This inspection took place on 17 April 2018 and was unannounced.

The 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. The service provides accommodation with nursing care for up to 36 people.

At the time of the inspection there were 23 people living at the home.

At our last inspection in June 2016 we rated the service good. At this inspection we found the service remained good.

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 felt safe living at the home. The way in which staff were deployed meant people’s needs were met in a timely and unhurried manner. People’s medicines were managed and administered in a safe way by staff who had been trained to carry out the task. People were protected from the risk of harm or abuse because the provider had effective systems in place which were understood and followed by staff. People were protected from the risk of the spread of infection.

People continued to receive effective care. People were supported by staff who were trained and competent in their roles. People’s health care needs were monitored and met. 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.

People were supported by kind and caring staff who took time to get to know people and what was important to them. Staff treated people with respect and respected their right to privacy. People lived in an environment which was welcoming and homely.

People were involved in planning and reviewing the care they received which helped to ensure people received a service which met their needs and preferences. There were daily activities for people which they could choose to join in with. Complaints were taken seriously and responded to. People’s religious and cultural needs were understood and met by staff.

The provider had effective systems in place to monitor and improve the quality of the service provided. People’s views were valued and any suggestions for improvement were responded to.

The inspection was carried out on 8 June 2016 and was unannounced.

The Court is registered to provide accommodation with nursing care for up to a maximum of 36 people. There were 30 people living at the home on the day of our inspection.

There was a manager in post who was present during our inspection. The manager was in the process of applying to become registered manager for the service. 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 felt safe living at the home as staff were available to support them when needed. People received care and support from staff who were knowledgeable about the different signs of abuse and who to report concerns to. Staff were aware of the risks associated with people’s individual needs and took appropriate measures to minimise these.

People felt that there were enough staff to meet their needs safely. The manager monitored staffing levels and ensured that staff had the skills and knowledge to support people safely. Staff felt well supported and had received training relevant to their role. The provider completed employment checks on prospective new employees prior to then starting work to make sure they were safe to work with people.

People were supported to take their medicines when they needed them. Medicines were stored and disposed of safely. Staff received regular competency assessment checks to ensure the ongoing safe management of medicines. Staff monitored people’s health and supported them to see healthcare professionals as and when required.

People were encouraged and supported to be involved in decisions about their care and treatment. Staff sought people’s consent before supporting them and respected their wishes when they declined support. Where people were unable to make decisions for themselves these were made in their best interest to protect their human rights.

People were offered a choice of what they liked to eat and drink. Drinks and snacks were readily available to people and their visitors. People’s nutritional needs were routinely assessed, monitored and reviewed. Where needed staff supported people to eat and drink.

Staff had formed effective working relationships with people and their relatives. People were given choice and felt listened to. People and their relatives found staff caring and welcoming. Staff promoted people’s dignity and independence. People received care and support that was tailored to their needs and were able to choose how they spent their time.

People, their relatives and staff found the manager approachable and fair. They were confident should they have any concerns these would be dealt with appropriately. People, relatives and staff were asked their opinions about the service and felt listened to. The provider had a range of checks in place to monitor the quality and safety of the service. They used the information gathered to drive improvements in the service.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We spoke with five people who lived at the home who confirmed that they felt safe and protected. One person said, “I feel safe, the staff do look after you well.” Care staff had access to care plans. These provided staff with information about people’s care needs and how to meet them. The staff we spoke with demonstrated a good understanding about the individual’s care and treatment needs and how to support them. This meant that people could be confident that their needs would be met.

Discussions with people who lived at the home confirmed that they were provided with support to take their prescribed medicines. We saw that medication systems and practices were appropriate to ensure the safe management of medicines.

Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people living in the home were protected from avoidable harm, abuse and breaches of their human rights.

Is the service effective?

The people we spoke with said that they were happy with the care and treatment they had received. One person said, “The staff are extremely friendly and are quick to respond when you need them.”

People told us that the meals provided were good. We saw that care records contained a nutritional assessment. This told staff about the support the individual required to eat sufficient amounts.

Is the service caring?

One person told us, “The staff always ask if there is anything that I need, they are very good.” A number of people who lived at the home had complex healthcare needs and were receiving end of life care. We saw that care staff were attentive to people’s care needs. Staff were aware of the importance of people having a dignified, comfortable and pain free end of life. We saw that people were made comfortable in their bed. People were repositioned whilst in bed to reduce the risk of pressure sores. We saw that records were maintained to show when these tasks had been carried out.

The care records showed that people had access to other healthcare services for routine health screening. This was also confirmed by the people we spoke with. This meant that people’s physical and mental health care needs would be met.

Is the service responsive?

The people we spoke with said they had never made a complaint. One person said, “I would speak with the staff or the manager if I had any concerns.” The complaints procedure was displayed in the home. Information about how to make a complaint was also identified in the service user guide. We saw that a record was maintained of complaints and showed what action had been taken to resolve the concern and to improve services. This meant that people could be confident that their complaints would be listened to and acted on.

Is the service well-led?

One person who lived at the home said, “The manager is very friendly and always ask me if I am happy with the care.” Discussions with the registered manager confirmed that they had a sound understanding of the individual’s specific care needs.

The registered manager informed us that regular meetings were carried out with people who lived at the home. This was also confirmed by the people we spoke with. Access to these meetings gave people the opportunity to have a say in the way the home was run.

The provider had an effective quality assurance monitoring system in place. Quality audits were carried out to ensure people received appropriate care and treatment. For example, we saw audits to ensure the safe management of medicines and that people received their prescribed treatment. An audit was also in place to ensure care records contained accurate information to reflect people's care needs.

We talked with some of the people who lived in this home and they said that they were well looked after. They said the staff always asked them how they would like things to be done. They said staff were always mindful of their privacy and treated them with respect.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, “I’m very content” and another said, “The staff are very kind”.

The provider had developed a system whereby they can monitor how well the home was meeting the needs of the people who live there.

We visited this home on 29 May 2012.

People who lived in the home, as well as some of their relatives, told us that the staff had explained to them what care and treatment they would be receiving. They also told us that the home had carried out satisfaction surveys where they could give their views on how well the home was meeting their needs and where improvements could be made.

Some of the people who were living in the home said that there are regular meetings of all of the people who live there where they can raise and discuss any issues that are affecting the care that they are receiving.

People told that there was a range of activities available for them to take part in should they wish to.

People told us that they had a range of meals that they could choose from and that it was well prepared and presented. One of the people told us “The food is excellent.”

We also talked to a number of people who were visiting their friends or relatives. They said that the home had always made them feel welcome.

The people who live in this home told us that they felt able to raise any issues about which they had concerns with the manager or one of the staff. They also said that they feel safe living in this home. They were very complimentary about the people who work in the home saying such things as “Very kind staff”.