This unannounced inspection took place on 25 and 26 July 2018. At the last inspection in January 2017, the service was rated as Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service. We did receive a comprehensive action plan within the time allocated to them.

At the last inspection we found the provider had breached regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 on person centred care as they did not ensure people using the service received person-centred care and treatment that was appropriate, met their needs and reflected their personal preferences. We also found a breach to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 on good governance as systems or processes were not established and operated effectively to ensure compliance with the requirements as the provider did not ensure that their audit and governance systems were effective. During this visit, we found the actions had been completed and breaches to the HSCA met.

Hanbury Court Care Home is a care home that provides care, including personal care for up to 34 adults. This includes nursing care for older people who may be living with dementia. 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.

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 and their relatives told us they felt safe using the service. Medicines were administered and managed safely. Risk assessments and risk management plans were in place to support people receive safe care and treatment. Staff knew how to recognise abuse and how to report safeguarding concerns. There were sufficient staff working at the service and recruitment checks completed with all new staff suitable and thorough. There were systems in place to maintain the safety of equipment used by the service and the safety of the property.

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. Deprivation of Liberty Safeguards had been applied for and authorised appropriately. People had access to healthcare professionals as required to meet their needs. People were offered varied menu choices of nutritious food and drink. Staff knew people they were supporting and their preferences. Staff received regular supervisions and appraisals.

We observed staff supporting people in a caring and respectful manner. People and their relatives told us the service and its staff were caring. People's privacy and dignity was respected and their independence encouraged. People and their relatives knew how to make a complaint. Meetings took place for people and their relatives so that they had input into the care they received. Staff meetings were held regularly so that they too could have input into the care provided. People, their relatives and the staff team all told us they found the management team to be professional and supportive. The provider completed audits to ensure systems worked and remained effective. The registered manager had oversight of the service through the systems in place and their strategy of continual improvement.

Hanbury Court Care Home provides 24 hour care, including personal care for up to 34 adults. This includes nursing care for older people who may be living with dementia. The service is a purpose built property. The accommodation is arranged over two levels. There were three bedrooms with en suite toilet facilities. All other bathrooms and toilets were shared. There were 30 people living at the service at the time of our inspection.

The service had a manager who had been at the service for 14 months at the time of our inspection and was awaiting the outcome of her application to become the registered manager of the service. 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 the last inspection on 22, 23 and 27 June 2016 we found three breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 regarding, medicines management and supporting staff and good governance.

We inspected Hanbury Court Care Home on 31 January and 1 February 2017. This was an unannounced inspection. At this inspection we found the service had improved in some areas. However further improvements should be made regarding care planning and quality monitoring at the service.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. Risk assessments were completed and management plans put in place to enable people to receive safe care and support. There were systems in place to maintain the safety of the premises and equipment. We found there were enough staff working at the service and recruitment checks were in place to ensure new staff were suitable to work at the service. Medicines were administered and managed safely.

Appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. Staff received appraisals and group supervisions. People using the service had access to healthcare professionals as required to meet their needs.

People were offered a choice of nutritious food and drink. Staff knew people they were supporting including their preferences. People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring and respectful manner. Staff respected people’s privacy and dignity and encouraged independence. People and their relatives knew how to make a complaint.

Regular meetings took place for staff, people using the service and their relatives. Staff, people and their relatives told us the management team were supportive and approachable. However, we found areas for improvement regarding quality assurance mechanisms used by the service.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations. You can see what action we asked the provider to take at the back of the full version of this report.

Hanbury Court Care Home provides 24 hour care, including personal care for up to 35 adults. This includes nursing care for older people who may be living with dementia. The service is a purpose built property. The accommodation is arranged over two levels. There were three bedrooms with en suite toilet facilities. All other bathrooms and toilets were shared. There were 32 people living at the service at the time of our inspection.

The service had a manager who had been at the service for seven months at the time of our inspection and was awaiting the outcome of her application to become the registered manager of the service. 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 inspected Hanbury Court Care Home on 22 and 27 June 2016. This was an unannounced inspection. At the last inspection on 31 July 2013 we found the service met the required standards. At this inspection we found two breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 regarding, medicines management and supporting staff.

People were not safe at the service. There were poor arrangements for managing medicines. People were at risk of harm when moving around the service. Staff did not always treat people with respect and dignity. Peoples care plans were not always person centred.

Staff did not always receive up to date training, supervision and appraisal. Some staff did not have a clear understanding of the application of the Mental Capacity Act (2005). There was poor record keeping and quality monitoring tools used by the service did not identify issues of safety and quality. Staff had mixed views about the staff culture and management team.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. There were up to date systems in place to maintain the safety of the premises and equipment. We found recruitment checks were in place to ensure new staff were suitable to work at the service.

Appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. People using the service had access to healthcare professionals as required to meet their needs.

Staff knew the people they were supporting. People using the service and their relatives told us the service was caring. Staff respected people’s privacy and encouraged independence. People and their relatives knew how to make a complaint. The service enabled people to maintain links with their culture and religious practices.

People expressed their views and were involved in making decisions about their care and treatment. People who used the service told us that they were treated with dignity and respect and that they were able to make choices about their daily lives. People said they were satisfied with the care and treatment they received. Comments included "I like it here" and "the staff here are nice, they treat me well."

People told us they felt comfortable and safe at the home. Comments included "I do feel safe, if I wasn't happy I'd speak up" and "I feel safe, I have no worries." People told us that they felt safe on the premises and found the environment pleasant. Comments included "it's a generally safe environment. I don't worry about that."

During the previous inspection we found that people were not adequaltely protected against Legionella and staff training in the use of equipment to move people was inadequate. During this inspection we found that these issues had been adequately addressed. People told us they were satisfied with the staff and that they were able to meet their needs. One person said "they're good."

We visited this service on 25th February 2013 and assessed that they were compliant with the five areas that we looked at. The areas were care and welfare of people who use services, meeting nutritional needs, safety and suitability of premises, safety, availability and suitability of equipment and assessing and monitoring the quality of service provision. However the Health & Safety Executive (HSE) have since notified us of their concerns about the environment, equipment and staff training to use equipment. As a result of this we visited the service with the HSE. We did not discuss these concerns with people who used the service as we had sought their views during the previous inspection.

We found that although the provider had taken some action to address the HSE concerns people were not protected against the risk of unsafe premises and were not supported by staff who had been adequately trained to deliver care and treatment safely and to an appropriate standard. Specifically systems were not in place to ensure that people were protected from the risk of Legionella. In addition most people who used the service required the use of a hoist or other moving and handling aids but staff had not been adequately trained to ensure that this was done appropriately or as safely as possible.

People told us that the service was meeting their care needs. A relative said "the care is very good, she is well looked after." People said they had access to health care treatment, one person said "if you need to go to the hospital they do it quick." Records showed that people had access to health care professionals, including GP's dieticians and speech and language therapists. We found that care plans and risk assessments were in place which set out how to meet people's individual needs. We found that people were given a choice of food and were provided with sufficient amounts to eat and drink. A relative told us “staff are caring and always coming in to the room and encouraging them to drink.”

People told us they were happy with the home's physical environment, and that they were able to move freely around communal areas. We found that steps had been taken to help ensure the environment and equipment used in the home was safe. The service had systems in place for monitoring and assessing the quality of care provided. These included seeking the views of people who used the service.