This inspection took place on 20 and 22 November 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

Allan Court is registered as a 'care home'. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide care for up to 60 people, some of which are living with dementia or have other mental health needs. At the time of the inspection, 57 people were living at the service.

We completed a full comprehensive inspection in April 2016 and rated the service ‘good’ overall.

At this inspection we found the service remained ‘good’ and met all the fundamental standards we inspected against. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. Full detailed findings can be found in the last inspection report.

The service had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like 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 understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Accidents and incidents were recorded, risk assessments were in place and appropriate health and safety checks were carried out.

Medicines were managed safely. Including arrangements for the safe administration, storage and disposal of medicines.

Enough staff were on duty to meet the needs of people who used the service. The provider continued to have a robust recruitment procedure in place and carried out suitable employment checks on the staff they employed. Staff were trained to meet people’s needs and received regular supervisions and appraisals.

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's dietary and hydration needs were met with a range of foods for people to choose from.

Discussions with people and staff confirmed that external health care professionals were involved should this be required.

Staff at the service ensured people were at the heart of their care and support. Staff and the management team were reported to be kind, caring and considerate. Staff treated people with dignity and respect and helped to maintain people’s independence where possible.

People’s needs were assessed before they came to live at the service and care plans were put in place to address individual needs.

Although we were not made aware of anyone who had reached the end of their life stage of care, staff told us they would work with healthcare providers to ensure people were well looked after.

People were protected from social isolation with various activities taking place, including trips out.

The service sought feedback on a regular basis and had received numerous positive comments and compliments. People told us they knew how to make a complaint if they needed to and a clear process was in place.

The provider had an effective quality assurance process in place which they were reviewing. Staff said they felt supported by the management team. We made one recommendation in relation to recording of provider visits.

The inspection took place on 12 and 13 April 2016 and was unannounced. This means the provider did not know we were coming. We last inspected Allan Court in July 2014. At that inspection we found the service was meeting the legal requirements in force at the time.

Allan Court is a care home with nursing that provides nursing and personal care for up to 60 people. The service is primarily for older people including people with dementia and there is a small unit for people with learning disabilities. At the time of our inspection there were 31 people living at the home.

The service had 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.

We found that care was provided in a safe, clean and suitably equipped environment. Risks to personal safety were assessed and managed to prevent people from being harmed. The service had established systems for protecting people from abuse and responded appropriately to any safeguarding concerns.

New staff were checked and vetted to make sure they were suitable to be employed at the home. There were enough skilled and experienced staff to ensure people received safe care and treatment. The staff team were given training and support that enabled them to effectively meet people’s needs.

Prescribed medicines were stored and administered safely by trained staff. People were supported to meet their health needs and access a range of health care services. Nutritional needs were monitored and specialist advice was sought when necessary. People were offered a varied diet with choices of meals and, where needed, were assisted with eating and drinking.

The service worked within the principles of mental capacity law. Formal processes were followed to act in people’s best interests when they were unable to give consent and make decisions about the care they received.

Staff had a good understanding of people’s needs and preferences and were caring and respectful in their approach. They treated people as individuals and supported them to make choices about their care. People and their relatives told us they were happy with the care provided at the home. Any complaints raised were taken seriously and promptly addressed.

Personalised care plans had been developed that were reviewed and adapted as people’s needs changed. Informative profiles were also in place which guided staff on what was important to each person and how they preferred to be supported. Daily activities were made available to help people meet their social needs.

The registered manager provided leadership and promoted an open and inclusive culture. People, their relatives, and staff were encouraged to express their views and feedback was acted on. Regular audits were undertaken to check and make improvements to the quality of the service.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found -

Is the service safe?

Issues in the environment had been addressed to ensure people’s safety and welfare was maintained.

Risks to people’s personal safety were managed to enable their care to be delivered safely. One person told us, “I’ve no concerns, everyone treats me very well”, and a relative said, “My parents are safe here”.

Staff were trained to protect vulnerable people from abuse and any allegations that people may have been harmed were responded to appropriately.

The home had suitable arrangements for supporting people with taking their prescribed medicines.

Is the service effective?

People’s care was well planned and checked at regular intervals to make sure it remained effective.

People living at the home, and their relatives, said they were happy with their care and support. They said, “The staff are brilliant with my husband and when I come in they tell me how he has been”, and, “I’m glad to be here, the carers and nurses are all very good”.

Is the service caring?

We found that care was planned according to people’s individual needs and wishes. People told us the staff were caring and this was confirmed by our observations. We saw that staff were attentive to people’s needs and encouraged them to be as independent as possible and do things at their own pace.

Is the service responsive?

People’s needs were fully assessed before they came to live at the home. Care records for people at the service were reviewed regularly to make sure that the information was accurate and up to date. We found that people’s care and treatment was monitored and adapted in response to any changes in their needs.

Is the service well-led?

The manager and staff had good understanding of the ethos of the service and their roles and responsibilities. Improved quality assurance processes were in place to check that standards were being maintained at the home. People and their families were asked to give their feedback on the quality of the service. They told us they were generally satisfied and had no complaints about the service they received.

We found action had been taken to maintain the home and carry out regular safety checks to ensure people were cared for in safe and suitable premises.

We spoke with five people who used the service and one relative. We asked people if they were asked for their consent to care and treatment. Comments included “Staff tell us what they are doing” and “They always ask my permission.”

We saw some of the rooms on the first floor did not have signs on to indicate the type of room. We found equipment had been stored in some of the bathrooms and a room containing hazardous equipment was unlocked.

We looked in the communal lounges and dining rooms and found they were clean. We looked at equipment such as hoists and shower chairs that were provided to help meet people's mobility needs. We saw this equipment was clean.

We found the first floor of the home had not been maintained to an appropriate standard. Safety checks on the fire alarms, call bell system and water systems were not up to date.

We spoke with four staff about staffing levels. They all said they thought there were sufficient staff throughout the home most of the time. Comments included “There’s enough to meet people’s needs”, “We have recently had increases in staff numbers” and “At times we are short staffed but we all help out and cover extra shifts.”

We found the provider had quality assurance systems in place to monitor the quality of care provision. We saw however, that these quality systems had not always been effective in addressing identified problems with the premises.

We spoke with ten people living at Allan Court. People were able to express their views freely and were involved in making decisions about their care. They told us their views and beliefs were respected and they were supported to do what they wanted. One person said, “Yes the Priest comes; you can have communion on a Wednesday if that’s what you want too.” Another person commented; “I like to go out and we do sometimes.”

We found people received the care they needed. The people we spoke with made positive comments about the care they received at the home. One comment was, ““They’re all nice lasses (the staff) and they’ll help.” Another person said, “They’ll do any mortal thing for you.” We observed people being cared for with dignity and respect. We saw staff promoting people’s independence. The atmosphere in the home was calm and relaxed.

We saw staff provide appropriate care, and were well informed about people’s preferences and needs. People told us they were happy with the staff who worked with them. One person stated; “The staff, they are brilliant.” Another person told us; “The staff are very helpful.”