This was an unannounced comprehensive inspection that took place on 17 October 2016. Douglas Court is a care home registered to provide accommodation for up to 43 older people. The service is located on two floors. Each person had their own individual room. The home had two communal lounges and dining rooms as well as a smaller lounge and sensory lounge. At the time of this inspection there were 30 people using the service.

The service had a manager who was in the process of becoming registered with the CQC and had submitted an application. 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.

At our last inspection on 21 January 2014 we found that the service was in breach of Regulation 13 management of medicines and regulation 21 requirements relating to workers of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010 which following legislative changes of 1 April 2015 corresponds to Regulation 12 safe care and treatment and Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements. We received an action plan from the provider in which they explained how they would make improvements. At this inspection we found that improvements had been made and the service was meeting these requirements.

We have made a recommendation about the deployment of staff. Some people said that at times staff were not visible in one of the lounges and we saw that this was the case for part of the morning in one of the lounges. One person said that this had recently improved. For the previous three months there had been an average of 10 accidents or incidents a month. Many of these were un-witnessed falls.

People were protected from the risk of harm at the service because staff knew how to recognise abuse and what action to take if they suspected abuse or had a concern. Risks to people's well-being had been assessed and action plans were in place. Pre- employment checks had been carried out to assess staff character and suitability to work at the service.

Routine maintenance and safety checks were carried out on the building and equipment used. Staff knew what action to take in the event of an emergency such as a fire or an accident.

People's medicines were managed safely and were given to them in accordance with their prescriptions.

Staff received appropriate support through training and supervision and had their practice observed and assessed. There was an on-going training programme to provide and update staff on safe ways of working.

There was a choice at each meal time and people had enough to eat and drink. People were supported to maintain a balanced diet and risk of malnutrition was assessed and managed. People had access to healthcare services and could see a doctor, community nurse or other professional as required.

People were supported in line with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We found that appropriate assessments of capacity had been completed and DoLS applications had been made. People were asked for their consent before receiving care and support.

Staff supported people in a kind and compassionate way. People had their dignity and privacy protected. Staff knew the things that were important to people and their individual preferences. People were supported to be as independent as they could be.

People said they would feel comfortable making a complaint and felt sure they would be listened to and action would be taken.

People had confidence in the manager and said they were approachable. Staff felt supported by the management team. People and their relatives were asked for their feedback abou

There were 43 people using the service at the time of our inspection visit. We spoke with ten people using the service, eight visitors and four staff. Following the inspection visit we spoke with a health and social care professional.

People using the service and their visitors told us that they were happy with the care and services provided at Douglas Court. Comments included “It can’t be faulted here, the staff, the food and everything is good" and “It’s got a homely atmosphere, we know all the staff and there’s good communication between staff and residents.”

During the inspection visit we observed that staff were responsive to people’s needs and wishes.

We saw that people's needs were assessed, and care plans were in place. This meant people received support in a way that met their needs.

The majority of the people we spoke with told us they enjoyed their meals. People also said that they received enough to eat and drink.

People were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Robust recruitment procedures were not in place to safeguard people who used the service.

Procedures were in place for managing complaints about the service. People, who use the service, told us they had no complaints about the service and felt safe at Douglas Court.

One visitor told us that their relative had initially been to stay at the home for respite care and now was at the home to stay permanently. The visitor told us how their relative was well cared for and that “it’s a lovely place."

Visitors said they were happy with the service provided. One visitor told us “so far I am pleased with the support my relative receives, the staff have been marvellous.”

Visitors told us they are contacted by the home if there have been any changes in their relatives health needs.

We spoke with four people living at the service. They all told us they were being supported well by the staff and they enjoyed living at Douglas Court. Comments included “it’s great here, I’m not going no where” and “I like living here, it’s not as good as being at home, but its close.”

People told us they enjoyed the meals provided and there was always plenty to eat. People stated “the food is very good,” “meals are varied” and “I like the food.”

People told us the entertainment provided was excellent. Comments included “there is always something happening”, “it’s the Halloween party tomorrow, we always have a party”, “singers come to the home and I like to take part.”

People told us they were able to raise concerns about care and support with the staff team. Comments included “I have no reason to complain, but would speak to the manager if anything was bothering me.”

People told us that care staff involved them in their care, treatment and support programme. They told us that they received input and treatment from other health care professionals such as general practitioners, opticians, chiropodists and specialist nurses.

People who used the service and their relatives, told us that they were encouraged to participate in a good range of social activities within the home.

People told us that they felt safe in the homes environment. They also thought the staff had the right qualifications, skills and knowledge to perform their duties safely.

People who used the service and their relatives told us that they were provided with the opportunity to comment on the quality of service provision at residents meetings and within quality assurance processes.

The following pages detail our findings and our regulatory judgement for each essential standard and outcome that we reviewed, linked to specific regulated activities where appropriate.