The inspection took place on 4 April 2018 and was unannounced.

Sun Court Nursing Home is a ‘care home’ with nursing. 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.

Sun Court Nursing Home provides accommodation and nursing care to a maximum of 29 people. At the time of the inspection 27 people were living at the home.

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. The registered manager was on leave at the time of the inspection, but we met with the registered providers and deputy manager.

At our last comprehensive inspection on 20 August and 1 September 2016 we found that the service was not meeting the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider was in breach of the regulations for good governance. Following the inspection, the provider sent us an action plan telling us how they would make the improvements needed. During this inspection the service demonstrated to us that improvements had been made and is no longer in breach of the regulation.

Improvements included use of an external auditing company and the ground floor clinic room, described in the previous inspection report as the ‘nurse’s station’, was now partitioned off with a concertina door to improve security of medicines related paperwork, and longer term the service planned to install a permanent structure to separate this area from the main hallway.

Since the last inspection, greater emphasis has been placed on safe storage of people's records, with use of wall fixed document holders to enable care plans to be stored in people’s bedrooms rather than in communal areas, as identified during the last inspection.

Each person had detailed risk assessments and care plans in place, including personalised evacuation plans and management of individual risks such as skin care and swallowing risks.

Staffing levels reflected the use of a dependency tool, identifying the need for higher staffing levels in the morning to complete personal care routines.

Staff approach and people’s records demonstrated adherence to the Mental Capacity Act and Deprivation of Liberty Safeguards.

People had choice of food and fluids, with value placed on nutrition and food quality.

Staff treated people with care and compassion, and took pride in their caring roles. Staff understood how to identify and report safeguarding concerns.

People accessed activities in the local community, maintained their spiritual wellbeing and spent time with relatives and friends.

People and their relatives knew how to make a complaint, and were encouraged to give feedback to the manager and providers.

The service provided a good standard of care to people who required support with complex health needs and those approaching the end of their life.

The service had governance processes in place for monitoring standards and quality of care provided, this included completion of regular clinical audits in areas such as medicines management and infection prevention control. The provider encouraged people and their relatives to give feedback on the service, and areas of improvement.

This inspection took place on 20 August and 01 September 2016 and was unannounced.

Sun Court Nursing Home provides accommodation and nursing care to a maximum of 29 people. At the time of our inspection 27 people were living in the home.

There was 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.

At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to related to the governance of the service. The provider was already aware of shortfalls in the quality monitoring systems in the home and had started to make changes. However, these were not sufficiently advanced at the time of this inspection visit. We also found that confidential information was not always secured.

You can see what action we told the provider to take at the back of the full version of this report.

Risks specific to individuals were well managed. However, personalised evacuation plans were required. There were enough staff available to ensure that people’s needs were met.

People were offered choices about what to eat and drink and specific dietary needs were catered for. People were caringly and respectfully supported to eat their meals as necessary.

Staff cared for and treated people with kindness, respect and interest. Their views about their care arrangements, life in the home and what was happening in the wider world were sought and discussed.

People were supported to participate in events happening in the community and people were able to raise concerns if necessary.

Staff enjoyed working at the service and felt valued by the management team.

The service provided a good standard of care to people who required support with complex health needs and those approaching the end of their life.

Sun Court Nursing Home could accommodate up to 29 people, the provider told us that they did not view their service as a specialist dementia care home. This was because they did not normally take people whose primary need was dementia. On the day of our inspection 27 people were residing in service, of these, one person had a primary and five people had a secondary diagnosis of dementia.

During this inspection we met 15 people, including those with dementia residing in the service, two relatives and six staff members which included the manager. The providers were also available throughout our inspection. We also left a comment box at the service for a week. This provided another forum for the people who used, worked or had contact with the service to share their views with us on the level of service being provided. Comments were received from five people. One person commented that, during the period their next of kin lived in the service, that their, “Care during the whole period and in particular over the last year has been beyond criticism.”

All the people we spoke with were happy with the care they received. One person told us, “I am happy and contented.” Another person described the staff as, “Friendly and helpful.”

People told us that the service was well led. Relatives told us that the staff and management communicated with them well. They felt staff fully involved them in any decisions and would listen and act on any information given. They told us they were made to feel welcome and were supported by staff as they watched their relative’s dementia progress. One person’s relative told us, how staff not only supported their next of kin’s, “Increasing dementia needs,” but provided emotional support for them on the, “Days when (person) does not know me.”

People were protected from harm because their individual risks had been assessed and managed. Where we identified during our inspection, that the unlocked front door could provide a security risk, the providers were quick to respond and address the situation. Staff received training in dementia which enabled them to provide safe and professional care.

Care records showed that staff were responsive to changes in people’s needs. We saw that health and social care professionals were consulted with, and staff worked with other providers to ensure people received the right care at the right time.

The manager had an effective way of monitoring and assessing the service provided to people. People told us they felt safe, listened to and were involved in the decisions regarding their care and the running of Sun Court Nursing Home.

During this inspection visit on 11 June 2012 we spent some of the time listening, asking questions and observing the interactions between the staff and people who lived at the home.

Throughout the day, we saw positive signs from those people who were living with complex needs and unable to verbally communicate, such as relaxed expressions, smiles when interacting with staff, appropriate tactility through hand massage and passive exercise and activities that were enjoyed.

We spoke with five people, four members of staff and four visitors as well as both proprietors and manager. We checked care plans and a random selection of records and policies.

All five people told us they were "Happy with the support they received".

Two people told us about the care plan notes held in their rooms and how the staff members use these notes to know their personal care requirements.

The staff team, we were told, were good and do the job required. One person told us "The staff are very kind and patient, a lot of them have worked here for a long time so I know most of them.