We inspected Leivers Court Residential Care Home For Older People on 9 May 2018. Leivers 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. The service was registered to accommodate up to 38 older people, with age related conditions, including frailty, mobility issues and dementia. On the day of our inspection there were 21 people using the service; five of whom were receiving long term care, one person short term care and 15 accommodated on the assessment units.

The service was last inspected on 11 February 2016; no concerns were identified and the service was rated ‘Good’ overall.

There was a registered manager in post, who was present on the day of the 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.

People received care and support from staff that were appropriately trained and competent to meet their individual needs. There were opportunities for additional training specific to the needs of the service, such as diabetes management and the care of people with dementia. Staff received one-to-one supervision meetings with their line manager.

People’s needs were assessed and improved care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were personalised and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

There were policies and procedures in place to guide staff on how keep people safe from harm.

People were supported with patience, consideration and kindness and their privacy and dignity was respected. People were protected from potential discrimination as staffs were aware of and responded effectively to their identified needs, choices and preferences. People’s individual communication needs were assessed and they were supported to communicate effectively with staff.

Thorough staff recruitment procedures were followed and appropriate pre-employment checks had been made.

Systems were in place to ensure medicines were managed safely in accordance with current regulations and guidance. People received medicines when they needed them and as prescribed.

The registered manager worked in cooperation with health and social care professionals to ensure people received appropriate healthcare and treatment in a timely manner. People were able to access health, social and medical care, as required.

The provider was meeting the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). 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 provided with appropriate food and drink to meet their health needs and were happy with the food they received. People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

The provider had systems in place to assess the quality of care provided and make improvements when needed. People knew how to make complaints, and the provider had a process to ensure action was taken where this was needed. People were encouraged and supported to express their views about their care and staff were responsive to th

This inspection took place on 11 February 2016 and was unannounced.

Accommodation for up to 38 people is provided in the home on one floor. The service is designed to meet the needs of older people. There were 36 people using the service at the time of our inspection.

There is a registered manager and she was available during the 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.

People felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. The premises were managed to keep people safe. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Safe medicines and infection control practices were followed.

Staff received appropriate induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate. People’s needs were met by the adaptation, design and decoration of the service.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received personalised care that was responsive to their needs. Care records contained information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the registered manager and that they would take action. There were systems in place to monitor and improve the quality of the service provided. The provider was meeting their regulatory responsibilities.

People’s relatives told us that staff members obtained their consent before supporting them with care or treatment. Care records recorded which decisions people were able to make for themselves and which decisions they did not have the capacity to make. Our observations also showed us that staff members obtained consent before carrying out any care.

People who use the service were protected from the risk of abuse, because care records contained enough information and guidance for staff to identify the possibility of abuse and prevent it from happening. Not all staff had received adequate training, although action had been taken to address this.

One person who used the service told us, “I’m very happy with the care and I like it here very much. I get on ever so well with the carers.”

We also spoke with a relative who said, “I’ve never regretted my relative coming here. Full marks to everyone – 10 out of 10.”

We saw that each person’s care plan contained detailed information about themselves and their care needs. During our inspection we noted that staff interacted well with people who use the service, offered choices to people individually and spoke in an appropriate manner with people who use the service.

On the day of our inspection, refurbishment work at the home was still on going. The manager confirmed this work was due to be finished by the end of August 2013.

We noted that refurbishment had been completed in a planned manner, had been managed to ensure the least possible disruption to people who use the service and that care continued to be delivered in order to meet people’s needs.

A relative said, “The work that’s been done is fabulous, it’s one hell of an improvement. It’s improved staff morale and when it’s all settled the building will be better for people living here.”

The manager confirmed that staff were recruited using standard procedures. Appropriate checks were undertaken before staff began work.

We looked at three staff files and all three were well organised. Staff members we spoke with confirmed they had submitted their documentation before they had started work.

We spoke with relatives of a person receiving support and they told us, “Staff ask for our relative’s consent and encourage us to be involved in their care too. Our relative is treated like an individual.”

A person who uses the service told us, “I’m happy living here and staff are helpful.” Staff were able to describe people’s individual care needs and referred to information which we saw in people’s care plans.

One staff member we spoke with said, “The home is generally clean but we could do with a general assistant in the afternoons to continue with the cleaning.”

An external health care professionals told us,“They could do with more staff. Sometimes staff don’t seem to be around but there is always someone on the units.” One staff member told us, “If we had more staff we could provide more activities for people.”

We spoke with a person using the service who said, “I like living here, there’s nothing to complain about.” We looked at the complaints register and saw that complaints received had been dealt with appropriately and in a timely manner.

Residents told us that staff showed them respect and ensured that their right to privacy and dignity was maintained. One person said, “Staff give me a lot of help.” Their contact with friends and family was being maintained by regular visits to the service. Residents were involved in their personal plans of care and were asked about their personal preferences. One person told us “I’m very, very happy here.”

The people we spoke with said they felt safe living at Leivers Court and would know what to do if they were worried about anything. We heard mixed opinions from people as to whether there were sufficient staff available at all times though no one thought they were kept waiting or ignored by staff. Residents were clear that staff were competent at their job. One person said that staff, “do a lot of training.”

Comments by the people we spoke with, about the quality of the service, were positive and they felt listened to.