This inspection took place on 30 October 2018 and was unannounced.

This was the second comprehensive inspection; the last inspection was rated Good in April 2016.

Scalford Court Care Home 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. The care home accommodates up to 59 people. On the day of our visit, there were 54 people using the service.

The service did not have a registered manager, a previous manager and a newly appointed home manager were manging the service. 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 and associated Regulations about how the service is run.

The provider had not ensured that people were always protected from health and safety risks associated with accessing areas such as the kitchen and laundry; they took immediate action to protect people at the time of the inspection site visit.

Staffing levels ensured that people's care and support needs were safely met most of the time; the provider was continuing to employ staff. Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

There was a very positive culture within the home where staff communicated well and people’s needs were met. The provider had achieved a gold award from the quality team at the local authority and investors in people.

This is the first time the service has been rated Requires Improvement.

Further information is in the detailed findings below.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Scalford Court Care Home on our website at www.cqc.org.uk

This was an unannounced comprehensive inspection that took place on 28 April 2016.

Scalford Court Care Home is a care home registered to accommodate up to 59 people who are aged over 65 and who are living with dementia or have a physical disability. The home is split into two sides. One side was set over two floors, with lift access to both floors. The home has a variety of communal rooms and areas where people can relax. At the time of the inspection 54 people were using the service.

The service had a registered manager. 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.’

People told us that they felt safe when staff supported them and that they enjoyed living at Scalford Court Care Home.

Risk assessments were in place which described how to support people in a safe way. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

The provider carried out the necessary pre-employment checks before staff started to work at the service.

Staff were trained and assessed as competent to administer medicines however, staff had not always signed to say that medicine had been given. People received their medicines as they had been prescribed by their doctor. We found that the temperature of the medication fridge had been recorded as being too high and no action had been taken. Where medicine was administered covertly this had been agreed with a doctor, however there was no specific guidance as to how this should be administered.

Staff were supported through training and supervision to be able to meet the needs of the people they were supporting. They undertook an induction programme when they started to work at the service and received further relevant training.

Staff sought people’s consent before providing personal care. People’s capacity to make decisions had been considered in their care plans.

People were supported to maintain a balanced diet. People were supported to access healthcare services.

People told us that staff were caring. Staff we spoke with had a good understanding of how to promote people’s dignity. Staff understood people’s needs and preferences.

People were involved in decisions about their care. They told us that staff treated them with respect.

People contributed to the assessment of their needs. People and their relatives were involved in the review of their needs.

People were supported to take part in activities that they enjoyed.

People told us they knew how to make a complaint. The service had a complaints procedure in place.

The service was well organised and led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

People were asked for their feedback on the service that they received. The provider carried out monitoring of the quality of the service.

As part of our inspection we spoke with seven people who used the service, eight members of staff working at the home and a visiting health professional.

People living at the home were generally quite happy with the service. They all told us that they liked their rooms and that the food was good. One person said: "The food is brilliant. The staff are brilliant." Another person told us: "There's always something going on here. I'm not bored." Several people who used the service said that the staff were very busy and that, at times, they did not have time to talk to them. We observed staff to be very busy during our inspection, however, we did find that people's care needs were being met.

Staff were generally happy working at the home. Care workers described a supportive environment and felt that the home had greatly improved since the current manager had been in post. Staff were very positive about the food at the home and said that there was plenty of activities on offer for people. One staff member said: "The food here is excellent. They've always cooked as fresh as they can."

We found that people were involved in their care planning and that they could choose how they spent their time. Suitable and nutritious food was being offered to people and the home and surrounding grounds were being adequately maintained. Selection and recruitment processes for staff were robust. Systems were in place to ensure that people’s complaints were addressed and taken seriously.

People told us that the care they received was appropriate. People also told us how much they enjoyed the new activities. We found the provider had addressed all of our earlier concerns and recognised how this had improved care for people who used the service and the morale and performance of staff. The provider is now working in a co-ordinated manner with external health professionals and commissioners and maintaining comprehensive records. Clinical protocols are now suitable and the improved staffing levels better meet the needs of people using the service.

As part of our inspection on this service we spoke to four people using the service, six members of staff working at the service and four relatives of people using the service.

The people we spoke to who used the service were happy with the care they received at the home. One person commented that, “The staff are great. They are very busy but they really care for us.” Another person we spoke to who used the service told us that more staff on duty would improve their life at the home, saying, “There isn’t enough staff. It affects my life. Sometimes I can’t get a carer.”

A relative of someone using the service told us that, "It is a very happy place, which is nice.” The same relative went on to tell us that, “I think the staff are a bit pushed sometimes, especially at the weekends." Another relative of someone using the service commented that, “There isn’t much intellectual stimulus at all at the home.”

Staff working at the service told us that they were happy working there and described feeling supported by the new manager who had been appointed to the home. One staff member told us, “The new manager is fantastic. I’ve been allowed to learn more since she’s been here.” Staff at the home told us they felt that, at times, they were too busy and that they would benefit from having more staff on duty. One staff member commented that, “I think we struggle at times.”

People told us that they were treated well by the staff, one person explained,” You can’t grumble about the staff at all, they are very good”. Another person told us, “The staff are very willing to help, they do look after me”.

Some people told us that they thought that there were enough staff on duty during the day; others felt that at times, they had to wait a while for staff to come and help, one person explained, “I ring my bell and they come”, whilst another person told us, “When I ring the bell, staff sometimes come quickly”.

Staff told us that sometimes they could do with more staff, particularly on the Good acre wing, they explained that they were responsible for all care and support there and at times this could be rather pressured. Other staff told us that weekends were not so good as staff didn’t seem to be quite so reliable.

One relative visiting at the time of our visit explained, “You can call in any time, they are very very helpful, they were particularly helpful when we came to look round”. Another relative told us, “It’s a wonderful care home; the staff feel like your family”.

We spoke with five people currently using the service and they told us that overall, they were satisfied with the care and support they receive, they told us:

"You can't complain about the staff, they are all nice and helpful".

"They are very good, they take their time and you don't feel rushed".

"The food is lovely, they always come and ask what you want and if you want anything else, they give you treats as well".

"The menu's are brilliant".

Two relatives who were visiting at the time of our visit also shared their thoughts about the care and support provided, they explained:

"The staff are nice, they really do try and there is always someone available".

"It's alright, some days are good, some days not so, some days she sits a lot".

People told us that they felt safe living at the service and overall had no concerns, they told us:

" I feel very safe, I have no worries".

"She is safe here, I don't go home and worry about her".