This inspection was carried out on 23 and 31 August 2017 and was unannounced. This was the first inspection since the service was registered on 31 January 2017.

River Court is a purpose built nursing and residential care home. The home is located on the outskirts of Watford Town Centre. It has the capacity for up to 120 older people, some of whom live with dementia and it also provides nursing care/palliative care.

There were 106 people living at the service on the day of our inspection. River Court consists of four units, Hampermill, Gade, Chess and Colne.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People told us they felt safe and secure living at River Court. We found that staff were knowledgeable in recognising signs of potential abuse and knew how to report concerns both within the organisation and externally if required.

Assessments were undertaken to identify any risks to people who received a service and to the staff who supported them. There were sufficient numbers of staff available to meet people's individual support and care needs at all times, including during the night and at weekends.

People received appropriate support from staff to enable them to take their medicines.

People and their relatives knew how to raise concerns and told us they were confident that these would be resolved without delay. People received care and support from a staff team that fully understood people's health and care needs and who had the skills and experience to meet them.

We found that people who used the service were treated with dignity and respect and their

privacy was maintained.

The activities programme in place required improvement as it did not always reflected accurately or meet the individual needs of the people who used the service.

The environment requires further adaptation with regard to supporting people who are living with dementia.

People were involved in the planning of their care and we found that people had access to independent advocacy services. Care plans were clear and gave staff enough information to meet people’s needs.

Safe and effective recruitment practices were followed to make sure that all staff were of good character, and were suitable to work in a care home environment as well as being fit for the roles they were being employed to carry out. Staff records confirmed checks had been made which ensured it was safe for them to work with vulnerable adults before a position was offered to them.

Staff were well supported by the management team and received an induction from senior staff when they first started working at the home. They received on going training and support to enable them to perform their roles effectively. Staff had regular individual supervision meetings, team meetings and had an annual appraisal to review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

People's views about the service were gathered using surveys and verbal feedback. Feedback was used in a positive way to improve the quality of the overall service. The majority of people we spoke with were positive and complimentary about all aspects of the service.