This inspection took place on 20 and 21 April 2017 and was unannounced. Manchester Court provides accommodation and personal care for up to 20 people who are living with a mental health condition. There were 20 people living at the home on the day of our inspection. The home is set over five floors with a lounge, dining room, smoking room and a secure back garden.

At the last inspection in November 2014, the service was rated Good. At this inspection we found the service remained Good.

People told us they were happy living at Manchester Court and that they felt safe. People received individualised care which reflected their personal preferences, wishes and routines. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible.

People’s care records were kept up to date with their changing needs. By closely working with health care professionals the risks to people’s health and well-being were reduced. People were supported to eat a healthy diet. They were encouraged to make choices about their care and support and to be as independent as possible. People were treated with dignity, respect and kindness.

People were supported by staff who had access to training and support to acquire and maintain the skills and knowledge they needed to meet their needs. Staff were supported to develop in their roles.

People’s views were sought as part of the quality assurance process to drive through improvements to the service. A range of quality assurance systems monitored the standards of care provided. The registered manager valued the feedback from people, their relatives and staff and acted on their suggestions.

Further information is in the detailed findings below.

We used a number of different methods to help us understand the experiences of people using the service. We did this because people who used the service had complex needs which meant they were not always able to tell us their about experiences. We observed staff interacting with people and spoke with staff about people's needs and examined their care records. We were able to speak with eight people but because of their complex needs we were not able to discuss aspects of their care with them. People told us they were happy at the home. Some people were able to go out independently into the local town. One member of staff told us they had taken one person to the local shop so they could do some shopping. One person told us they went to a social club one evening a week. People told us they liked the re-decoration of the home as one person described it as being "posh". Staff told us they liked working at the home and felt well supported by other staff and the management.

We followed up three compliance actions which we issued following the inspection on the 8 November 2012. We found these had all been met.

Care records contained details of people's needs and how they liked to be supported. Staff demonstrated good knowledge of people's needs.

People were provided with a choice of suitable and nutritious food and drink.

The purpose of this inspection was to follow up on the actions we took after the inspection on the 8 November 2012. At the November inspection we found the premises placed people's welfare and safety at risk due to inadequate maintenance. Some of the equipment used was unsafe and placed people at risk of injury and did not promote their comfort. There was also no effective system in place to regularly assess and monitor the service.

At this inspection we found that the provider had re-decorated the majority of the home. We found the communal areas had been repainted and new flooring fitted in the entrance hall and on the stairways. New flooring had also been fitted in some people's bedrooms. Some bedrooms were in the process of being refurbished. All the unsafe equipment had been replaced.

Some people had been reviewed by external health care professionals and they had been provided with new beds, mattresses and other equipment required to meet their needs. We saw new chairs were in the lounge as the old ones were damaged.

We spoke with three people who all said the new decor was an improvement and a member of staff also felt the same.

A system had been put in place to regularly assess and monitor the service provision and this included obtaining the views of people and staff.

We felt that the re-decoration had greatly improved the environment for people.

Ten people we spoke with and a relative of a person told us they were happy at the service. They told us there were no restrictions on them and they could go out and about into the local community. People also told us the staff were friendly and nice. One person said they 'are my family'.

Staff told us it was a nice a place to work and they felt well supported by other staff and the management of the home.

We observed the staff treating people with respect.

We found concerns with the upkeep of the environment and the cleanliness. Some of the equipment used by people was in a poor state of repair. Staff were not receiving training pertinent to their role.

Quality monitoring of the service had failed to identify areas that required improvement.

We spoke with five people living in the home. They made a number of comments about the quality of the care and living in Manchester Court. Comments included: "its quite a good place to live, easygoing and you can come and go as you please", "I get the care I need, staff are all very good","meals are very good there is always a choice".

One person told us: "I like living here it's a good home. They always give me the help I need and staff are very kind".

This was an unannounced inspection which was carried out on 25 and 26 November 2014.

This service was last inspected on 2 April 2013 where it was found to be fully compliant.

Manchester Court provides care and support for older people and for those with mental health needs. It can accommodate 20 people. At the time of the inspection17 people were living at the service. The facilities were set out across four floors with kitchen and utilities on the lower ground floor. The main communal areas were on the ground floor. A passenger lift helped people get to the first and second floors where there was a second lounge, bedrooms and bathrooms.

A registered manager was in position and had been managing Manchester Court since April 2014. 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.

The environment was clean and there were processes in place to stop infection spreading.

People received their medicines as prescribed and were supported to administer these themselves if able to do so. Arrangements were in place to ensure people were protected from potential errors related to their medicines.

People were protected against abuse because the staff knew how to recognise abuse and appropriately report any allegations of abuse to relevant agencies. Potential risks to people were identified and managed well.

People were supported and had their needs met by staff who had been checked as being suitable to work with vulnerable adults. Individualised care was delivered by staff who had time to do this and who had the correct support and skills to do this effectively.

People were provided with choices in food, what they did each day, who cared for them and when they wanted support it was provided. Several people were supported to or used the local community independently. This included visits to a social club, hairdressers, shops and other places of choice. A volunteer provided a quiz on two nights of the week and encouraged people to join in topical conversations. Any activities or entertainment involving an external entertainer had to be paid for by those who wished to partake in this. We were told that people rarely wanted to do this.

Some people had behaviour that could be perceived as challenging. The staff worked closely with other health and social care professionals to manage risks associated with this. For example, one person received the support of a psychologist. Detailed risk management strategies and effective staff support meant people’s challenging behaviour was effectively managed in the least restrictive way.

People’s rights were protected through the appropriate application of mental capacity assessments. People with mental capacity were actively involved in the decisions made about their care, health and welfare. A volunteer helped people voice their concerns, goals, aspirations and preferences. These were incorporated into people’s individual care plans and acted on.

Appropriate people and those who mattered to the person, were involved in planning and reviewing the person’s care, if, this is what the person wanted. People had access to health and social care professionals who helped to ensure their needs were met and their support remained effective.

The registered manager was a strong advocate for the people she supported and ensured their rights and needs were maintained and met. The registered manager worked hard with other professionals to ensure people’s wishes about their health and future were met.