The inspection took place on 18 January 2017 and was an unannounced inspection. The home is registered to provide accommodation with personal and nursing care for 29 people. At the time of our visit there were 28 people living at the home.

There was a manager in post who had a pending application to become the registered manager. 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 home is run.

People’s relatives told us that people were safe at the home. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff who were competent to do so. Risk assessments recorded what action staff should take if someone was at risk. Referrals were made to appropriate health care professionals to minimise risks and meet people’s health needs.

There were sufficient staff to keep people safe and meet their needs. The registered manager had followed safe recruitment procedures. Medicines were given to people on time and as prescribed. However we raised concerns with the manager regarding the way medicines were dispensed.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. Staff understood the processes in place for ensuring decisions were made in people’s best interests. Staff and the manager were ensuring these steps were taken for people living at the home. Staff sought people’s consent and recorded this.

Staff were caring, they knew people well, and they supported people in a dignified and respectful way. Staff acknowledged and promoted people’s privacy. People felt that staff were understanding of their needs and they had positive working relationships with them.

People and their relatives were involved in the assessment and reviews of their needs. Staff had knowledge of people’s changing needs and they supported people to make changes to their planned care when people wanted to. Staff were not always consistent in their approach to offering choices. People told us that they had access to activities and hobbies.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the service’s quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.

This inspection took place on 03 November 2014. The inspection was unannounced. The provider registered this home with us in October 2013 and no previous inspections had been undertaken.

Kings Court Nursing home provides nursing and residential care for all ages and is located in the centre of Grantham. It provides care for 29 people in a mixture of single and shared rooms.

The provider is required to have a registered manager to manage 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.

Prior to our inspection we had received a notification that the registered manager had left the home and that a new manager was in place. However, at the time of our visit the registered manager was still registered with us and we had not received an application from the new manager to register. Following our visit the previous manager was de-registered and an application to register was received from the new manager.

People felt safe living at the home. Staff were aware of the need to keep people safe from harm and they were clear on how to raise concerns within the home. However, staff were not always sure how they could raise concerns with external agencies.

People were supported to make choices about the care they received. Where people were unable to make choices for themselves information in their care plans helped staff to support them appropriately. The manager was aware of the latest guidance regarding the Deprivation of Liberty Safeguards and were working with the local authority.

Risks to people’s health and welfare were identified and where necessary action had been taken to reduce the level of risk for people. Medicines were well managed and advice was sought from doctors and pharmacists when medicines needed reviewing or administering differently. People were able to access healthcare professionals when they had concerns about their health. Where people were at risk of malnutrition appropriate action had been taken.

While staffing levels allowed people’s needs to be met this was not always in timely manner. Staff distribution meant at times care was delayed. The provider was in the process of reviewing the level of nursing and care workers hours needed. However, no method of identifying how many staff were needed to meet people’s needs were used. Staff had not been supported with appropriate training.

Staff talked to people and engaged them in their care and most people were complementary about the staff. However, some people told us how staff were not always in good mood and how this impacted on their mood for the day. Staff did not always respond appropriately when a person raised concerns.

There was an activities co-ordinator in place, however, people told us they were not supported to pursue interests and activities they had before they moved into the home.

People and staff told us while the manager was approachable; they were often not available. The lack of availability of the manager left the staff team without a consistent set of values to work to and this was sometimes reflected in how they responded to people’s needs. There was a robust quality assurance system which had already identified the concerns we found during our inspection.