Court House is registered to provide accommodation for people who require personal care. The service provides care and support for 29 people; some people are living with dementia. This inspection took place on 1 and 30 March 2017 and was unannounced. There were 24 people living at the service at the time of the inspection. Court House is the main building with an attached annexe; there is also a separate building called The Cottage. The Cottage has its own sitting and dining room, and a kitchen that can be used by the people living there. The Cottage, which is based in the grounds of the care home accommodates six people.

We last inspected Court House on 11 and 15 July 2016; the overall rating for the service was ‘good’. We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 relating to the management of medicines and identified areas for improvement. The registered manager had produced an action plan to ensure improvements were made and sustained. At this inspection, we found that improvements had been made and the breach was met.

People said they felt safe and secure living at the home. They were positive about their relationships with staff and each other, for example, “I find it very nice, I am very happy here.”

People were protected from potential abuse and avoidable harm. Staff had undertaken safeguarding adults training and understood their responsibility to reports concerns immediately. There were sufficient numbers of suitable staff available at all times to meet people's individual needs.

Since the last inspection, the registered manager had resigned. The providers were present on both days of the inspection and advised us they had appointed a new manager. By the second day of inspection, the new manager was in post and had already taken action to address issues that had been identified for improvement on first day of the inspection. The provider and the manager told us after an induction period, the aim was for the manager to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Court House was run by providers who worked closely with staff and the manager. Through investment they showed an on-going commitment to improve the experience of people living and working at the home, including refurbishment. Further improvements had been made to the garden and the home continued to be refurbished and updated in an on-going commitment to improving the experience of people living and working there. Staff praised the team work and how they were supported to carry out their job. They respected people’s choices and valued people as individuals knowing when to change their approach based on their knowledge of the person.

The manager was spending time to get to know staff and people living at the home and had already begun to instigate changes based on feedback. The manager was getting to people living at the home and they were establishing relationships with them and gaining the confidence of staff. People said concerns or complaints would be listened to and acted upon. People were offered a choice of meals. They were supported with their health needs and had access to health professionals, when necessary.

There were gaps in recruitment information from 2016, which had not been identified by the providers but was addressed during the inspection. The new manager showed they were clear about the steps needed to make recruitment practices more robust. They confirmed requests for key pieces of recruitment information were now their remit and their practice and records demonstrated their experience in this role. Work was also completed during the inspection to ensure r

Say when the inspection took place and whether the inspection was announced or unannounced. Where relevant, describe any breaches of legal requirements at your last inspection, and if so whether improvements have been made to meet the relevant requirement(s).

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

N.B. If there is or should be a registered manager include this statement to describe what a registered manager is:

‘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.’

Give a summary of your findings for the service, highlighting what the service does well and drawing attention to areas where improvements could be made. Where a breach of regulation has been identified, summarise, in plain English, how the provider was not meeting the requirements of the law and state ‘You can see what action we told the provider to take at the back of the full version of the report.’ Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work at there.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was unannounced and took place on 5 and 6 November 2014. Twenty people were living at the home. This is the first inspection since the providers registered with the Care Quality Commission (CQC) in September 2014. The inspection was brought forward in response to some information of concern CQC received about low staffing numbers for the number and needs of people living at the service and people being unhappy with their care.

Court House Residential Home is registered to provide accommodation for up to 23 people requiring personal care. A new manager had been recruited by the providers a week before the inspection started; they are not yet registered with the CQC. 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.

No-one living at the home was currently subject to a Deprivation of Liberty Safeguards. The provider understood when an application should be made and how to submit one but advised this had not yet taken place for four people. They were aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests, although the provider recognised records needed to be improved to show how best interest decisions had been reached. The MCA provides the legal framework to assess people’s capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant.

The new manager and the provider had begun to identify where improvements were needed in staff recruitment, medication management, care planning and record keeping. They had already started to instigate some new ways of working. They recognised time was needed to establish effective quality assurance processes to include regular supervision and audits of the service. But they also recognised further training was also needed to support a change of approach for caring for people living with dementia.

People living at the home were positive about their care and the support they received from staff. This included having their medication provided on time. They told us staff listened to them and they could make choices about their daily routine. Most people felt there were enough staff on duty to meet their social and care needs. People were satisfied with the standard of cleanliness and the quality of the food. The overall view of visitors to the home was that people were cared for by helpful staff. External health professionals told us the staff managed risks to people’s health well and followed advice.

Staff were positive about the appointment of the new manager and told us the manager had the right skills to support them.

There was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 because suitable arrangements were not in place to obtain, and act in accordance with, the consent of people living at the home. You can see what action we told the provider to take at the back of the full version of this report.