The inspection took place on 10 January 2017, and the visit was unannounced.

Welford Court provides residential care to older people including people recovering from mental health issues, sensory impairment and people who are living with dementia. Welford Court is registered to provide care for up to 14 people. At the time of our inspection there were 13 people living at the home.

A registered manager was 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 the last inspection of the service on 6 August 2014 we asked the provider to make improvements in how medicines were stored. We received an action plan from the provider which outlined the action they were going to take. This advised us of their plan to be compliant by November 2014. At this inspection we found that improvements had been made and medicines were stored appropriately

At the last inspection we also asked the provider to take action to ensure staff gained people’s consent prior to care being offered. We found that improvements had been made to how people were asked for their consent to care prior to their admission to the home. This was in addition to staff agreeing their actions prior to each caring intervention.

People were provided with a choice of meals that met their dietary needs. The catering staff were aware of people’s dietary needs, and sought people’s opinions about the menu choices in order to meet their individual dietary needs and preferences. A range of activities tailored to people’s interests were provided by staff and external professionals on a regular basis. Staff had had access to information and a good understanding of people’s care needs. People were able to maintain contact with family and friends and visitors were welcome without undue restrictions.

Relatives we spoke with were complimentary about the registered manager and staff, and the care offered to their relations. People were involved in the review of their care plan, and when appropriate their relatives were included. We observed staff positively interacted with people at lunch, where people were offered choices and their decisions were respected. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to peoples care and treatment and people were offered and attended routine health checks, with health professionals both in the home and externally.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.

Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance contractors to manage any emergency repairs. The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours if an equipment repair was necessary.

The provider carried out quality monitoring checks in the home supported by the registered manager and home’s staff. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals.

We received positive feedback from the staff from the local authority with regard to the care and services offered to people at Welford Court.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At the last inspection 22 May 2013 the service was found to be fully compliant with the regulations we looked at.

We inspected the service 6 August 2014. This was an unannounced inspection. Welford Court provides accommodation and personal care for up to 14 people with needs related to mental health, dementia and sensory impairment.

On the day of our visit there were 13 people living at the service There was a registered manager in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People who used the service were complimentary about the care and support they received. There were a range of activities provided to ensure that people were engaged in activities that were meaningful to them. Throughout our inspection we observed staff to be caring and attentive to people’s needs. Staff were respectful and demonstrated a good understanding of people’s needs.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found the provider had not acted in accordance with the DoLS legislation and had not made appropriate applications to the supervisory body.

People’s health and well-being was supported by staff arranging appointments with external healthcare professionals when required, such as a doctors . Staff communicated effectively with people who used the service and with their relatives where appropriate.

Risks associated with people’s needs such as malnutrition and risk of developing pressure sores had not been properly assessed.

People received their prescribed medicines safely and as prescribed by the doctor. Controlled medicines were not stored in accordance with legal requirements.

The provider did not carry out checks to assess and monitor the quality of service provision.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

We spent time with people who used the service and observed staff to be attentive to people’s needs. People were relaxed in their environment and spent some of their time engaged in activities on a one to one basis with the activity organiser. In the afternoon a number of people had an appointment with the visiting hairdresser which they spoke positively about.

We found people’s needs were identified within their care plan and that people’s health and welfare was monitored by staff and external health care practitioners.

We found people were served hot and cold drinks and snacks throughout the day. People were seen to eat and enjoy their lunchtime meal and were supported by staff where appropriate. The chef was aware of the specialist diets of people and people’s individual likes and dislikes.

We spoke with two people who were visiting people who used the service. They told us they were happy with the care and support provided by staff and that they felt informed about the persons needs and the care there relatives received. They told us they were made to feel welcome and were confident in the service provided.

People’s views and experiences were taken into account when planning and delivering people’s care and support. People at the home told us they were consulted regularly about daily activities. Resident meetings were held as regularly as possible to discuss general issues which, included menu planning and day trips. We spoke with seven people who when we asked about resident meetings told us “they always ask us for our views and what special trips we'd like.” “We all get to say where we want to go.”

It was difficult to talk with people however, People when asked about their views of the service told us, via staff or relatives: - “It’s a good place.” and “you can ask any time of the day if you need something and they get it for you.” One person also told us that they thought it comfortable and the staff were kind.

People who use the service told us staff were helpful and that they could talk to them. During the inspection we saw people approach the deputy manager and staff members seeking reassurance and assistance about aspects of their daily lives.

The people at the home enjoyed the games that the activities coordinator tried to encourage all people to join in (three days per week). She was good at involving individuals and groups depending on their preferences.

No negative comments were made by people living at the home. They expressed positive views about key aspects of care provided at the home. This included the home itself and the people who worked in it.

People who used the service told us that they were happy living at the home and that the staff looked after them well. One person said “I’ve lived here for a while now and I’m happy with the way things are.” Another person we spoke with told us “I’m happy here and the staff are nice.”

People we spoke with and visitors told us that they were happy with the care and support provided at Welford Court. They told us that staff were polite and courteous and that the service was relaxed and friendly.

People are encouraged to engage in a range of activities which helps them to keep mentally alert and physically active. People who live at Welford Court enjoy each others company and interact well with each other.

Staff have a good understanding of the needs of people and have an in depth knowledge about the people they care for which helps them to support and care for people well.