We undertook an unannounced focused inspection of Warmley Court on 19 June 2018. This inspection was carried out to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on11 October 2017 had been made.

One inspector inspected the service against two of the five questions we ask about services. These were; is the service safe? and is it well led? This was because the service was not meeting a legal requirement at our last inspection. Specifically the provider’s system of quality auditing was not effective. It had not identified a medicines recording shortfall that could have put a person at risk.

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Warmly Court is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Warmly Court care home accommodates 10 people with an acquired brain injury in one adapted building.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

There was a 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 told us staff were caring towards them. We also saw that the staff we met were kind caring and respectful towards everyone who lived at the home. This conveyed that people felt safe at the home and with the staff who supported them. People were protected from abuse and the risks from avoidable harm. This was because staff were properly trained and knew how to keep people safe.

The provider’s system for the management of people’s medicines ensured they were looked after properly. Where people wanted to they were supported to be responsible for their own medicines.

There was a quality system in place to properly monitor and check the quality of the service. Audits demonstrated that regular quality checks were completed in relation to the safety and quality of the service. Audits identified medicines recording shortfalls and these were promptly addressed.

The quality checking system in place for auditing and monitoring quality and safety was now being used much more effectively. Failing and shortfalls in the service in relation to medicines, and other areas were swiftly picked up and addressed.

Warmley Court provides accommodation and personal care for up to 10 people with an acquired brain injury. At the time of our inspection 10 people were using the service

This inspection took place on 11 October 2017. The inspection was unannounced, this meant the staff and provider did not know we would be visiting.

At the last inspection in May 2015 the service was rated ‘Good’.

At this inspection we found that overall the service remained ‘Good’.

There was no 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. Since our last inspection a registered manager had been appointed and left their position. The provider had appointed a new manager who was in the process of applying to the Commission to register as manager.

The quality auditing systems had not identified one occasion where the medicine administration records had not been fully completed. This had not been identified by staff administering medicines on subsequent days or, by the auditing systems operated by the manager.

People shared some frustration with us regarding the accommodation. They felt repairs and maintenance of the building was not always carried out in a timely manner. They also told us they had identified alterations to increase their independence with the provider but had not been informed of when these would be completed.

There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability to care for vulnerable people. Staff understood their role and responsibilities to keep people safe from harm. Individual risks were assessed and plans put in place to keep people safe.

Staff received regular supervision and the training needed to meet people’s needs. The service complied with the requirements of the Mental Capacity Act 2005 (MCA). Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. People had access to the food and drink they chose when they wanted it.

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The care and support people received was individualised. They were offered a range of activities both at the service and in the local community.

There was a clear management structure in place. The manager and other senior staff were well liked and respected by people and staff. The vision, values and culture of the service were understood by all staff. During our inspection we noted the complimentary skills, knowledge and experience of the management team and, were assured by this in addition to their passion and commitment to work towards providing high quality person centred care.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

On the 20 September 2013 we carried out a visit to follow up improvements we had asked the home to make following an inspection in March 2013. We found that the home had done a lot of work to ensure that improvements had been made.

Since May 2013, the home had recruited more care staff and existing staff had remained. One new care worker told us they really enjoyed working at the home and felt that it was "a really great team to work in".

During our visit we spoke with two people about their experience of living at the home. They were both very positive, stating that staff were really good and they felt respected and safe. One person told us that it was a lot calmer in the home.

During the day we observed six people who lived in the home go about their daily tasks and activities. We saw that there were positive interactions between staff and people, with jokes and friendly banter. The home had a relaxed and calm atmosphere at all times. We saw that care staff were attentive to people and were aware of the how they liked things to be done. People were given choices about what they wanted to do and we saw that staff responded in a pro-active way when one person expressed a wish to do something else.

The provider had made revisions to risk assessments, care plans and behavioural support plans in order to provide more detailed guidance for staff to more fully support people in their care.

At the time of our visit only one person was able to discuss their care with us. We looked at care records of other people and talked to staff about their care needs.

We saw that people were comfortable and relaxed with the staff and had access to all the communal areas of the home. People were able to help themselves to food or drink in the kitchen with staff support.

We spoke to all three of the staff on duty during our visit.

Warmley Court is a care home registered to accommodate up to 10 people with an acquired brain injury. At the time of our inspection seven people were using the service.

This inspection was unannounced and took place on 28 and 29 May 2015.

There was no registered manager in post when we carried out our inspection. 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 provider had recently appointed a manager who had commenced on 6 May 2015. The manager was present throughout our inspection and had already applied to CQC to become the registered manager.

People were safe because the manager and staff team understood their role and responsibilities to keep people safe from harm. Staff knew how to raise any concerns regarding people’s safety. People were supported to take appropriate risks and promote their independence. Risks were assessed and individual plans put in plans to protect people from harm. People were protected from the risks associated with medicines because the provider had clear systems in place and staff had received the appropriate training. Employment checks were carried out on staff before they started work to assess their suitability.

People were provided with effective care and support. Staff had received the appropriate training to meet people’s needs. The service complied with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were supported to eat and drink to maintain an appropriate body weight and remain hydrated. Arrangements were made for people to see their GP and other healthcare professionals when they needed to do so.

People received a service that was caring. They were looked after by care staff who were familiar with their needs and wishes. People were involved in making decisions about how they wanted to be looked after and how they spent their time. People had positive relationships with the staff caring for them. Staff treated people with dignity and respect.

People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The manager and senior staff provided good leadership and management. The vision and culture of the service was clearly communicated. The quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.