Lavender Court is a care service. People in care services receive accommodation and nursing or personal care as a single package under one contractual agreement. Lavender Court can accommodate up to 85 people. At the time of the inspection there were 68 people living at the service.

The service is divided into three units, residential care on the first floor, general nursing care on the second floor and the third floor accommodates people who have a dementia. All bedrooms are for single occupancy and are fitted with en-suite facilities. The service is staffed 24 hours a day and registered nurses are available on the nursing unit.

At our last inspection, we rated the service 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 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.

At this inspection we found the service remained Good

There was a registered manager in post. 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 safe. Staff understood how to recognise and report signs of abuse or mistreatment. Staff had received training on how to recognise the various forms of abuse, which was regularly updated and refreshed. The provider carried out risk assessments to identify any risks to people using the service and to the staff supporting them. Safe recruitment processes were completed. There was enough staff to meet the needs of the people living at the home.

The provider had systems in place to manage medicines safely. There were suitable arrangements for storing and recording medicines that required extra security. Staff recorded room and fridge temperatures.

Staff followed good infection control practice. Staff knew the reporting process for any accidents or incidents. Records showed that the provider had taken appropriate action where necessary, and made changes to reduce the risk of a re-occurrence of an incident. The service had suitable processes to assess people’s needs and choices, the registered manager assessed people prior to a moving in to the service to check the service could meet the person’s needs.

Staff had appropriate skills, knowledge, and experience to deliver effective care and support. All new staff completed an induction. Records showed staff received comprehensive training, which enabled them to carry out their roles effectively. Staff received regular supervision and appraisals. Staff completed food hygiene training, they knew about good practice when it came to nutrition and hydration.

Staff asked people for their consent before delivering care or support and they respected people’s choice to refuse care. Care records showed that people gave their consent to the care and support provided. Most people we spoke with said they had been included in some of their care planning. All the relatives we spoke with said they had good communication with staff and were involved in their relative’s care.

The provider worked with health and social care professionals to ensure each person received a support package tailored to meet their individual needs. We spoke with professionals, who told us they could contact the provider by phone or email and they got a response straight away.

The provider sought people’s feedback and took action to address issues raised. There was a system in place to manage and investigate any complaints. People had information about how to make a complaint. The provider recorded incidents and accidents. They used this

This inspection took place on 21, 22 and 26 January 2016 and was an unannounced inspection.

At the last inspection carried out on 11 December 2013 we did not identify any concerns.

Lavender Court can accommodate up to 69 people. The home is divided into two units and it provides general nursing care and residential care to older people. Within the building there are also 10 flats which are not currently occupied. Lavender Court is purpose built. All bedrooms are for single occupancy and are fitted with en-suite facilities. The home is staffed 24 hours a day and registered nurses are available on the nursing unit. The home is situated in a residential area close to the centre of Taunton.

There is a registered manager who is responsible for the home however they have submitted an application to cancel their registration for Lavender Court as they had moved to another of the provider’s homes. 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 and associated Regulations about how the service is run.

The home was being managed by an acting manager who had worked at the home for many years as a deputy manager. The acting manager had an excellent knowledge about the needs and preferences of the people who lived at the home. They had a clear vision for the home and they made sure this was understood and followed by the staff team. They were committed to ensuring people received the best possible care and they demonstrated a very good knowledge of the legal responsibilities which would be expected of a registered manager.

Staff morale was very good and there was a happy and relaxed atmosphere throughout the home. Staff interacted with people in a very kind and caring manner and people looked relaxed and content with the staff who supported them. One person told us “I’m treated like royalty; I really am. The staff help you in such a wonderful way. They are just so kind and caring.” Another person said “The staff are very pleasant, I’m treated with respect and dignity. They are all very caring and the manager is very good and comes to chat with me. The care is very good, I can make choices and I’m very well looked after you know.”

People told us they felt safe at the home and with the staff who supported them. One person told us “They know what I want I don’t have to worry. I feel safe here.” Another person told us “I feel very safe here. They take good care of me and I have nothing to worry about at all.” There were policies and procedures in place to minimise risks to people and to help keep them safe. These were understood and followed by the staff team.

People received care and support which was adjusted to meet their changing needs. People had access to appropriate healthcare professionals to make sure they received effective treatment when required. There were safe systems in place to make sure people received their medicines when they needed them. One person told us “They’ll always get the doctor if you need them. I was getting a lot of pain. I told the staff and the doctor came to see me. I have pain killers now which helps a lot.”

People had their nutritional needs assessed and food was provided in accordance with people’s needs and preferences. Examples included soft or enriched diets. People who were at risk of malnutrition were weighed at least monthly to monitor their well-being. People told us they were provided with plenty to eat and drink. A choice of hot and cold drinks were offered regularly throughout the day and provided on request.

People were cared for by staff who were knowledgeable about their needs and preferences. Staff received regular training to keep their knowledge and skills up to date. A visitor told us “The care is good and [person’s name] is very happy. I’m happy with

Earlier this year the Commission approved an application from the provider to increase the number of people the home could accommodate. Ten self-contained flats and communal areas had been created on the second floor of the home. We did not visit this floor during our inspection as none of the flats were currently occupied.

When we visited 55 people were using the service. The home was divided in to three units. One provided general nursing care, one provided residential care and the third provided care to people who had a dementia. We met with people on each unit, staff and two visitors. We also spent time observing how staff interacted with the people who lived at the home.

The people we spoke with were positive about the care and support they received. Comments included “I am very happy living here. The staff are very kind indeed.” The home employed designated activity staff which meant that people were provided with opportunities for social stimulation every day. There were sufficient numbers of staff on duty to meet the needs of the people who lived at the home. We observed that staff were competent and professional in their interactions with people.

The home followed appropriate procedures for the management and administration of medicines.

We saw that people had been provided with equipment in line with their assessed needs.

People who used the service were provided with opportunities to express a view on the quality of the service they received.

When we visited 44 people were using the service. The home was divided in to three units. One provided general nursing care, one provided residential care and the third provided care to people who had a dementia. We met with people on each unit, staff and four visitors. We also spent time observing how staff interacted with the people who lived at the home.

People told us that they were able to make choices about their daily lives. Comments included “It is very good and relaxed here. I like to stay in my room mostly and the staff know that” and “I say what I want and the staff always respect what I say.”

We looked at three care plans. These contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure that they reflected people's current needs.

All staff spoken with were aware of indicators of abuse and knew how to report any worries or concerns. They said they felt confident that any reports would be fully investigated to ensure that people were protected.

Systems were in place which meant that staff had the skills, support and training needed to meet the needs of people who lived at the home.

The home had a complaints procedure which provided people who used the service and their representatives with clear information about how to raise any concerns and of how any concerns would be managed.

The home was divided into three units. People who lived on the first floor were receiving general nursing care. On the ground floor one unit provided care to people who had a dementia and the other provided ‘residential’ care. During our visit we spent time on each unit where we spoke to people using the service, observed how people spent their day and how they were offered choices. We also spoke to the staff on each unit and a visitor.

During our visit we observed that staff offered assistance to people in a discreet and respectful manner. We noted that everyone who lived at the home was very well presented demonstrating that staff took time to support people with personal care and dressing. People being nursed in bed looked clean and comfortable and we were able to see that people had access to regular drinks.

We observed people moving freely around each unit. People who required staff assistance to mobilise were asked where they would like to spend their time. People told us that they were able to make choices about how they spent their time. People said “you can spend time in your bedroom when ever you want to”, “I prefer to stay in my room and the staff always knock on my door before they come in”.

One person said “they don’t make you get up or go to bed at certain times, you can go when you like really”. Another said “they bring me a cup of tea in the morning and sometimes I like to have breakfast in my room”.

People told us that they had plenty to eat and that choices were available. Comments included “there are always two choices for every meal” and “I never feel hungry, there is plenty to eat here”. People spoken with also confirmed that staff were aware of their preferences for food and drinks.

All appointments with healthcare professionals had been recorded in the care plan showing that people had access to healthcare professionals in line with their individual needs. Staff observed and spoken with, demonstrated a good knowledge of the needs and preferences of people who lived at the home.

Everyone asked, who was able to express a view said that they felt there were always enough staff on duty to meet their needs. One person said "There are plenty of staff and they are always quick to help." Another person said "Staff will do anything they can to help you, you only have to ask."

We observed that staff responded promptly to any requests for assistance. There was a relaxed atmosphere in the home and staff had time to socialise with people as well as undertake tasks. There was a good staff presence on each of the units.

All staff appeared confident and well motivated. One person said "all the staff are very good, I like them all” and “they are kind, gentle and patient”. During our visit we spoke to a visitor who confirmed that there was a good staff presence each time they visited the home.