We inspected the service unannounced on 19 November 2018. Lester Court provides accommodation for up to 10 adults with mental health needs. At the time of our inspection, nine people were using the service.

Lester Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection on 17 November 2015 we rated the service ‘Good’ overall and in all domains. At this inspection and from our ongoing monitoring there was no evidence or information 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.

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People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Staff understood the challenges people might face and how to support them with these. The home was well-staffed and people said this made them feel safe. People received their medicines when they needed them. The home was clean and fresh throughout.

People continued to receive an effective service. People were assessed before they came to the home to ensure staff could meet their needs. Staff were well-trained, skilled and knowledgeable and understood the importance of providing an effective and non-discriminatory service. Staff supported people to eat and drink enough. People had access to the healthcare services they needed. The premises were designed to support people to live independently. People were supported, in the least restrictive way possible, to have maximum choice and control of their lives.

People continued to receive a caring service. Staff had mutually-respectful relationships of trust with people. People were involved in the provider’s ‘Big Wish’ project where they had the opportunity to make a wish which staff supported them to achieve. People told us they enjoyed taking part in the project and it made them feel valued. People were supported to express their views and were actively involved in making decisions about their care and support.

People continued to receive a responsive service. The home used the ‘recovery star model’ to support people to progress towards independence. People were engaged in their recovery through personalised reviews. People had access to the information they needed in a way they could understand it, for example face-to-face, in writing, and/or pictorially. People had the opportunity to take part in a range of activities including college, shopping, playing pool, and sport.

People continued to receive a well-led service People and staff made many positive comments about the quality of the accommodation, care and support. The registered manager was well-liked and respected. People and staff had the opportunity to share their views on the service. The registered manager and provider carried out regular quality audits to ensure the home was running well and made improvements where necessary.

Further information is in the detailed findings below.

We inspected the service on 17 November and the visit was unannounced.

Lester Court provides accommodation for up to eight adults with mental health difficulties. At the time of our inspection, six people were living at the service.

The service is required to have 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. There was a registered manager in post at the time of our inspection.

People felt safe at the service. They knew how to raise a concern and staff knew about their safeguarding responsibilities. Risks had been assessed and people using the service were involved where possible.

The provider was monitoring health and safety and learning from incidents that had occurred. There was not a comprehensive plan of what to do in emergencies. The registered manager acted upon this when we visited.

People were supported by staff who had been through a thorough recruitment process and staffing levels were suitable to support people using the service. People received their medicines as prescribed by their doctor. We found effective systems for managing medicines but the temperature of the room they was stored in was not being monitored so there was a risk that medicines stored there would not be as effective as they should.

Staff received regular training that was devised to ensure that they could respond effectively to people’s needs as they changed. The manager had highlighted further training following an incident. Staff were effective in offering their support in a person-centred way and were able to adapt their style of communication where needed. We found staff to be caring.

Staff were receiving regular support from their manager including formal supervision. Staff and relatives described the registered manager as approachable. The registered manager knew their responsibilities in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and they had followed the required processes appropriately. We found that people using the service and relatives were involved in reviewing the care and support received.

Some people had their own kitchenette which enabled independence in the preparation of food. Relatives described the food positively. Staff were described as good. We found interactions between staff and people using the service to be positive. Care was focused on things that were important to people and this had been documented. People were listened to and action was taken by staff to make changes where requested. There were action plans in place to support people to achieve greater independence and develop skills. We found that privacy and dignity were understood by staff and arrangements were in place to embed these values in practice.

People using the service and relatives were involved in the planning of care being provided. People chose to take part in activities and leisure interests that were important to them and we found there were enough staff to support this.

The service had received complaints which had been addressed with outcomes recorded. Relatives knew how to complain and felt they were able to if necessary. When a person using the service had complained, this had been addressed to their satisfaction.

Ideas for improving the service were taken on board by the provider. Relatives told us they were confident to discuss suggestions with the management. There was no formal system in place for capturing the views and experiences of relatives or others coming into contact with the service. The registered manager and senior managers conducted regular audits. These highlighted areas for improvement and we saw that they had taken action where required.

The registered manager understood their responsibilities and accountabilities and had put in place systems to make sure communication was effective, such as staff meetings.