Victoria Court is a residential care home for 40 people who are elderly and some people were living with dementia. The home is arranged over three floors. Each floor has bedrooms, with shared bathrooms and dinning space. A number of rooms have ensuite facilities and kitchenettes. The ground floor has a large lounge area with a bar and a quiet space sectioned off with a reading area. At the time of the inspection 33 people were using the service.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ . 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.

The service continued to keep people safe. Staff had received training and knew how to keep people safe from harm. Risk assessments had been completed and there was guidance to reduce any risks. There were sufficient staff to support people’s needs and be responded to in a timely manner. Medicines were managed safety and people were supported to remain independent in this area if they wished. Measures were taken to reduce the risk of infection and lessons had been learnt from events.

The service continues to be effective. People were able to make choices about their day. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The staff had received training for their role and felt able to implement the skills they had acquired. People’s health had been maintained and their wellbeing promoted. The atmosphere was homely and people could personalise their bedrooms.

People received Good care. The home provided a feeling of person-centred culture, with people at the heart of the care being delivered. All the people we spoke with said the care they received was individual, caring and compassionate. Staff promoted peoples independence and had the opportunity to develop relationships with people and family members .People’s dignity was respected and support offered when required to support people’s decisions. People spiritual needs had been supported, along with different methods of communication.

The service continues to be responsive. People were supported in accordance to their needs and preferences. Care plans provided details covering all aspects of the person’s needs. When people required support, this was available. Things of interest were available and people enjoyed the activities offered and were able to contribute to the ongoing programme of events. There was a complaint’s policy which had been followed when concerns had been raised.

The service continues to be welled. There was a registered manager who understood their registration. Staff felt supported and people had been consulted about the home. Improvements were on going and were supported by a range of audits and methods to identify how the home can continue to develop. A range of professionals had been involved in the service to develop good partnerships.

Further information is in the detailed findings below

We carried out this inspection to see if the provider had made improvements since our last inspection in February 2013. At that time we had concerns about the standard of care and welfare experienced by people who use the service and how the provider managed medicines.

At our last inspection people told us they were happy with the care they received, that they received their medication when required and had not experienced problems with their medication. We saw evidence that confirmed this.

At our visit we spoke with a group of six people. They told us they had given their written agreement for the home to retain and administer their medicines on their behalf and said these were given to them when required.

All confirmed that staff, were usually available to provide the care and support they needed. Although they felt that staff, were often very busy and not always able to spend as much time with them as they would like.’ Three people spoke about arrangements to recruit additional staff, including team leaders, which they were pleased about.

They all agreed that staff were respectful and maintained their dignity and privacy. One person said, ‘They know how to help me.’

We asked them to tell us about some of the ways they were consulted with about the care and services they received. One person told us, ‘We have regular meetings.’ Another person said, ‘We sometimes have questionnaires asking us what we think and there is a comments book in the dining room for meals.

They also said that minutes of meetings held with them, were put on their notice board. They gave us some examples of matters recently discussed with them in those meetings. These included staffing arrangements, meals and activities. One person said there was a complaints procedure.

At our visit we spoke at length with five people accommodated in the home. All said their rights to privacy, choice, dignity and respect were usually upheld. Feedback they gave, together with our observations, told us they were mostly well supported and consulted with about their individual care, treatment and daily living arrangements.

They told us they were provided with a range of written information about the service, to assist and inform them. Each gave examples for the latter, which included for meals, making complaints and suggestions, activities arrangements, what to do in the event of a fire, newsletters and minutes of meetings held with them. They also gave examples of ways in which they were consulted, such as individual discussions with their key worker, surveys and meetings held with them.

All said that for the most part they received the care and support they needed and were always able to access relevant outside health and social care professionals. However, all expressed concerns that staffing levels were not always sufficient. They gave us some examples of their perceived impact from this on their daily living arrangements. These included, waiting times for assistance, their observations of staff morale and reduced access to the local community.

One person said, ‘Staff work hard and I am comfortable here, but there are not always enough on duty.’ Another person said, ‘There are usually activities we can join, but there is not as much choice as there used to be. Staff, are too busy.’ Another said the same as the latter and also told us, ‘I do enjoy the garden, visiting library and some of the quizzes and games nights.’ ‘I try not to ring for assistance if I can help it, because I know the staff, have more than enough to do.’

A group of three people told us that food provided was, ‘OK,’ ‘Satisfactory,’ and ‘It’s quite sufficient. Menus show alternatives that are always available to request in advance.’ Another person told us they came into the home three times each week to each lunch with their friend living there, which they enjoyed.

The same five people referred to above said the home was usually kept fresh and clean, comfortable and well maintained. One person told us, ‘I am very satisfied with my room. I chose the colour scheme when it was redecorated and I have plenty of room here for my own things.’

This inspection was unannounced and took place on 5 and 6 January 2016. The service was registered to provide accommodation for 40 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 36 people were using the service. Our last inspection took place in June 2013 and at that time we found the provider was meeting the regulations.

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 and their visitors told us that this was a warm and friendly place to live. The manager made people feel comfortable and familiar with their surroundings and this helped people settle in the home. All the staff were passionate about providing a service that met people’s needs People, relatives and visiting professionals could not speak highly enough about the support and care that was given. People we spoke with told us they received care which was compassionate, kind and respectful. The management team used a range of different methods to give support and guide staff to enable people to be as independent as possible. People were supported to make choices and to take ‘risks’ in their daily lives. Any risks were identified and assessed and kept to a minimum, to avoid any restriction on the person doing what they wanted. Staff had received training in the Mental Capacity Act 2005 and they were able to explain how they applied this to support people to make decisions. Safeguarding procedures were in place to keep people safe from harm. People felt safe living at the home and if they had any concerns, they were confident these would be addressed quickly by the management team. Staff had been recruited using clear guidance and staff received core training and more specialists training, so they had the skills and knowledge to meet people’s specific needs. The service offered a choice of meals and people could decide where they wished to have their meals. Staff were trained in the safe administration of medicines and kept records that were accurate. People were encouraged and supported to take their medicines themselves if they wanted to. There were sufficient staff to support people’s needs and the provider maintained a clear audit on the staff numbers in relation to the support of the people using the home. People were offered opportunities to join an activity which reflected their own interests and hobbies. Staff spent quality time with people to give them emotional support and comfort. Staff reminisced with people about their life and discussed what was happening in the world. There were strong links with the local community and people’s independence was encouraged. We observed the staff used the care records to reflect a personal approach to ensure people received the care in the way they wished. The provider had a notice board which provided a broad range of information about the service, covering forthcoming events and other information relating the home. There was a complaints procedure and any complaints that had been received, had been dealt with efficiently. The manager had an open door approach and knew the people within the home and was able to provide clear guidance to the staff on how to support people. The provider had sought formal feedback and acted on requests received to improve quality. There were regular audits on a range of areas to ensure the quality of the care was maintained and improved.