Rawreth Court provides accommodation and personal care for up to 35 older people living with dementia and who may also be living with mental health needs. 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.

Rawreth Court is a large single storey building in a quiet residential area in Rawreth, near to Rayleigh and close to all amenities. The premises provide each person using the service with their own individual bedroom and adequate communal facilities available for people to make use of within the service. The service is divided into zones according to people’s needs.

This inspection was completed on 21 and 22 November 2018 and was unannounced. This was the service’s first inspection since being newly registered as a care home on 23 November 2017. There were 33 people living at the service.

The service had 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.

Improvements were required to the service’s governance arrangements to assess and monitor the quality of the service. The current arrangements had not identified the issues we found during our inspection.

Care plans did not fully reflect people’s holistic care and support needs or provide sufficient guidance for staff as to how these were to be met. Care plans did not adequately address people’s mental healthcare needs and the impact this had on their overall health and wellbeing. People’s end of life care needs were not recorded. Not all risks to people’s safety and wellbeing had been identified, and suitable control measures had not always been considered and put in place to mitigate the risk or potential risk of harm for people using the service. Improvements were required to the service’s medication arrangements as discrepancies relating to staff’s practice and medication records were found.

Although the deployment of staff was suitable to meet people’s needs, staffing levels as told to us were not always maintained and this impacted on people using the service. The principles of the Mental Capacity Act 2005 to make a specific decision had not always been assessed and best interest assessments completed. Staff did not always support people in the least restrictive way possible.

Not all staff employed at the service had received a robust and comprehensive induction. Staff received regular training opportunities, though improvements were required as not all staff had completed relevant training relating to mental health conditions. Appropriate arrangements were in place to recruit staff safely in line with regulatory requirements. Staff felt supported and received appropriate formal supervision at regular intervals and an appraisal of their overall performance. Safeguarding concerns were reported to the Local Authority.

Staff worked well with other organisations to ensure they delivered good joined-up care and support. Individuals were complimentary about the care and support they received and about the staff team and received good person-centred care. People’s healthcare needs were met and people were supported to have access to a variety of healthcare professionals and services as required. The dining experience was positive and people had their nutrition and hydration needs met. People were supported to have their social care needs met and relationships with family and friends maintained.

Staffs’ practice was suitable, with staff following the service’s policies and procedures to maintain a reasonable standard of cleanliness and hygiene within the service.