The inspection took place on 19 September 2017 and was unannounced.

Mary Chapman Court provides care for up to 34 people. There were 27 people living in the home on the day of our inspection. The home supported people who were over 65 years of age, some of whom were living with dementia. The building offered accommodation over two floors.

On the ground floor were a communal lounge, separate dining room and conservatory, where people could socialise and eat their meals if they wished. On the first floor were an additional two lounge’s and hairdressing area. The service provided transport for access to the community.

It is a condition of the provider's registration that a registered manager is in post at this location. The registered manager had left the service in August 2017. The provider had a nursing home, next door to Mary Chapman Court; the registered manager for that location has submitted an application to register with the Commission. Meaning they intend to have a dual management role supporting both locations. 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 of the Health and Social Care Act 2008 and associated regulations. There was an acting deputy manager in post who was supported by senior staff.

At the last inspection on 14 and 15 June 2016 the service was rated 'Requires Improvement'. The report was’ published in August 2016. At the last inspection we found there was an insufficient number of staff to keep people safe and meet people’s needs. We identified the service had not monitored peoples weight for some time so did not take timely actions to protect people from the risks of unplanned weight loss. The service was not following their procedures in the safe administration of medication. Consequently we found the manager had not completed robust and sufficient audits. Following the inspection the provider sent us a detailed action plan telling us how they would address the concerns we identified. At this inspection we found sufficient improvements in all of these areas. The service had continued to develop and had further strengthened their very caring approach. People received exceptional care that was personalised to them, taking account of their individual needs and wishes.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People who were able to said they felt safe at the home.

People’s care records showed risks to their safety were assessed and the action needed to mitigate those risks. These assessments and care plans were reviewed and updated at regular intervals to ensure people's changing needs were met. Accidents and incidents were accurately recorded and were assessed to identify patterns and trends. Records were detailed and referred to actions taken following accidents and incidents.

There were sufficient staff in place to meet people's needs. The manager used a dependency tool to assess staffing levels and to ensure they were based on people's needs, were up to date and reviewed monthly. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

Staff received an induction into the service and senior staff checked competencies in a range of areas. Staff had received a range of training and many had achieved or were working towards a National Vocational Qualification (NVQ) or more recently Health and Social Care Diplomas (HSCD). Staff received formal supervision and annual appraisals from their managers.

People were supported by sta

The inspection took place on 14 and 15 June 2016 and was unannounced.

Mary Chapman Court provides care for up to 31 people. The home supported people who were over 65 years of age, some of whom were living with dementia. The building offered accommodation over two floors.

There was a registered manager in place, and a tier of senior staff. At the time of the inspection there was a vacant deputy manager post, but a recruitment process was under way. 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 service did not follow their own procedures in the safe administration of medication.. Good practice was not being followed in all areas in the administration of medicines. Medication audits had not always identified issues with medicines, or found timely solutions to any issues discovered.

There were insufficient numbers of staff to keep people safe and meet people’s needs. The service had acknowledged this issue and there was a recruitment plan in place. However, robust interim measures had not been put in place before new staff were appointed.

The service identified and responded to the risks people faced. However, the service had not monitored people’s weight for some time.

People benefited from being supported by staff who were safely recruited, trained and who felt supported in their work by their colleagues and by the manager. Although staff did not have regular supervisions, the manager was addressing this issue.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns.

Staff told us despite the staffing levels they were happy working at Mary Chapman Court. They assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s needs. People and their relatives had been involved in making decisions around the care they received. People’s needs had been reviewed. However people’s assessments were not person centred. Staff lacked a full picture of the people they supported.

People were supported to maintain good health and wellbeing. The service responded proactively to changes in people’s health and social care needs.

The service was making positive steps to make good links with the local community.

People were encouraged to maintain relationships with others and the service actively welcomed family members and visitors to the home. However, there was a lack of planned activities, due to staffing levels, staff did not have the time to talk and engage with people on a regular basis. The service was aware of this issue and they had made plans to resolve this issue.

There was a positive and open culture. There was a homely and welcoming atmosphere to the home. Relatives felt involved and listened to. They were confident that any concerns they may have had would be addressed.

People living in Mary Chapman Court said that they were happy there. One person said, “I am very happy here and get well looked after. I have a lovely room”. Another person said, “ All the staff are lovely. I have no complaints”.

The people we spoke with told us that they had been involved in making decisions about how they wished to be cared for and supported. We noted that people’s bedrooms were individualised according to what people wanted. This included their own furniture and choice of soft furnishings.

The care plans we reviewed were detailed and personalised. They included appropriate risk assessments and regular reviews of people’s needs to determine if any changes were needed in the care provided by the staff. We saw evidence that the care delivered by the carers reflected what was documented in people’s care plans.

There were choices from the menu at meal times and the people we spoke with said that they enjoyed the food. Nutritional assessments had been completed and were regularly reviewed.

We saw that there were enough suitably trained and experienced staff to meet the needs of the people using the service most of the time. Generally, people were satisfied with the staffing arrangements although some people felt they had to wait too long to be attended to.

The service had various methods that were used to ensure the quality of the service was monitored and audited. During our visit we observed a ‘residents’ meeting. Each person was encouraged by the manager to give feedback about all aspects of Mary Chapman Court.

The purpose of this inspection, carried out on 12 December 2012, was to ensure that the necessary improvements had been made following concerns identified at our annual scheduled review of this service undertaken in August 2012.

We found that the provider had taken appropriate action to ensure improvements had been made.

Improvement had been made to the choice available during mealtimes. We saw that new menus had been developed and spent some time talking with the cook. They told us how they now delivered a new four weekly menu plan. We saw that to avoid confusion the correct menus were now displayed in both dining areas of the home and that a daily menu was placed on the tables.

We also found that improvements had been made to ensure people's care records were kept up to date.

We spoke with five people who lived at Mary Chapman Court. Each person told that they felt cared for and looked after in the home. One person told us “I get looked after very well” and another person commented “I have nothing to complain about, they [the staff] are very good to me”.

We also spent some time observing the care and support that was provided by staff during the lunchtime meal. We found that people were not given a choice about what they ate for lunch and that on two occasions’ people’s dignity was not maintained through lack of support during the lunch sitting.