We carried out an unannounced inspection of Selborne Court on 10 and 11 January 2019.

Selborne Court 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 20 older people in one adapted building. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have 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. A registered manager was in post at the time of our inspection.

At our previous inspection on 24 October 2017 we found the provider was not meeting the required standards. The provider had not fully implemented systems and processes to monitor the quality and safety of the service to drive improvement within the home. People did not always receive care and support in accordance with their wishes and we identified risks to people’s safety. There was a breach of the legal requirements and improvements were needed across the service. We rated the three key questions of ‘Safe’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. During this inspection visit we checked action taken. Sufficient improvement had been made to address the breach in the regulations and the key questions of ‘Safe’ and ‘Responsive’. Action was in progress to fully address improvement within the key question of well led. We rated the service to be ‘Good’ overall.

Quality monitoring systems had been introduced or improved to gather people’s views and drive improvement of the home. The provider had undertaken some meetings with people and staff. Audit processes had improved following the last inspection but some records did not demonstrate risks were managed well. This included recruitment records, medicine records, accident and incident analysis and health and safety records.

People has access to some social activities which they enjoyed and their religious needs were supported as appropriate. In response to people's feedback a new staff member was being recruited to increase social activity opportunities.

Staff had completed training to make sure they knew how to support people safely and people felt safe were suitably trained. Staff felt confident in their roles and understood their responsibilities. They had regular supervision meetings with the registered manager to assess any ongoing training and development needs.

People felt safe living at Selbourne Court and the atmosphere was relaxed and homely. Staff knew how to recognise signs of abuse and understood their responsibilities to report any concerns. Staff knew people well and knew how to manage risks to keep people safe. No safeguarding incidents had occurred since our last inspection. People knew who to speak with if they had any concerns. When concerns had been raised, they had been investigated and responded to.

The home was clean, and staff understood what was required of them to maintain good infection control within the home.

People were happy living at Selborne Court and were happy with the staff, care, and support they received. People were encouraged to have choice and control of their lives and to make decisions about their care. Staff treated people with kindness and knew what was i

We carried out an unannounced inspection of Selborne Court on 24 October 2017.

Selborne Court 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 20 older people in one adapted building. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have 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. A registered manager was in post at the time of our inspection.

At our previous inspection on 16 and 24 August 2016 we found the provider was not meeting the required standards. The provider did not have systems to monitor the quality of service people received. Records were not sufficiently detailed to demonstrate the care and support required and provided to people. We identified a breach of the legal requirements and found improvements were needed across the service. We rated the three key questions of ‘Effective’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Responsive and Well Led. They sent us details of what actions they proposed to take to address the improvements required. During this inspection we found improvements had not been sufficient. This meant for a third time the key questions of Responsive and Well Led required improvement. In addition we also found improvement was needed to another key question, Safe. The registered manager told us further improvements were planned.

Staff felt they had good communication with people and systems and processes to support the effective running of the home continued to be developed. The provider had arranged and undertaken some meetings with staff and people to gain their views of the service. However, these had not taken place regularly to help continually drive improvement of the home. A quality questionnaire had been developed to assess people’s views of the service but this was to be implemented.

People were happy with the care they received and there was a relaxed and homely atmosphere within the home. People said they felt safe at the home and staff knew how to recognise signs of abuse and understood their responsibilities to report any concerns. There had been no safeguarding incidents of concern that had occurred in the home.

Some people felt more could be done to support their interests and social care needs. This included opportunities to go on outside visits from the home. People had a choice of meals and mealtimes had been made more flexible to meet people’s preferences.

Care plans had been reviewed to make them more person centred and they contained detailed information to support staff in meeting people’s needs. These included risks associated with people’s care.

Staff had completed essential training such as moving and handling people and first aid to support them in their role. Staff were required to complete training on a regular basis to ensure their skills and knowledge was updated.

All the people we spoke with told us they were able to access a doctor if they needed one and records confirmed health professionals were contacted promptly when concerns were identified.

People received their medicines as prescribed and regular checks we

We carried out an unannounced inspection of Selborne Court on 16 and 24 August 2016.

Selborne Court provides personal care and accommodation for up to 20 older people. There were 17 people living at the home when we visited.

A requirement of the service’s registration is that they have 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. A registered manager was in post at the time of our inspection but they were not available during our visit.

At our previous inspection on 8 September 2015, we found the provider was not meeting the required standards. This was because people did not receive person centred care, it was not clear what staff training had been completed and some of the management processes were not effective in monitoring the quality of the care and services provided. As a result of the required standards not being met, there were two breaches of legal requirements. The impact this had on people who lived at Selborne Court meant we rated the key question of ‘Effective’, ‘Responsive’ and ‘Well Led’ as ‘Requires improvement’. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Selborne Court on our website at www.cqc.ork.uk.

As the provider had not complied with the required standards, we asked them to take the necessary actions to improve. Following our last inspection the provider sent us an action plan telling us how they were going to do this. During this inspection we checked to see if sufficient action had been taken to improve and address the breaches in the regulations. We found some improvements had been made but these were not sufficient in regards to management processes. Therefore there was a continued breach of the legal requirements. You can see what action we told the provider to take at the back of the full version of the report.

The provider did not have sufficient systems and processes in place to assure themselves that people living at the home received a consistent good quality service that met their needs. Quality monitoring systems had not been fully developed. People were not given opportunities to provide their opinions of the service and share their experiences. There was a lack of effective audit processes to ensure improvements to the service were identified and acted upon in a timely manner, for the benefit of people who lived there. Communication systems across the home were not always effective to ensure staff were kept up to date with issues relating to the operation of the home. Care records were not always clear to demonstrate risks associated with people’s care were being address effectively.

Some work had been undertaken to develop person centred care plans so that staff had clear information about people’s interests and personal preferences about how they wished their care to be delivered. However, we found this information was not always being used to deliver person centred care. For example, ensuring people’s interests were pursued and opportunities were made available to them in relation to their social care needs. Sometimes information gathered about people was not used to enhance their daily lives.

Action had been taken to increase the choices made available to people at mealtimes and people were positive about the food provided. Further improvements were planned in regards to menus and choices.

People received their medicines as prescribed and these were administered by care staff who had completed medicines training.

Staff had completed essential training such as moving and handling people and first aid to support them in their role. Training was completed by staff on an ongoing basis

We carried out an unannounced inspection of Selborne Court on 8 September 2015.

Selborne Court provides personal care and accommodation for up to 20 older people. There were 18 people living at the home when we visited.

A requirement of the service’s registration is that they have 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.’ A registered manager was in post at the time of our inspection.

We found people’s needs were not always met in accordance with their preferences. People’s care plans identified their care needs but they contained insufficient information to support staff in delivering person centred care. This meant people may not always receive care in accordance with their wishes. For example, some people stated they would like more social interaction and activities to be provided. We found there were limited opportunities for people to be involved in social activities and outings.

People were restricted in their choices to have a bath or shower because the showers had steps which meant most people could not access them. People had limited choices of meals because usually there was only one main meal provided each day. Staff did however say an alternative choice would be offered if a person did not like the meal provided.

Quality monitoring systems had not been developed to drive improvement within the home. For example, there were no meetings where people, relatives and staff could offer their opinions and views about issues related to the running of the home. People were not asked through satisfaction surveys if they were happy or unhappy about any elements of the care and services they received. Staff however told us that in their view there was effective communication between themselves and the people that lived there.

Systems and processes in the home had not been implemented in accordance with the current health and social care standards and regulations. Staff were also not fully aware of them and the provider had not ensured this had been addressed as part of their auditing processes.

People we spoke with were overall happy with the care they received and there was a relaxed and homely atmosphere within the home. People told us that staff respected their privacy and dignity when delivering care and we saw this happened. People were well dressed and staff took time to assist people with their personal care needs.

All the people we spoke with told us they felt safe at the home and nobody raised any concerns with us regarding their safety. Staff knew how to recognise abuse and told us they would report abuse if they observed this happening. There had been no safeguarding incidents that had occurred in the home.

Care staff told us they communicated any concerns in relation to people at the handover period between shifts so any risks to people’s health and welfare could be managed. There were some plans in place for staff to follow in the event of an emergency, such as a fire, to make sure people were kept safe.

The registered manager and staff had some understanding of the Mental Capacity Act 2005 (MCA). Staff were not fully clear on their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS) and how potential restrictions to people’s care should be identified and managed in particular for those people with dementia.

People received their medicines as prescribed and these were administered by care staff who had completed medicines training. Staff completed essential training such as moving and handling people on an ongoing basis but some of their training was due to be updated. People felt their care needs were being met by suitably trained staff.

All the people we spoke with told us if they needed a doctor the staff would make an appointment for them. We saw that health professionals visited the home to support people’s needs when needed. This included physiotherapists, chiropodists and opticians.

We found there were two breaches 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 the report.

We carried out this inspection on 9 December 2013 to follow up on non-compliance with record keeping that we identified during our visit on 30 July 2013.

We found sufficient improvements had been made to record keeping. Care plan records contained more detailed information and were being regularly reviewed to make sure they were accurate and up-to-date.

During our visit to Selborne Court we spoke with five of the 17 people living at the home. We also spent time sitting in the lounge observing what daily life was like for people. We saw that people watched television or read the newspapers. Sometimes people talked with one another. People in the lounge looked well cared for. During the afternoon we saw staff arranging to play dominoes with people who had expressed an interest in this.

People told us: “It’s very good.” “It’s quite good, it’s not perfect, but what is.” “It’s alright.” People told us their care needs were being sufficiently supported by staff and they felt safe living in the home. We saw that people felt at ease to approach staff and we saw staff were friendly in their approach to people.

We found people had a choice of meals and enjoyed the food provided.

Staff records showed appropriate recruitment checks had been carried out when they had been employed. This was to help ensure staff were deemed safe and suitable to work with vulnerable people living in the home.

The service had a complaints and safeguarding adult policy and procedure. People told us if they had any concerns about anything they would tell a member of staff or the manager. People told us they had no complaints.

We found that improvements were needed to record keeping.

During our visit to Selborne Court we spoke with three people living at the home. We also spent time sitting in the lounge observing what daily life was like for people. We saw that people were smiling and looked comfortable. People looked well cared for. We saw some people talking with one another and others reading the newspapers. We observed that some people were able to do things independently for themselves. During the afternoon we saw people playing cards and bingo.

People told us: “When I came here as soon as I walked through the gate I thought this is for me.” “Staff went through a list of what is wrong with you and asked what you can do. I am very independent.” “ We do pretty much what we like, it’s like being in your own home. I am quite content here.” “It is so nice, staff can’t do enough for you.”

We saw that staff knew people at the home well and spoke with them in a friendly, respectful way. Throughout the day we noticed that staff were prompt to attend to people’s requests. People we spoke with during our visit made positive comments about the staff team. They told us: “Fantastic all of them, I couldn’t fault any of them….they have got brilliant staff.” “Good, very good.”

We saw that meals looked appetising and people told us they were happy with the food provided. They commented: “The food is great.” “Brilliant, lamb today.”

We spoke with six people who live at the home and four visitors. We spent time observing the interactions between staff and those living at the home. People told us that "the food is good and everyone is nice." "I like it here, I am very comfortable, staff are all kind and the manager is great." Everyone spoken with said that the food was good.

Visitors spoken with were complimentary about the home, they said "the home is always clean and tidy." "The staff are all lovely, there is no problems at all." "I feel that XX is safe and happy."

The home was warm and clean on the day of our visit and no odours were noted. People commented about how pleased they are with their rooms and the lovely views of the gardens.

Some of the documentation including care plans and policies require updating to ensure that staff have all of the information they need to be able to do their job appropriately and safely.