Heatherstones Court provides accommodation and personal care for up to 15 adults in 12 apartments. When we inspected the service there were five people who were supported with personal care. The inspection took place on 8 August 2018 and was announced. The last inspection was on 29 June 2017 and there was one breach of regulation 17, relating to good governance. This was because systems and processes were not robustly in place to assess and monitor the quality of the service.

At this inspection, we found the provider had taken sufficient action to address the breach and ensure systems and processes were more thorough.

Heatherstones Court is a 'care home'. 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. Heatherstones Court provides accommodation and personal care for up to 15 adults in 12 apartments. This service provides short term residential care and support to enable people to regain independence and skills, lost through illness or injury. When we inspected the service there were five people who were supported with personal care.

People felt safe in the care of Heatherstones Court. Staff knew how to keep people safe and there were clear procedures and guidance in place for staff to manage risks. Risk assessments were much clearer and consistently recorded than at the last inspection. We recommended the provider addresses the fire officer's recommendations and keeps the fire safety risks under continuous review.

People were supported to have maximum control and choice over their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Systems for managing medicines had improved since the last inspection and documentation was clearer. The service was working closely with the local pharmacist to ensure safe practice. We made a recommendation for the management team to review the intervals at which controlled drugs stocks were reconciled with balances, in order to ensure irregularities were identified as soon as possible should these occur.

Staff were well supported and valued. There was regular communication with the management team through supervision, handovers and meetings. Staff training was in place and where there were some identified gaps, there were plans to ensure training was scheduled.

There was a clear assessment process which ensured people had choice and involvement in their care and support. Staff demonstrated caring and compassionate behaviours and attitudes towards the people they supported and their families.

Staff were committed to positive outcomes for people and placed emphasis on enabling people to be as independent as they could be to ensure they were ready to leave the service.

Staff supported people’s dignity and were respectful in verbal and written communications. Care was responsive to people’s needs and very person centred. There was clear emphasis on involving and including people as active partners working towards their goals.

Care records had much improved since the last inspection, information was accurately detailed and easy to locate. Information was person centred and presented in the first person style with individual input into the plans.

The complaints process was clear, although no complaints had been received.

Issues from the last inspection had been addressed and the management team was working to ensure further improvements could be made to the service.

The service was well run and the registered manager was aware of the strengths and areas to improve. Audits were clear with defined responsibilities and actions for improvement. Gaps in auditing had been identified and addressed by the management team. We made a recommendation for the service to develop the missing persons policy/procedure to align with the protoco

Heatherstones Court provides personal care for up to 15 adults in 12 apartments. When we inspected the service there were two people in receipt of personal care. One person was in hospital and one person was taken to hospital and although they returned the same day it was not appropriate for us to speak with them.

The last inspection was in June 2016 and the service was rated ‘requires improvement’ at that time and there were two breaches in regulations. This was because safeguarding incidents had not been identified and procedures had not been followed to ensure people's safety and there were shortfalls in medication records. At this inspection we found the provider had taken steps to improve their practice in relation to ensuring people's safety. However, we identified a breach in regulation 17, good governance because there were still some weaknesses in the way the quality of the service was checked.

There was a registered manager in post. 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. The service was in the process of changing registered managers and we saw both the new manager and the exiting manager working together during the inspection.

Staff understood safeguarding and whistleblowing procedures and there was a clearer knowledge of how to identify and report concerns. Individual risk assessments were in place although there was conflicting information regarding people's mobility.

Medicines recording had been improved since the last inspection.

Accidents and incidents were recorded with evidence of action taken in response to these.

The provider had taken steps to improve medicines management since the last inspection and there were clearer systems for monitoring and improving communication around this.

Staff were supported through regular training and supervision. Staff we spoke with understood the legislation around mental capacity and people's rights and consent.

Communication between staff was effective and staff reported effective teamwork to meet people's needs.

Staff were dedicated to their role and very caring in their approach. People's independence was a clear focus of staff's work and they emphasised the importance of empowering people to do as much as they could for themselves.

People's needs, goals and preferences were highlighted in their care plans. Staff demonstrated a person centred approach and an understanding of working with people in individually meaningful ways.

Complaints were responded to in line with the organisation's procedures. Many compliments were received and there were positive questionnaires although these were not dated.

The service had a clear line management structure and staff understood their roles and responsibilities. There were audits but these were not robust enough to demonstrate thorough checking of documentation to ensure it supported the running of the service. There was a clear handover in place for the new manager to understand the requirements of the service and the people they supported.

You can see what action we asked the provider to take at the back of the report.

This inspection took place on 26 May 2016 and was announced. We gave the provider 48 hours notice of the inspection to ensure staff and people who used the service would be available to speak with us. This was the first inspection of the service since it was registered in January 2015.

Heatherstones Court provides accommodation and personal care for up to 15 adults.in 12 apartments. When we inspected there were 11 people using the service, however only four of these people were receiving personal care. The service provides short stay care free of charge for people who live in Calderdale so they can be rehabilitated after being in hospital before returning home. Support staff are available from 8am until 1pm and 4.45pm until 9.45pm. No overnight care is provided by the service. Out of hours support is accessed via an emergency response team through Careline.

The home has a registered manager who commenced in post in January 2016. 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 told us they felt safe. We saw there were enough staff to provide people with the support they needed and suitable arrangements were in place to provide emergency support when staff were not on site. The pre-admission assessment process ensured only people whose needs could be met by these staffing arrangements were admitted to the service.

Staff understood safeguarding procedures and how to report any concerns. However, some safeguarding incidents had not been identified and referred to the local safeguarding team or reported to the Commission. This meant correct procedures had not been followed to ensure people were kept safe and was a breach of regulations.

People told us they received their medicines when they needed them, however shortfalls in records meant we were not assured this was always the case. This meant there was a risk people may not receive their medicines as prescribed and was a breach of regulations.

Staff recruitment procedures ensured staff were suitable to work in the care service.

Staff received the training and support they required to carry out their roles and meet people’s needs. The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005.

Staff supported people to access the healthcare services they required. People chose what they wanted to eat and drink and staff supported them with shopping and preparation of meals. Staff supported people to lead active lives of their choosing.

Care and support was planned and delivered with people to meet their needs and preferences. Staff knew people well and provided support in a way that maximised their independence and enabled them to return to live in their own homes. People knew how to raise any concerns and were provided with information to guide them in the complaints process.

The service was well led by a registered manager who led by example and promoted person-centred care. Staff told us they felt supported and praised the leadership and management of the service. Quality assurance systems had only recently been introduced and required further development and embedding to ensure continuous service improvement.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.