This inspection took place on 9 August 2018, and was unannounced. At the last inspection on 1 March 2017, we rated the service as Requires Improvement. At this inspection we found the service had made improvements, however, further improvements were needed.

Darwin Court Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Darwin Court Care Centre accommodates up to 112 people in one adapted building. At the time of the inspection there were 100 people living in the care home.

There was a registered manager in post at the time of the inspection. 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.

Improvements were needed to ensure people had consistent access to staff at the times they needed support. Checks on the quality of the service provided to people were not always effective.

People were protected from abuse and risks to their safety were assessed, identified and managed appropriately. The home and equipment were maintained to minimise the risk of cross infection. The registered manager had systems in place to learn when things went wrong. People had their medicines as prescribed.

People’s needs were assessed and plans were in place to meet their needs. The home was adapted to meet people’s needs. Health care professional were involved in peoples care as required. Care was delivered consistently and we found staff newly appointed received an induction, had their competency checked and received regular updates to their training.

People had enough to eat and had a choice of meals. 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 received support from caring staff. People were supported to make choices and were supported to maintain their independence. People had their communication needs assessed and systems were in place to support them to communicate effectively. People were treated with dignity and respect.

People received support from staff that understood their needs and preferences. Staff understood how to provide end of their life. People understood how to complain and these were responded to.

People and their relatives had the opportunity to share their feedback. Staff felt supported by the management team.

This inspection was unannounced and took place on 1 March 2017. Darwin Court Care Centre is registered to provide accommodation and nursing care for up to 112 people. At the time of our inspection, 105 people were using the service. People lived in six separate units across four floors, which ranged from general nursing support to specific units for people who were living with dementia.

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.

We had previously inspected the home on 16 and 17 March 2016, when it was under a different provider. When the new provider took over the home, the management team and staff remained the same. This was our first inspection since the location had reregistered with us. We have referred to the previous inspection within this report.

At our last inspection, we told the provider to take action to make certain improvements. When people were not able to make certain decisions, the provider had not always acted in accordance with the guidance available. People were not always treated with dignity and respect, and records relating to the care of people were not always fit for purpose. The provider sent us an action plan stating how they would address these issues.

We had also found that improvements were needed to ensure people received consistent support from staff that knew them well to enable them to carry out their roles effectively. We also reported that improvements were needed to ensure that people received care that was individual to them and responsive to their needs, and that consistency in leadership was required across the units.

At this inspection, we found that the provider had made various improvements, but further improvements were still required. We had concerns that some people did not have their drinks monitored effectively and people gave mixed feedback about the meals. People were not always at the centre of the care they received and did not always have the opportunity to participate in stimulating activities.

People were safe receiving support from staff who understood how to protect people from harm. Risks were assessed, managed and reviewed to minimise potential harm. There were enough staff to meet people’s needs and keep them safe. The provider had safe recruitment processes in place and people’s medicines were managed to ensure they were protected from the risks associated with them.

Staff understood how to support people to make decisions, and when needed decisions were made in their best interests. Staff gained people’s consent before support was given and when people were restricted this was done lawfully. Staff were equipped with the knowledge and skills needed to carry out their roles. People were supported to maintain their physical health.

Staff knew people well and supported them in a dignified manner. Their privacy was respected and important relationships were maintained. People were involved with the planning of their care. They knew how to raise complaints and the provider acted on these in a timely manner.

There was effective management and leadership across the units and people’s care records reflected their needs. There was a positive culture within the service and people were actively encouraged to share their experiences and provide feedback. There were systems in place to assess, monitor and review the quality of the service. The provider used this information to drive continuous improvement.