified and experienced staff. The registered manager and senior staff from the provider's head office had carried out regular monitoring of the care, treatment and support that people experienced.

People were satisfied with the support they received at Kibworth Court. They found the staff friendly and polite, and felt they did their jobs well. People enjoyed their meals and felt that the food provided was of a good quality.

Some people told us they would have liked more to do in the home, as they were sometimes bored with little to occupy their time.

The inspection took place on 8 and 9 June 2015 and was unannounced.

At our last inspection on 9 June 2014 the service was meeting the regulations.

Kibworth Court is a 40 bed care home located in the village of Kibworth Beauchamp in Leicestershire, and is for men and women with age related needs including dementia. Accommodation is arranged over two floors. Access to the upper floor was by stairs or lift.

There should be a registered manager at the service. 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 time of our inspection the manager at the service had been in post for three months and was just beginning the formal registration process.

Since the new manager had been in post staff members told us that positive changes had been made. These included the introduction of staff supervision. We found that although there appeared to be a lot of work in progress and ideas in development there were a number of concerns that needed addressing urgently.

People told us they were happy at the service and that staff were nice. Staff spoke kindly to people when they supported them with tasks. However, people received little interaction from staff and there were no regular activities that took place.

Staff told us how they were in the process of reassessing people’s needs and completing care plans to ensure that their care needs were met. We found that at the time of our inspection that some people were not receiving care and treatment that met their needs.

People told us that they enjoyed the food at the service, although relatives told us it appeared bland. We saw that people had access to drinks and snacks throughout the day. People were not always provided with appropriate assistance with their meals.

Decision specific mental capacity assessments had not been carried out where there had been a concern identified about a person’s capacity. The service had made a decision relating to a person’s care and treatment and not acted in accordance with the Mental Capacity Act.

Staff told us that they felt well supported in their roles. However, they had not received sufficient training at the service to enable them to fulfil their roles. Staff had a good understanding of how through their work they were able to respect people’s privacy and dignity and promote their independence.

Quality assurance systems that were in place had failed to identify the concerns that we found and did not identify or manage risks associated with the environment. Records were not completed accurately or stored securely to ensure that information was kept safe.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.