This comprehensive inspection took place on 14 and 15 August 2017. The first day was unannounced. At the time of the inspection 59 people were receiving care and support. The service is registered to provide a service to a maximum of 62 people. It specialises in the care of those who live with dementia. 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.

During the inspection we followed up one legal requirement. This had been issued at the last inspection on 22 October 2016. This related to the maintenance of people’s care records in association with their nutritional risks. The provider submitted an action plan which told us how this legal requirement would be met and stating this would be fully met by the end of April 2017. At this inspection we found records pertaining to people’s nutritional risks had been improved and maintained well.

The arrangements in place helped to keep people safe. Risk assessments showed that risks to people’s health and well-being were assessed and managed. Staff were fully aware of what support they needed to provide people with in order to keep them safe. One relative told us they considered their relative to be safe. They said, “I know [name] is safe here and that [name] is not going to be ill-treated.” Relatives and people told us they were happy with the care provided. People were treated with dignity and respect. Comments referring to how well this was done were made by relatives on a website used to review the service.

Staff received training and support to be able to meet the needs of people who lived with dementia and challenging behaviour. Care was planned around people’s individual needs and their preferences. Relatives were supported to be involved in the planning and reviewing of their relatives care. They were encouraged to speak on behalf of their relative if their relative could no longer do this for themselves. Relatives were encouraged to provide staff with information about their relative’s lives. This information helped staff tailor people’s care and provide activities which were meaningful. The staff knew those they cared for well and had built up good relationships with family members. A relative told us that when they visited, staff always knew about their relative and were able to tell them what had been going on for that person. A review comment from the website we visited said, “You always seem to know [name].”

People health needs were assessed and met by nurses employed by the provider and other visiting health care professionals. The service had trained staff so that certain health needs could be met by staff in the care home. This sometimes avoided the need for unsettling visits to the GP surgery or hospital. Staff worked closely with GP’s, end of life specialists and the NHS rapid response teams to help achieve this. The principles of the Mental Capacity Act were followed. 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. Where people were deprived of their liberty this was done lawfully with authorised Deprivation of Liberty Safeguards in place or these having been applied for.

There were arrangements in place for complaints and areas of dissatisfaction to be expressed, listened to, investigated and resolved. There was an open and positive culture in place and senior management staff were keen to learn from and improve the service from the feedback they received. Relatives told us they felt comfortable in raising any concerns or areas of dissatisfaction they may have. They told us these were list

This inspection took place on 18, 20 and 22 October 2016 and was unannounced. It was carried out because we had received information about the service which was of concern. The service was last inspected on 7, 8 and 9 September 2015. At that point it had been opened for five months, had eighteen people living there and had been rated as overall ‘Good’. During this inspection the service was fully occupied with 62 people receiving care. The service specialises in the care of people who live with dementia and it employs nurses to care for people who are funded to receive ‘nursing’ care. The information of concern was explored during this inspection and we could not find evidence to substantiate these concerns.

We found records relating to people’s nutritional needs were not sufficiently maintained. This put people at risk of potentially not receiving safe or appropriate care and treatment due to a lack of accurate information held about their needs. This is a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see what action we told the provider to take at the back of the full version of the report. We did however observe people receive the support they needed to eat and drink and there was evidence to show that some people’s nutritional health had improved.

The registered manager had managed the service since October 2015. 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 and her senior management team had provided stability to the service. This team were now in a position to provide consistent and effective leadership to staff. They shared the same values, visions and expectations and these were communicated to the staff effectively. The provider had a quality monitoring system in place, which in places recorded detailed findings. The audit process had been effective in highlighting some gaps in practice and process but there was not always the evidence to show that the auditing process was fully completed.

Wentworth Court had been a previous care home which the current provider completely re-configured and extended. Existing areas of the building were complemented by the addition of areas of new build. People lived across two floors with the first floor being accessed by a passenger lift or stairs. Each person had their own bedroom which they could or were supported to personalise. Each bedroom had a private toilet and washing facilities [a wet room]. There were additional bathrooms and toilets which had been adapted to help those who required specialised equipment to bathe safely. Each floor had its own communal rooms where people sat, socialised and ate. The main reception area also offered a place to sit with an on-site café which was staffed on a regular basis. This provided an opportunity for family and friends to enjoy a coffee or tea with homemade cakes and pastries with their relative or friend. This facility was also open to and used by the local community. Leading off this was an outside court-yard style garden. People could sit inside and observe the seasons and the plants or they could enjoy the outside safely. In addition to this the main garden was fully enclosed. Major improvements to this had been carried in the last year. It provided people with another outside place to enjoy with relatives, friends and staff. Following the improvements this included raised plant borders, chickens and a large shed. The shed was a project specifically designed to provide men with activities that would be more meaningful to them.

The registered manager had managed the service since October 2015. A registered manager is a person who has registered with the Care Qualit

The inspection took place on 7, 8 and 11 September 2015 and was unannounced.

The service cares for older people who live with dementia. It can accommodate up to 63 people and at the time of the inspection 18 people lived at Wentworth Court. The service had only opened in May 2015.

We inspected this service at the time we did because we had received concerns about how it was managed. We had also been told that there were not enough staff on duty and staff had lacked appropriate training. We found the provider had been faced with having to find a new home manager eight weeks after the service had been registered with the Care Quality Commission. Interim arrangements had been made however these had not provided staff with the leadership they required. During this time the provider had appropriately used the resources they had to monitor the services performance. They had been proactive in making sure people remained safe and that the service remained compliant with relevant regulations.

At the time of the inspection the service did not have a registered manager. 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 service was managed by an acting manager who had been in position for two weeks, although this person had worked in the home for several months. They had the previous care home management experience which was required. Recruitment for a new home manager had been taking place since the last one left. The provider was at the point where they were ready to interview several candidates at the time of the inspection. Since the inspection a successful candidate was employed as the new home manager.

People were cared for by staff who were kind and compassionate and there were enough of them to meet people's needs. Staffing numbers were adjusted according to people’s needs and as the numbers of people using the service grew. Staff had received training and further improvements to the staff training programme were planned. New staff received the support they needed to learn and to improve their skills. Staff recruited processes helped protect people from those who may not be suitable to care for them.

People’s care needs were met and staff were proactive in making sure people’s health needs were addressed. This was despite the new service having some problems in developing working relationships with other health care professionals. Risks which could potentially affect people’s health and safety were identified and managed. People received their medicines safely and given the support needed to take them. People received help to maintain a healthy diet and where they needed help to eat their food and drink this was provided. People had opportunities to socialise and take part in activities. The staff were working hard at trying to make these more meaningful to individual people. Where people lacked mental capacity they were protected under the Mental Capacity Act 2005 because staff adhered to the Act’s code of practice.

In the absence of a permanent home manager the provider’s own quality monitoring systems had enabled them to remain fully aware of what was happening in the care home. They had been well informed of what shortfalls there were and what actions were needed to address these. They had then ensured these had been taken. The provider had remained open to people’s suggestions and had been transparent in their dealings of any concerns that had been raised with them. Although staff had lacked consistent leadership the service had remained well-led.