About the service: Silverpoint Court Residential Home provides personal care and accommodation for up to 36 older people, some of whom may be living with dementia. Accommodation is on three floors. There is a passenger lift to enable people to access the second and third floors. There is an accessible garden to the rear of the property, including an area for charging and storing mobility scooters. At the time of our inspection, there were 29 people using the service.

People’s experience of using this service:

Staff knew people well and were kind and sensitive to their needs. They treated people with dignity and respect and promoted their independence. Positive relationships had been formed between staff and people using the service.

Staff were recruited safely. There were enough staff to meet people's needs and people told us when they needed assistance, staff responded promptly. Risk assessments were in place to manage potential risks within people's lives, whilst also promoting their independence. People’s medicines were managed safely. Incidents and accidents were investigated and actions taken to prevent recurrence. Effective infection control processes were in place.

People's needs were assessed prior to them moving into the service to help ensure they were cared for and supported effectively. Staff knew people’s care and support needs. They had received relevant training, support and supervision to enable them to effectively fulfil their roles and responsibilities. People were provided with a nutritious and varied diet and they were complimentary about the quality and choice of food offered. Staff worked well with external professionals to promote people’s health and wellbeing. People had access to social activities and events.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The culture of the service was person-centred. The registered manager was visible around the home and staff had a clear understanding of their roles and responsibilities. People were encouraged to express their views on the service they received and be involved in the running of the service. There were effective quality assurance systems in place to drive continuous improvement.

More information is in the detailed findings below.

Rating at last inspection: Good (report published 21 December 2016)

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on the 1 December 2016 and was unannounced.

Silverpoint Court Residential Care Home is registered to provide accommodation with personal care for up to 36 older people, some of whom may be living with dementia related needs. There were 33 people receiving a service on the day of our inspection.

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.

At our last inspection we found the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010; Regulation 13 Management of Staff and Regulation 23 Supporting Staff. During our inspection we found improvements had been made in these areas and in accordance with the new regulations.

People told us the service was a safe place to live. The registered provider’s recruitment procedures ensured that only suitable staff were employed. People were supported by staff that had the skills and experience needed to provide effective care and there were enough staff to help keep people safe, meet their needs and protect them from harm and abuse. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

People’s capacity to consent had been assessed. The registered manager and staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff knew people very well and were kind and sensitive to their needs and ensured their privacy and dignity was respected. People told us they were happy with the care and support they received. People’s nutritional needs were met and people were supported to maintain a healthy and balanced diet. People received support to access health care professionals and services when required.

Where possible people and their families were involved in the planning and review of their care and support; care plans were person centred and were regularly reviewed. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. Staff shared information effectively which meant that any changes in people’s needs were responded to appropriately.

There were systems in place to regularly assess and monitor the quality of the service provided and people living and working in the service had the opportunity to say how they felt about the home and the service it provided. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced. This meant the provider knew we were going to inspect the service. The last inspection took place in January 2014, during which, we found there were no breaches in the regulations.

At our last inspection to the service on 11 July 2013, six out of seven outcomes were judged to be compliant.  A follow-up inspection was conducted in January 2014 to check that action had been taken to achieve compliance. The service was able to demonstrate that compliance had been achieved.

Silverpoint Court Residential Home is a purpose built care home that provides accommodation for up to 36 older people and older people living with dementia related care needs. At the time of our inspection there were 30 people living at the service.

Silverpoint Court Residential Home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of our inspection a registered manager was employed at the service.

Medication practices at the service were not robust and did not ensure that people’s medicines were managed safely.

People told us that they were happy with the care and support provided at the service. We saw that staff provided good levels of care and staff were able to demonstrate that they knew the needs of the people they supported.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that people who used the service had had their capacity to make day-to-day decisions formally assessed. Where appropriate, referrals to the supervisory body (Local Authority) had been made if people’s liberty had been restricted.

We found that appropriate systems were in place to ensure that there were sufficient numbers of suitable staff employed at the service. Arrangements were in place to ensure that newly employed staff received an induction and received opportunities for training. We found that staff had not received regular supervision or an annual appraisal in line with the service’s policy and procedure.

The care needs of people living at the service were assessed and recorded. Risk to people’s health and wellbeing were clearly identified so as to minimise these and ensure people’s safety. We found that people’s healthcare needs were considered and access to healthcare professionals provided where appropriate.

Our observations throughout our inspection showed that people’s privacy and dignity were respected and upheld.

Records viewed showed that the manager had responded to people’s complaints and concerns in line with the complaints procedure. We found that people had been listened to and the issues raised acted upon. People told us that they felt confident and able to raise issues.

We found that assessments for people considered to be at nutritional risk were recorded. We found that information relating to discussions with healthcare professionals and the reason for the decision making process were not always clear and robust.

The service was able to demonstrate that there were systems in place that assessed and monitored the quality of the service provided. The views of the people who used the service and relatives had been sought.

We found two breach's of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

On the day of our inspection we found the service to have a relaxed atmosphere. During the day we observed staff's interactions with people. These interactions took place both in communal areas and in people's individual rooms. Interactions were friendly and professional.

We found that the provider did not always document when someone lacked capacity and required decisions made for day to day activities, such as, being supported with taking medication.

We noted that the premises were free from unpleasant odours. Although there were some areas, such as trims on furniture, that were in need of repair or replacement these did not affect the safety of people using the premises.

People were protected against the risks of unsafe premises and equipment because the provider had systems in place to ensure the maintenance of both premises and equipment. We saw that the provider had a preventative maintenance plan, regular servicing contracts and responsive maintenance log for both moving and handling equipment, and premises systems, for example gas and electricity.

We saw that staff had been recruited using appropriate processes and checks such as interviews and uptake of references prior to a job offer. We found evidence that records relating to this; people's care; and other records relating to the running of the service were accurate and kept securely.

Staff said they feel supported, they receive training and regular updates to deliver individual care to the people that live in this home. During our visit we spoke with four people who lived in this home, some family members and staff. The people that lived here said; ‘’The home is excellent’’ and ‘’The staff are first class.’’ In relation to activities people using the service said ‘’I have been out on day trips’’ and ‘’I am not bored’’. People also said about the home that, ‘’It is very clean.’’

The relatives considered that the care delivered is excellent and they ‘’Cannot speak too highly of the carers’’. They also said they, ''Liked the atmosphere in the home, we are always offered a drink, we have eaten here and the food is lovely’’.

The staff we observed delivering care were kind and did not rush the people they were looking after. People who lived here had detailed risk assessments in place. Their care planning documentation is being updated to contain more detail and individual information.

Staff said they feel supported, they receive training and regular updates to deliver individual care to the people that live in this home.

People told us that they were happy living at Silverpoint Court. They told us that the staff were kind and caring, the food was excellent with plenty of choice and that there was plenty of activities to fill their time. People told us that they went out into the local community and told us of a recent trip to the local yacht club for lunch.

People told us that the environment was lovely and that they had good views of the sea from some of the rooms. People said that they were consulted on how the home was run and that they had been fully involved in writing their care plans. People said that the home was always clean and fresh.