2 Christchurch Court is registered to provide accommodation and personal care for up to 21 people who have an acquired brain injury. There were 11 people living at the home at the time of this inspection. At the last comprehensive inspection, in May 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to meet people’s needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to carry out their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager and deputy manager were positive role models in the home. People and other professionals told us that they had confidence in the manager’s ability to provide consistently high quality managerial oversight and leadership to the home.

We carried out an unannounced comprehensive inspection of this service on 12 May 2015. After that inspection we received concerns in relation to a lack of staffing, particularly at night, and concerns with how people’s medicines were handled. We also received concerns that new people were being accepted into the service that the staff could not meet their needs and concerns that people were not receiving the support and rehabilitation they required. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Christchurch Court – 2 Christchurch Road on our website at www.cqc.org.uk

This unannounced focussed inspection took place on 12 July 2016. This residential care home is registered to provide accommodation, personal care and treatment for disease, disorder and injury for up to 21 people. At the time of this inspection there were 15 people living at the home.

There was not 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. A manager had been recruited to role and it was planned they were commencing on 1 August 2016.

People were safely supported by staff. There were enough staff to meet people’s needs at night and call bells were answered quickly. The home had a backup system in place in the event additional staff were required.

People received their medicines efficiently. Staff understood how they were responsible for checking that people received the correct medicines at the correct time. Medicines were stored appropriately and people were able to receive medicines for pain relief when they required them.

People’s needs were fully assessed before they moved into the home. A pre admission procedure was in place and the deputy manager was able to decide if staff were able to meet people’s needs.

People were able to make progress and develop their life skills if they wished to and were able to. Staff were aware of how they could help and support people to make progress to their goals and supported people to achieve them.

This unannounced inspection took place on 12 May 2015. The home provides support for up to 21 people with acquired brain injuries or neurological conditions. The homes focus is on rehabilitation and people are supported by an integrated care pathway through all stages of the rehabilitation. At the time of the inspection there were 16 people living at the home.

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 were cared for by a multi-disciplinary staff team that knew them well and understood their needs and rehabilitation goals. There were robust and effective recruitment processes in place so that people were supported by staff of a suitable character. Staffing numbers were sufficient to meet the needs of the people who used the service and staff received regular and specialised training to meet the needs of the people they supported.

All grades of staff were knowledgeable about their roles and responsibilities and had the skills, knowledge and experience required to support people with their care and support needs. Medicines were stored and administered safely. People received their medicines when they needed them.

People were actively involved in decision about their care and support needs There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People received a detailed assessment of risk relating to their care and staff understood the measures they needed to take to manage and reduce the risks. People felt safe and there were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

Staff had good relationships with the people who lived at the home. Staff were aware of how to support people to raise concerns and complaints and the manager learnt from complaints and suggestions and made improvements to the service. The registered manager was visible and accessible. Staff and people living in the home were confident that issues would be addressed and the any concerns they had would be listen to.

The home is a ‘Headway approved provider’ and the manager engages with sharing good practice at conferences and has also been a speaker at some conferences.

During our inspection of Christchurch Court Limited we set out to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People told us that the environment was clean and homely and they felt safe living at the service. We found that health and safety checks had been carried out to make sure the premises and equipment used were safe for people using the service. We also found there were sufficient numbers of experienced and competent staff on duty to safely meet people's care needs.

Is the service effective?

We saw all the people’s care plans had been reviewed and the information was being recorded into a new care plan format, which was easy to understand. Staff told us that these plans were detailed and provided them with good information on how to meet people’s needs. The staff on duty had a good understanding of how to meet the needs of people who used the service.

Is the service caring?

All the people we spoke with told us that they liked living at the service. They told us that the staff were kind and supported them. One person said, “Staff are very nice, they listen and sort things out for me when I ask”. We observed staff spoke to people in a kind and dignified manner. The staff told us that they had team meetings and one to one meetings and felt listened to by management. They told us that they enjoyed working with people and they worked well as a team.

Is the service responsive?

The provider took action from the outcome of our last inspection visit. We saw that the environment had been improved to meet all the people’s needs. We saw that meetings took place with people using the service to listen to their views. Any suggestions made were acted upon by the staff. For example, one person said that they asked to go to the seaside and this was organised. Another person stated that their room was too warm and this was resolved by having a cooling fan.

Is the service well-led?

The provider had monitoring systems in place to ensure that health and safety checks were also undertaken regularly to ensure all systems were kept up to date to keep people safe. People’s care plans and risk assessments were being monitored and updated to meet their current needs. The service had a quality assurance system to obtain annual feedback from people who used services to monitor the quality of service provided.

During our inspection visit to 2 Christchurch Court, we spoke with nine people who used the service and many staff on duty. At the time of our inspection the provider did not have a registered manager in post. The deputy manager had been promoted to the acting manager’s position.

People expressed satisfaction with the care and support they received from the service. They told us that they received care from staff who were “kind and respectful”. One person said that they were treated with respect by staff and this included knocking on their door before they entered their room. We saw staff talk to people in a respectful manner and worked at their pace. Another person said that the staff listened to them and had good understanding about their condition and their needs. They also said that they received their medication at the right time.

People using the service told us that they felt safe living at the service. One person told us “I do make my own lunch and staff helps me” and we observed this on the day of the inspection visit. They also told us that they had an individual weekly activity programme to tell them what they were doing each day.

Most of the people using the service told us that they knew how to make a complaint. One person told us “I would tell my keyworker because they are nice and listen to me” Another person said “I would tell them in the residents meeting if I had any concerns and they listen and the advocate is good”. We saw that people’s meetings were held on a monthly basis at the service. We saw that health and safety, fire drill, people’s activity programmes, food menus, and in-house issues were being discussed at this meeting.

We found people received care that met their needs and that staff were appropriately trained and supported. We saw that the provider had a complaints system in place to ensure that any complaints raised were handled appropriately. We also found that the staffing levels had been increased to meet people’s needs. However, we found that the environment did not meet the needs of some of the people who used the service.

During the inspection visit, we spoke with five people who used the service and one visiting family member. We also spoke to the registered manager and seven care staff on duty.

Most of the people told us that they liked living at 2 Christchurch Road. They told us that they had resident’s meetings once a month to discuss activities, menus, and any other issues they wanted to discuss about the running of the home. They told us they were aware of the complaints procedure and knew how to make a complaint, if they were not happy. One person said “if you want to make a complaint, the staff takes you to the office and you can talk about this and they sort it out” Another person told us that they spoke to the advocacy service and told us that this information was displayed on the notice board.

People we spoke with told us that the food was very good and they said that they had two choices of meals. One person told us that the vegetarian option was also nice. They also told us that they were involved in planning their care and care staff spoke to them about their weekly activity programmes to help them meet their personal goals. For example a few people told us that they were learning to buy their own food and cook their own meals with support from staff.

People told us when they visited the home, they liked it and they wanted to come and live at the home. They told us that they do lots of activities with staff. One person told us “I do my own cooking” and staff support them with this. All the people said the staff were very nice and listened to them.

They told us that they had residents meetings and talked about menus, activities, holidays and anything they were not happy about in the home. They said they knew whom to talk to if they were not happy or wanted to make a complaint.