About the service:

Gildawood Court is a care home, providing personal care and accommodation for up to 60 people. It provides care to older people, some of whom are living with dementia. Care is provided in five separate units; with the fifth unit on the first floor. Each unit has their own lounge, dining area with a kitchenette. At the time of our inspection visit 56 people lived at the home.

What life is like for people using this service:

• People’s risks to safety and well-being were assessed, recorded and reviewed. However, actions to mitigate risks of harm or injury to people had not always gone far enough to ensure people’s safety was maintained.

• Staffing levels at night were insufficient and meant people were, at times, left unattended on units. Staffing deployment during daytime shifts meant people’s safety was not consistently maintained because communal areas were left unobserved by staff.

• People had their prescribed medicines available to them. However, there had been incidents when people ran out of their medicines because staff had not taken action to ensure there was sufficient stock.

• Overall, staff followed the training they had been given. However, this was inconsistent in, for example, staff's hand hygiene practices.

• Improvement was required in the overall cleanliness of the home.

• People had individual plans of care, so staff had the information they needed to care for them.

• Staff received training, and most were suitably skilled to meet people’s day to day physical needs and protected people from the risks of abuse.

• People, especially those living with advanced dementia, experienced minimal activities and social interaction.

• People had access to healthcare when required.

• Overall, people received enough food and drink to meet their dietary requirements.

• People’s dignity was not consistently promoted by staff.

• People made decisions about their care and were supported by staff who worked within the principles of the Mental Capacity Act 2005.

• The provider’s quality assurance system did not always ensure quality and safety and actions were not always taken to make improvements where needed.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:

Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment

Regulation 17 Regulated Activities Regulations 2014 - Governance

Rating at last inspection: At the last inspection the service was rated as Good. (The last report was published on 9 May 2016.

Why we inspected: This was a planned inspection based on the rating of the last inspection. The service is not rated as ‘Requires Improvement’ overall.

Enforcement: Action provider needs to take (refer to end of report).

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 11 April 2016. The inspection was unannounced.

Gildawood Court is a care home providing personal care and accommodation for a maximum of 60 older people living with dementia. The home is located in Attleborough within a mile of Nuneaton town centre in the county of Warwickshire. There were 59 people who lived at the home at the time of our visit. All the people at Gildawood Court lived with dementia.

The service had a registered manager. This is a requirement of the provider’s registration. 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 refer to the registered manager as the manager in the body of this report. We refer to the registered manager as the manager in the body of this report.

People and their relatives told us they felt safe living at the home and staff treated them well. Staff knew how to safeguard people, and were clear about their responsibilities to report safety concerns to the manager. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible; they were safe to work with the people who lived there.

Risks associated with the delivery of care and support for people who lived at the home had been assessed. However, risk management plans and risk assessments had not always been updated when people’s care or support needs changed, and were not always followed by staff. This meant the risks associated with people's care were not always monitored and managed, so that risks to people were minimised. Medicines were managed safely. However systems to ensure medicines were stored correctly were not consistently effective.

New, and existing staff received training which ensured they had the skills and knowledge needed to support people effectively. Staff felt well supported by the management team.

People were supported in line with the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Where people could not make decisions for themselves, people's rights were protected because important decisions were made in their 'best interests' in consultation with health professionals. The provider had made applications to the local authority in accordance with DoLS and the MCA, and at the time of our inspection was awaiting the outcome of some of those applications.

People were encouraged to eat a varied diet that took account of their preferences and specific dietary requirements. People were supported to attend health care appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing.

Staff treated people with respect and dignity, mostly respected people’s privacy. Staff enabled people to maintain their independence. People who lived at the home were encouraged to maintain links with friends and family who could visit the home at any time.

There were enough staff at Gildawood Court to support people safely. Staffing levels enabled some people to have the support they needed to take part in interests and hobbies that met their individual needs and wishes.

People’s care records were mostly reflective of their care and support needs. Where up to date information was lacking, staff demonstrated a good understanding of the needs and preferences of the people they supported. People and their relatives thought staff were caring and kind.

People knew how to make a complaint if they needed to. Complaints received were fully investigated and analysed so that the provider could learn from them. People who lived at the home and their relatives were given the opportunity to share their views about how the service was run.

The provid