The inspection was unannounced and took place on 16 August 2017. At our previous comprehensive inspection in April 2015, we found that the service was not always effective. This was because the staff had not received training in epilepsy awareness and mental capacity assessments were not carried out for some people who might lack capacity. This could put people at risk of not receiving appropriate care. Following that inspection the provider sent us their action plans on how to make improvements. We then carried out a follow up inspection in November 2015 and found that the required improvements had been made. We found that staff had received epilepsy training and mental capacity assessments had been completed for people.

Emerson Court is registered to provide accommodation for persons who require personal care for 21 older people, some of whom have dementia. At the time of the inspection, there were 21 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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.

We found that people were not always safe at the service. This was because the registered manager did not have enough staff to provide safe care, especially at mealtimes. We made a recommendation that the registered manager adopts best practice guidelines for reviewing and deploying the staffing level to ensure people were safely supported at all times.

The service had a robust staff recruitment process which ensured that staff were employed only after they had been checked they were safe to work with people. Staff had also attended a range of training programmes related to their roles. We found that they were aware of how to protect people from abuse. Staff had knowledge of the Mental Capacity Act 2005 and could be confident that they were provided with regular support and supervision.

People's assessment of needs was completed before they moved in to the service. This ensured that their care needs and preferences were identified and met at the service. There were systems in place to allow people and, as appropriate, their relatives to be involved in the development and review of the care plans.

Staff knew how to ensure people's privacy was protected. We also found that staff were polite, friendly and supported people to be as independent as possible. Each person had a risk assessment which identified possible risks and provided staff with guidance so that they knew how to manage the risks. We found staff were caring, respectful to people, and knew how to deal with safeguarding incidents.

Medicines were safely stored and administered as prescribed by staff who had received training. The service also ensured that people's healthcare needs were reviewed and they had access to healthcare. People and relatives were satisfied with the variety and amount of food provided at the service.

The management of the service was open and transparent with people, relatives and staff having easy access to the deputy managers and registered manager. We also noted that the registered manager actively sought feedback and used the views of people, relatives and staff to improve the quality of the service.

At the last inspection on 28 April 2015 we found the service was not always effective. We found staff had not received training in epilepsy and mental capacity assessments were not carried out for some people who might lack capacity. We stated that this could put people at risk of not receiving appropriate care.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Emerson Court on our website at www.cqc.org.uk.

Emerson Court is a privately owned care home without nursing for 21 older people. The service is registered to accommodate a maximum of 21 people. At the time of this inspection there were 18 people using the service and one person was in a hospital.The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

People told us staff were good and they were happy living at the home. We observed staff were kind and attentive to people's needs. Staff told us they had a range of training opportunities and were well supported by the registered manager and deputy manager.

Each person had a care plan and risk assessment which were reviewed and updated regularly. We noted people and their representatives were involved in the review of care plans. This ensured that people's wishes were included in their care plans. Records showed people had access to appropriate healthcare and staff had guidance that they were advised to follow to care for people with medical conditions such as epilepsy.

The service had systems in place so that the requirements of the Mental Capacity Act 2005 were implemented when required. This legislation protects people who lack capacity to make informed decisions in their lives. We noted that best interest meetings had taken place and Deprivation of Liberty Safeguards (DoLS) applications made to authorities as required. DoLS applications are authorised to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

This unannounced inspection took place on 28 April 2015. The service was last inspected on 8 September 2015 and was meeting all regulations inspected.

Emerson Court is a privately owned care home without nursing for 21 older people. The service is registered to accommodate a maximum of 21 people. At the time of the inspection there were 18 people using the service and one person was in a hospital.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

Staff received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training. Deprivation of Liberty Safeguards is where a person can be lawfully deprived of their liberties where it is deemed to be in their best interests or for their own safety. Staff were aware that on occasions this was necessary. We saw that DoLS were in place for some people to keep them safe.

We found that staff had not received training in epilepsy and mental capacity assessments were not carried out for some people might lack capacity. This could put people at risk of not receiving appropriate care.

Staff were vetted before starting work at the home. We noted staff were caring and had received a range of training programmes. We observed staff explain to people what they were doing, for example when administering medicines. We noted that people could choose their meals and decide where and when to have them. This showed that staff respected people’s decisions.

People told us that they felt safe in the home. They said staff were always available when they needed them. They told us staff responded to their needs. We noted that people were involved in their assessments of needs and review of care plans. Risk assessments were reviewed and action put in place to ensure risks such as falls were minimised.

People had access to healthcare services and received ongoing healthcare support. For example, people had healthcare checks and attended appointments with opticians and dentists. Referrals were also made to other healthcare professionals when and as needed. This showed that there were systems in place to monitor and respond to people’s healthcare needs.

A single inspector carried out this inspection. During the inspection we spoke with three people who used the service. We spoke with the manager, a senior care worker, two other care workers and relatives/visitors. We reviewed the care records for three people and reviewed a selection of other records, including audits, staff files, policies and procedures.

We considered all the evidence we had gathered under the outcomes inspected. We used the information to answer the five key 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.

Is the service safe?

Risk assessments of people had been documented in their care records together with guidance on action to take to protect people. There was documented evidence that staff had been provided with essential training such as first aid and health and safety to enable them to care for people safely.

Staff received training and guidance regarding the requirements of the Mental Capacity Act (MCA) 2005. The manager demonstrated to us their knowledge of the Deprivation of Liberty Safeguards (DoLS) and the MCA requirements. No recent applications had been submitted.

We checked the premises during our inspection and found it provided a safe and suitable environment for good care to be delivered.

Staff and volunteers had been suitably checked and the provider had an effective and robust recruitment procedure in place.

Is the service effective?

Feedback from people who used the service was limited due to the nature of their dementia. We spoke with relatives and visitors who indicated the service was effective and responsive to the needs of people. One person said, "Everything is good here." One relative said, "The staff are great." People's care needs had been assessed with the help of their relatives and/or representatives. Their choices and preferences were documented and staff we spoke with were aware of these. One staff member said, "We try to accommodate their wishes." This enabled staff to respond effectively when caring for people. Care plans had been prepared in detail. These were up to date and were regularly reviewed.

Is the service caring?

We saw feedback from relatives of people who used the service, which indicated the staff were caring and kind. We observed the staff treating people with respect and dignity. A relative wrote, "This place is always cheerful."

Is the service responsive?

The manager informed us the provision of services and care was regularly reviewed and if there were problems or suggestions made, they would respond. When we needed information regarding the care provided and the management of the service, this was promptly provided by all the staff.

Is the service well-led?

The staff who were present during the inspection were knowledgeable regarding their roles and responsibilities. There were arrangements for monitoring the quality of care provided. The senior care worker said they had been given good support and plenty of training to do the job. Staff were aware of the policies and procedures in place.

The provider had ensured people who used the service were given safe and effective care. People's needs had been assessed and a care plan developed to meet their individual needs. Care plans were updated when people's needs changed to ensure they were appropriate. A relative told us 'their health has really improved since they came here.' People had been asked to give their consent to their care plan. They told us the service met their individual needs. One person said 'if you want something they sort it out for you.'

The provider had made sure equipment in the service was suitable and that people received their medicines safely. In March 2013 we were concerned that the provider did not have suitable arrangements to ensure staff received professional development, supervision and appraisal. On this visit we found staff were well supported and received a regular appraisal.

People using the service and their relatives were very positive about the service. One person said "it's a very good place with good staff." People said they had a choice about how their care and support was provided. We found that people were receiving safe care and observed that staff were attentive to individual needs. A relative said "the staff seem to sense when someone needs a little chat." We observed that the premises were clean and bright and the provider told us that there had been recent improvements to the decor and wiring at the home. We were concerned that the provider did not have suitable arrangements to ensure staff received professional development, supervision and appraisal and have asked them to take action on this.

People using the service informed us that they were happy living at the home and that they liked the staff team. A relative spoken to said, ‘I am not going to get any better. I am very happy with the service and they do provide a good service. I have made complaints and they get on the case straight away.’ Another relative spoken to said ‘My loved one is happy and very merry at the home. They were really poorly before they moved in and really are a different person now. They have improved so much and are always smiling. I have had nothing to complain about. They are fantastic.’

Relatives we spoke to, spoke positively about the staff team. Comments included,

’The staff are fantastic. My loved one loves the girls. The management are very, very good and I have never had a problem with them.’

‘The staff are fine and my loved one is always dancing with them.’

‘The staff are brilliant, they are very friendly. The management is fine. I always phone them and they always have time to have a chat. If I was older, I would move there myself.’

People using the service told us that they like living at the home and are happy with the premises. However, one relative said ‘My loved one has a nice room. Décor could be better as the home is a bit tired looking and could do with a paint.’