We carried out this inspection on 17 July 2018 unannounced and returned announced on 18 July 2018.

Scraptoft Court is registered to provide accommodation and care for up to 43 people living with dementia. At the time of the inspection they had 26 people living at the service. Scraptoft Court is in a residential area of Leicester and is registered to provide accommodation and personal care to people who may or may not have nursing care needs.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

There was 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.

People were treated with kindness and compassion. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. However, people’s dignity was compromised where staff did not ensure they wore their own clothes.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

There were a suitable number of staff deployed and the provider had followed safe recruitment practices. People received their medicines in line with their prescription.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff supported by the registered manager and senior team, and had one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People mostly were asked for consent prior to care being provided. People were mostly supported to have choice and control of their lives. We have made a recommendation about involving people in decisions about their support.

People had enough to eat and drink to maintain good health and nutrition. People were supported to access health professionals when required.

Where possible the registered manager involved people in care planning. Families were involved in reviews and were kept up to date with changes in their loved one’s care needs.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service had a positive ethos and an open culture. The providers and registered manager provided positive leadership to all staff.

The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

We carried out an unannounced comprehensive inspection of this service on 8 March 2017. There were two breaches of legal requirements found. We found people’s medicines had not been managed in a safe way. Staff did not follow the guidance to protect people at risk of choking or who had swallowing difficulties. Staff did not use equipment correctly to move people safely and infection control procedures were not followed. We also found the provider did not have an effective system to regularly assess and monitor the quality of service that people received.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection on 25 August 2017, which was unannounced. We checked whether they now met the legal requirements. This report only covers our findings in relation to ‘Safe’ and ‘Well-Led’. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Scraptoft Court Care Home on our website at www.cqc.org.uk

Scraptoft Court Care Home provides residential and nursing care for up to 34 people. The home specialises in caring for older people including those with physical disabilities, or living with dementia and who require end of life care. At the time our inspection visit 29 people were in residence.

Scraptoft Court Care Home 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.

We found improvements to the management, storage and administration of medicines. Staff supported people with their medicines in a safe way. Staff were trained to use manual handling equipment correctly and their competency to move people safely had been assessed. We also saw staff followed infection control procedures. Regular checks were carried out on the premises and equipment to maintain people’s safety.

Risks associated to people’s physical and mental health had been assessed. Care plans included advice sought from healthcare professional to ensure staff had guidance to follow to meet people’s needs. For example, guidance from the healthcare professionals had been followed by staff as to the texture of food and how to prepare drinks for people at risk of choking or had swallowing difficulties.

People told us that they were supported by staff when they needed it and we observed this to be the case. Records showed people, and their relatives, where relevant were involved in their review of their care plans. This ensured people’s ongoing needs were managed and continued to be met safely.

The registered manager provided leadership and welcomed feedback about the service. We found improvements had been made to the provider’s governance system. People’s views and the opinions of their relatives and staff were sought in a number of ways. A range of audits were carried out to monitor and improve the quality of the service provided.

This inspection took place on 8 March 2017 and was unannounced. We returned on the 9 March 2017 announced to complete the inspection.

Scraptoft Court Care Home provides residential and nursing care for up to 34 people. The home specialises in caring for older people including those with physical disabilities, people living with dementia and those who require end of life care. At the time of our inspection there were 29 people in residence.

At our last comprehensive inspection in April 2015, the service was rated as ‘Requires Improvement'. We undertook a focused inspection of the service in December 2015 to check that the registered persons had followed their plan of action to meet the legal requirements. We found the service had made the improvements. We were unable to change rating as these improvements needed to be sustained

A registered manager was 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.

We found that further action was needed to ensure people’s health, safety and wellbeing was maintained. We found the management of medicines was not safe and staff did not follow infection control and prevention procedures and did not move people safely. Risks associated with people’s individual health needs had been assessed and, advice sought from health care professionals. However, we found staff did not always support people to be positioned correctly to eat. Staff did not always follow advice in regards to preventing people from the risk of choking because people’s drinks were not always made up with the thickeners in accordance with prescriptions.

We found the provider’s governance system was not used effectively to monitor or identify shortfalls that we found during this inspection and to drive improvements.

People’s care needs had been assessed and measures to manage risks were put in place. Most staff understood people’s needs and the support they required. People were involved and made decisions about their care and support needs. Care plans were focused on the person and incorporated advice from health and social care professionals. People’s care plans and risks were reviewed but not always in a meaningful way as some lacked detail about changes to people’s needs and did not show the involvement of the person or their representative. Where changes had been identified people’s care plans were not always amended to reflect those needs. Despite this staff were kept up to date about changes to people’s needs through the daily handover meetings.

People told us they felt safe with the staff. The registered manager and staff were trained in safeguarding adults, understood their responsibilities in this area and were aware of the procedures to follow if they suspected that someone was at risk of harm.

Staff were subject to a thorough recruitment procedure that ensured care staff and nurses were qualified and suitable to work at the service. The registered manager ensured there were enough staff to meet people’s needs and used agency staff to manage absences. Staff received training, support and supervisions in order to meet people’s needs effectively. The registered manager provided clinical support to staff to ensure they were competent and their practice was safe.

People told us they were provided with a choice of meals that met their dietary needs. People were asked for their views about the meals provided and their preferences were taken into account in the menu planning.

The registered manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and were dedicated in their approach to supporting people to make informed decisions about thei

We carried out an unannounced comprehensive inspection of this service on 7 and 8 April 2015. We found a breach of a legal requirement. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation the breaches. That related to the steps taken by the provider to improve the standards of cleanliness of the premises and ensured regular maintenance and timely repairs carried out to protect people’s safety.

We undertook this focused inspection of this service on 29 December 2015 which was unannounced. The focus of the inspection was to check that they had followed their plan of action and to confirm that they now met legal requirements. This report only covers our findings in relation to the requirement and information gathered as part of the inspection. You can read the report from our last comprehensive inspection, by selecting ‘all reports’ link for Scraptoft Court Care Home on our website at www.cqc.org.uk

Scraptoft Court Care Home is a care home that provides residential and nursing care for up to 34 people. The home specialises in caring for older people including those with physical disabilities, people living with dementia or those who require end of life care. At the time of our inspection there were 30 people in residence.

A registered manager was 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.

We found that the provider had taken action and made the required improvement to meet the legal requirement in relation to the breach.

People told us that they lived in an environment that was clean, safe and well maintained.

We found repairs had been carried out to the premises. The service employed a team of house-keeping staff that ensured the premises were regularly cleaned and hygienic.  We found the communal areas, and bedrooms were clean. The management team carried out regular checks to ensure the environment and equipment were regularly maintained to protect people’s safety.

We spoke with several people who used the service and with three relatives who were visiting. One relative who was able to visit frequently told us ‘the staff are brilliant and they look after her so well. She is always clean and dressed nicely and she has put on weight since she came here”. Another relative told us about their relative, “she is looked after like a queen, we wish she had come here sooner, the care is so good”.

We saw that care staff spoke with people in a sensitive and caring manner and that people were helped to make choices about how they spent their time and what they wanted to eat. Some people chose to stay in their rooms. People were supported and encouraged to be involved in a number of activities.

We saw that people's support plans were detailed and took account of individual needs and how these would be supported.

The provider took appropriate steps to protect the people living and working there from harm.

Staff were trained and supported and delivered care which met people's needs. Staff understood people's needs and preferences and respected their choices.

The provider had adequate quality assurance systems which made sure the safety and comfort of the people they cared for were maintained and any problems resolved.

The provider had systems in place to monitor the quality of the service and to find out he views of people who used the service and of their representatives.

We spoke with several people who used the service and with three visiting relatives. One person told us "I can do as I please here. No-one tells me what to do. Sometimes I stay in my room and that's fine with staff as long as I'm happy".

A visiting relative told us "you come for a visit and you go away happy because they are happy". They added that the food was good and included vegetables.

One relative told us that the most important thing was that the carers were good but added that there was a problem with an unpleasant smell and that the carpet was not hygienic.

We found that people using the service received care that met the essential standards but that some aspects of the physical environment did not. There was a smell of urine noticeable on entering the home. It was evident in the lounges, dining rooms and the upstairs and downstairs corridors where there was a heavily patterned carpet. Although regularly cleaned it continued to harbour the smell.

We also considered that the use of heavily patterned materials did not take into account current good practice on what kind of environment was beneficial for people living with dementia. Scraptoft Court has people using the service who are living with dementia.

People we spoke with told us they liked the meals provided by the home and that the Chef asked them each day what they would like from the menu. People had the opportunity to attend meetings and talk about the day to day running of the home. Newsletters were available providing information about the service.

We spoke with someone who told us what time they prefer to go to bed and said that in most instances they are supported at this time.

We saw that staff placed themselves in busy areas of the home where a majority of people spend their early evening to ensure that they were safe and supervised. Whilst other staff provided personal care and support to people as it was needed.

This inspection took place on 7 and 8 April 2015 and was unannounced.

Scraptoft Court Care Home is a care home that provides residential and nursing care for up to 34 people. The home specialises in caring for older people including those with physical disabilities, people living with dementia or those who require end of life care. At the time of our inspection there were 29 people in residence.

A registered manager was 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.

We found the premises had not been well maintained, or secured. Damaged equipment, environmental risks and faults had not always been assessed, repaired or replaced in a timely manner. Improvements were needed to ensure people lived in a clean and safe place which protected their health and welfare.

The provider’s quality governance and assurance systems were not used effectively and consistently to ensure people’s health, safety and welfare. People had limited opportunity to share their views about the service and make suggestions on how the service could be improved.

People we spoke with told us that their care and support needs were provided safely. People were protected from harm and abuse. Staff were knowledgeable about meeting people’s needs and their responsibilities in reporting any concerns about a person’s safety including protecting people from harm and abuse. Medicines were stored safely and people said they received their medicines at the right time.

Staff were recruited in accordance with the provider’s recruitment procedures. This ensured staff were qualified and suitable to work with people at the home. The service continues to use agency staff to ensure people were supported in a timely and their care needs were met.

Staff received an induction when they commenced work. Although on-going training was not monitored plans had been put into place to ensure staff received the relevant training for their job role in a timely manner. Staff were knowledgeable about people’s needs and could refer to people’s care records. Staff received support through meetings and staff appraisals. We observed the staff supported people safely when using equipment to support people.

People were protected under the Mental Capacity Act and Deprivation of Liberty Safeguards. The registered manager and staff understood their role in supporting people to maintain control and make decisions which affected their daily lives. Referrals, where appropriate, had been made to supervisory bodies where people did not have capacity to make decisions to were made in the individual’s best interest.

People were provided with a choice of meals that met their dietary needs. Drinks and snacks were readily available. People at risk of poor nutrition had assessments and plans of care in place for the promotion of their health.

People’s social needs were met. People received visitors and spent time with them as they chose. There were a range of opportunities for people to take part in hobbies and activities that were of interest to them, including meeting people’s religious and spiritual needs.

People’s health needs were met by the nurses and health care professionals. Staff sought appropriate medical advice and support form health care professionals when people’s health was of concern and were supported to attend routine health checks.

People told us that they were treated with care and that staff were helpful. We observed staff respected people’s dignity when they needed assistance. Some shared bedrooms had privacy screens and new screens had been ordered to promote people’s privacy and dignity.

People were involved in making decisions about their care and in the development of their plans of care. Where appropriate their relatives or representatives and relevant health care professionals were also consulted to ensure people received person centred care.

People were confident to raise any issues, concerns or to make complaints, which would be listened to and acted on appropriately. Records showed complaints received had been documented and included the outcome and response to the complainant.

Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew it would be acted on.

The registered manager understood their responsibilities and demonstrated a commitment to provide quality care. Throughout our inspection visit the registered manager took action when issues and shortfalls were identified.

The registered manager worked with the local authority commissioners that monitor the service for people they funded to ensure people received care that was appropriate and safe.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.