The inspection took place on 21 and 22 June 2016 and was unannounced. We had previously inspected the service in August 2014 and found no breaches of regulations in the standards inspected.

Dove Court is a 32 bed residential care home, 30 people lived there when we visited. It provides accommodation with personal care to older people but does not provide nursing care.

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.

People consistently told us about the excellent care they received. People mattered, staff were patient, and they demonstrated empathy in their conversations with people and in how they spoke about them. The service had received numerous compliments and an award for their caring ethos.

Staff developed exceptionally positive caring and compassionate relationships with people. The ethos of the home was that of an extended family. People were treated with dignity and respect and staff were caring and compassionate towards them. Staff had signed up to the national ‘Dignity in care’ initiative and were committed to taking action, to uphold the ten good practice steps to demonstrate compassion and respect for people. Staff knew each person as an individual and what mattered to them. Consistently positive feedback from people and relatives meant Dove Court had received a top 20 care home award from the care homes association for the past two consecutive years. People having end of life care were kept peaceful, and pain free.

People, relatives and professionals consistently gave us positive feedback about how the service was personalised to meet people’s individual needs. Staff supported people with communication difficulties in innovative ways. Staff knew each person as an individual, their preferences and interests. The home had a wide range of activities suited to the individual needs of people which brought pleasure to their lives which enhanced people’s health and wellbeing. People were part of their local community and participated in local events. People’s wellbeing had improved because staff and volunteers had befriended and engaged with people in ways that prevented them becoming isolated. Comments included, “He is so happy now that he has people to talk to and activities to join in with” and “ She has a new lease for living which is so good to see.”

People experienced effective care and support that promoted their health and wellbeing from staff that had the knowledge and skills needed to carry out their role. People were supported by enough skilled staff so their care and support could be provided at a time and pace convenient for them. Each person’s needs were assessed and care records had personalised information about how to meet them. Care was focused on people’s wishes and preferences and people were supported to remain active and independent. People praised the quality of food, and were offered a well-balanced diet. Health and social care professionals gave us positive feedback about the care and support of people.

People were supported to express their views and were involved in decision making about their care and were offered day to day choices. Staff sought people’s consent for care and treatment and ensured they were supported to make as many decisions as possible. Staff confidently used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, capacity relatives, friends and relevant professionals were involved in best interest decision making.

People said they felt safe living at the home. Staff were aware of signs of abuse and knew how to report concerns; any concerns reported were investigated. A robust recr

Our inspection team was made up of a single inspector. We considered all the evidence we had gathered under the outcomes we had inspected. We used the information to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people using the service, staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that the managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. The home had proper policies and procedures in relation to the Mental Capacity Act 2005, and the Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people were safeguarded.

Recruitment practice was safe and thorough for example the provider and Registered Manager asked for advance checks to be performed on all staff prior to an offer of employment being made.. No staff had been subject to a disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's healthcare needs were assessed with them but they were not always involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Some people said they had been involved in writing them and said that care plans reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, “The staff are very nice and help me a lot, I don’t know how I would have coped without them”. People were treated with dignity and respect by the staff.

People using the service, their relatives, friends and other professionals involved with the service completed bi-annual satisfaction surveys. Where shortfalls or concerns were raised these had been addressed.

People’s preferences, interests, aspirations and diverse needs had been recorded and care support had been provided in accordance with people's wishes.

Is the service responsive?

People regularly completed a range of activities in the home. Most people enjoyed the entertainment and trips out. All people were offered the choice of outings but some declined.

The service responded well to peoples changing health care needs. The home had good working relationships with local GP's and district nursing teams and plans of care were well documented and person cantered.

People knew how to make a complaint if they were unhappy. No one we spoke to felt the need to make a complaint as they were very happy with the service they received. We looked at how complaints had been dealt with and found that the responses had been open, thorough and timely. People could therefore be assured that complaints were investigated and action was taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure that people received the best care that could be provided.

The service had a quality assurance system that frequently asked for feedback from friends, family and people using the service to assess the quality of care being provided. Records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving. Staff told us they were clear about their roles and responsibilities.

There were 28 people living at Dove Court when we visited. We spoke with 10 people to ask them about the care and treatment provided. One person said, “staff are very kind”, another person said, “you haven’t got to worry about a thing” and a third person said, “they look after me very well”. One person who was confined to their room because of ill health told us how much they appreciated regular visits by the activity co-ordinator who chats with them and listens to music with them. Everyone we spoke with praised the quality of food and choices available at the home.

We looked at the care records for three people who lived at the home. We spoke with nine staff and asked them about how various aspects of people’s care needs were met.

We found people experienced safe and appropriate care and were supported to keep healthy and well nourished. People were safe because their surroundings were adapted to provide safe access and suitable equipment was available meet individual people’s needs. We saw that people’s comments and complaints were listened to and acted on.

We found the home was compliant with the five essential standards we inspected.

We (The Care Quality Commission) carried out an unannounced visit to Dove Court on 19 June 2012. At our previous visit in January 2012, we identified some problems in relation to the care records, cleanliness of some bathroom areas and in quality monitoring systems. We followed these up at this visit and found that improvements had been made.

On the day we visited, there were 23 people living at the home, one of whom was in hospital. We spoke to 13 people about their experiences of living at the home and one relative who visited daily. We looked in detail at the care given to three people who lived in the home, we talked to them, looked at their care records and discussed with care workers how they met those people’s needs. We spoke to seven staff in total, four care workers, kitchen and domestic staff and the general manager.

One person said ‘I feel safe and happy here’, another said ‘I am being well looked after’. A third person who had previously lived in another home commented ’as homes go, you couldn’t improve on it’. One member of staff we spoke to said ‘Dove Court is the best home I’ve worked in’, another said there was ‘good team work and a friendly atmosphere’ in the home.

People we spoke with confirmed that care workers involved them in making decisions about their care and respected their wishes. We observed that care workers treated people with dignity and respect.

We looked at systems for recruiting staff and found that all the required checks were made to ensure vulnerable people were protected from unsuitable workers.

The provider was compliant with the five essential standards of quality and care we inspected.

We (The Care Quality Commission) carried out an unannounced visit to Dove Court on 10 January 2012. On the day we visited, there were 29 people living at the home. We spoke to ten people who lived there about their experiences of living at the home, one person we met was unable to give us feedback because of communication difficulties but we observed staff interactions with them. We looked in detail at the care of three people who lived at the home, talked to those people, looked at their care records and discussed with care workers how they met those people’s needs. We spoke to eight staff in total, four care workers, two members of the kitchen and domestic staff, the registered manager, general manager and the provider.

We found that people were offered choices and were involved in decisions about their care and their privacy and dignity is respected. People we spoke with confirmed that care workers involved them in discussions about their care and respected their wishes. We observed that care workers respected people’s privacy and people told us they were given choices about food and how they spend their time. Group activities were provided for those who chose to participate in them. Individual activities were also provided to meet the needs and preferences of people confined to their rooms.

We identified some problems in relation to the quality and consistency of care records kept. For example, we found that one person admitted two and a half weeks previously did not have any care plans about their care needs. A second person had no care plan written about the need to encourage them to drink fluids regularly and monitor their fluid intake and their fluid chart and other daily records seen were poorly maintained which put them at risk of dehydration. We found other inconsistencies in the quality of daily record keeping, which put people at increased risk of not having their care needs met.

People who lived at Dove Court were protected from abuse because care workers were knowledgeable about the signs of abuse and knew the appropriate steps to take in response to suspected abuse. The systems for managing monies safeguarded people from financial abuse.

The communal areas and furniture seen around the home were clean and the home smelt fresh and odour free in all areas. However, there were inadequate systems for preventing the spread of infection because equipment is not cleaned adequately and access to hand washing facilities was limited in some areas of the home.

People we spoke to thought staff were appropriately trained for the work they do. Good opportunities for training and development were seen for care workers. They have regular training updates and were supported by an annual appraisal and by regular supervision.

The service has a range of systems in place to monitor quality and check that the health, welfare and safety needs of people who receive care. However, the quality of care records and infection control suggested the monitoring of these areas is inadequate and needs improvement.