This inspection took place on 6 September 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

St Peters Court is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Peters Court accommodates a maximum of 40 older people, including people who live with dementia or a dementia related condition, in one adapted building. At the time of inspection 37 people were using the service.

At our last inspection in May 2016 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. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us they were safe and were well cared for. Staff knew about safeguarding vulnerable adults procedures. Staff were subject to robust recruitment checks. Arrangements for managing people’s medicines were safe.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People told us staff were very kind and caring and they felt comfortable with all the staff who supported them.

Appropriate training was provided and staff were supervised and supported. People were able to make choices about aspects of their daily lives. They 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.

Menus were varied and a choice was offered at each mealtime. Staff supported people who required help to eat and drink and special diets were catered for. A variety of activities and entertainment was available for people.

People and staff spoke very well of the registered manager and they said the service had good leadership. There were effective systems to enable people to raise complaints, and to assess and monitor the quality of the service. People told us they would feel confident to speak to staff about any concerns if they needed to. The provider undertook a range of audits to check on the quality of care provided. These methods included feedback from people receiving care.

Further information is in the detailed findings below.

The unannounced inspection took place on 1 March 2016. We last inspected St Peters Court in June 2014 when we found the service was meeting the regulations that we inspected.

St Peters Court provides residential care for up to 40 people, some of whom are living with dementia. At the time of our inspection there were 32 people living at the service.

The service had 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.

Staff at the service managed people’s medicines safely and kept them stored in appropriate arrangements. The provider had just introduced a new electronic means of managing medicines at the service, which included automatic ordering and the use of scanning equipment to record when people had taken their medicines.

People told us they felt safe and that their belongings were protected too. Staff were able to explain their safeguarding responsibilities and there were procedures in place to support them, should they need to contact professionals in relation to this.

Emergency procedures were in place and monitored by staff at the service. Accidents and incidents were recorded and checked for any learning to try and ensure the same accident did not happen again.

People told us there were enough staff at the service to support them and we confirmed this through viewing staff rotas and from our own observations. Call bells were answered within acceptable timescales and staff were able to sit and talk with people in an unhurried manner.

The premises was well maintained, suitably designed for people’s needs and kept clean and tidy. Fresh flowers were displayed throughout the service with fruit available for people to eat.

People enjoyed the food and refreshments that were prepared and staff helped those that needed support to ensure their nutritional and hydration needs were met. On the day of the inspection, people that wanted one, enjoyed a ‘99’ ice cream from an ice-cream van that called.

Staff received suitable training to help them support people appropriately. They told us they were well supported and received regular supervision and appraisal from their line manager. Safe recruitment practices were in place to ensure that suitable staff were employed at the service. Once employed, new staff completed a planned induction programme.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. DoLS applications to the local authority had been made for them to authorise in line with legal requirements.

All of the people we talked with, and their relatives spoke highly of the staff and how well they cared for them. Relatives told us they always felt welcome. Staff had good relationships with people, they responded with a gentle and kind manner when people were distressed. For example, those that were living with dementia. Healthcare professionals reported that the staff were caring.

Staff respected people’s privacy. They knocked on the door and waited for permission before entering people’s bedrooms. They spoke to people with respect and addressed them politely.

People and their relatives told us they knew how to complain and would feel comfortable in doing so. People were able to make choices and participated in a wide range of activities. Staff encouraged and supported everyone to maintain social and f

At the time of the inspection there were 34 people living at the home. Due to their health conditions and needs not all people were able to share their views about the service they received. During our visit we spoke with five people who used the service and observed their experiences. We spoke with the registered manager, the deputy manager, six care staff, five relatives and two visiting social work professionals.

We considered all the evidence we had gathered under the regulations we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we have found.

Is the service safe?

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We saw risk assessments had been completed for people who were assessed as being at risk of falls.

We saw people were safe and protected from abuse. Staff demonstrated to us an understanding of the types of abuse and how they should be reported. All staff had received training in the safeguarding of vulnerable adults and whistleblowing.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw policies and procedures were in place and the manager and deputy manager had received training in the Mental Capacity Act 2005 (MCA) and DoLS.

We saw there were sufficient members of suitably qualified and experienced staff on duty to meet people’s needs.

Is the service effective?

People were treated with respect and dignity. People who used the service were asked about the support they received and if they understood their rights. They were given the information they needed to make an informed decision about their care.

People we spoke to were aware of their rights and what to do if there were any problems. One person told us, “I understand my rights. I can do anything I want”.

Is the service caring?

People's preferences, interests and needs were recorded in people’s care records. Staff were able to give examples of these when we spoke to them and displayed a good knowledge of the people living at the home and what their likes or dislikes were.

People's health and care needs were assessed with them and they were involved in this process.

People we spoke with were positive about the care they received from the service.

One person who used the service said, "It is very nice here. The girls (staff) are lovely to me."

Is the service responsive?

There was an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.

We saw evidence that care staff identified changes in people's needs and acted to make sure they received the care they needed. For example, there was evidence that where one person's health had declined an immediate referral was made to the correct medical professional for advice and support.

Is the service well led?

We saw there was a registered manager in post. Staff told us they would immediately report any concerns they had about poor practice and were confident these would be addressed. People's views were gathered and listened to. The service had a quality assurance system in place that included the use of surveys from people who used the service.

People told us they were consulted about their care and asked for their consent before they received care and treatment. Where appropriate we found the provider acted in accordance with legal requirements where people did not have the capacity to consent themselves. Comments included, "They always ask me if I want to take my tablets" and "I do need help but I like to do some things for myself, like getting washed at the sink, so they always ask me."

We found that people's care and support needs were appropriately planned and their individual care needs were met. People said the staff were very caring, looked after them well and they enjoyed living at St Peters Court. Comments included, "We are one big happy family," "It's champion living here" and "The staff are great, nothing is a bother."

The premises were clean and comfortable and there were systems in place to ensure they were safe and well maintained.

There were systems in place to help ensure appropriate staff were recruited to care for the people who used the service.

There was an effective procedure in place for dealing with complaints. People were given support to make a comment or complaint where they needed assistance. People said they knew how to make a complaint if they needed to. Comments included, "There is no need to complain about anything here" and "I have never had to complain because it's great."

People told us what it was like to live at this home and described how they were

treated by staff and their involvement in making choices about their care. They

also told us about the quality and choice of food and drink available. This was

because this inspection was part of a themed inspection programme to assess

whether older people living in care homes are treated with dignity and respect

and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an "expert by

experience" (people who have experience of using services and who can provide

that perspective) and a practising professional.