We carried out an unannounced inspection of Hendra Court on 6 July 2018. Hendra Court is a ‘care home’ that provides care for a maximum of 48 adults. 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. Most people living at the service had a diagnosis of dementia or mental health condition. At the time of the inspection there were 45 people living at the service.

The service is on two floors in the main house and on one floor in the adjoining annex (called the bungalow). Shared living areas include three lounges, a conservatory, two dining rooms, garden and patio seating areas. In the main house there is a passenger lift and stairs to access the first floor.

There was a registered manager in post who was responsible for the day-to-day running 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 and associated Regulations about how the service is run.

As part of this comprehensive inspection we checked to see if the provider had made the improvements recommended at the inspection of 26 June 2017. In June 2017 we found records to evidence when staff monitored certain aspects of people’s care were not consistently completed. Also at that time extensive work to upgrade and improve all areas of the premises was in progress. Some parts of the premises were either out of use or in the process of being adapted to make them suitable to meet the needs of the people who lived there. People, who were cared for in bed, had bedrooms in an area of the main house that, due to the work that was in progress had low occupancy, and was isolated from the rest of the service.

At this inspection we found all the major work to redesign and upgrade the premises had been completed. The bungalow area of the service, not in use during the last inspection, had been completely reconfigured and redecorated and was being used by people. A corridor had been constructed around one of the shared lounges in the main house. This meant people, staff and visitors no longer had to walk through this lounge to access other parts of the service. Eight out of the ten rooms on the first floor of the main house had been upgraded and all eight were occupied. The shared lounge and dining room in this part of the service were now being used and people living in this area were no longer isolated. We observed people seemed happy and calm in the reconfigured and upgraded environment. We also saw people spending time in newly created enclosed garden areas, walking in and out whenever they wanted to.

During the inspection we spent time in the shared living areas across the service to observe staff interaction with people and how people responded to the care and support received. We observed that people were relaxed and comfortable with staff, and had no hesitation in asking for help from staff. People and their relatives told us they were happy with the care they received and believed it was a safe environment. Comments included, "The staff make me safe because they are always around to help", "All the staff are very helpful" and "The staff are always keeping an eye on me." Staff knew how to recognise and report the signs of abuse.

Care records were personalised to the individual and detailed how people wished to be supported. They contained accurate and up to date information to enable staff to provide the agreed care and support for people. Risks were clearly identified and included guidance for staff on the actions they should take to minimise any risk of harm. Risks in relation people’s skin care and nutrition were being effectively monitored.

Management and st

We carried out this unannounced inspection on 26 June 2017. This was the first inspection for the service since registering under a new provider in late December 2016.

Hendra Court is a care home which is registered to provide nursing care for up to a maximum of 48 older people, some of whom had a diagnosis of dementia. Accommodation is divided into two units with 36 bedrooms in the main house and 12 bedrooms in the adjoining annex (called the bungalow). On the day of the inspection there were 30 people living at the service. At the time of the inspection communal areas in the bungalow (lounge, dining room and kitchen) were not in use due to refurbishment.

There was a registered manager in post who was responsible for the day-to-day running 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 and associated Regulations about how the service is run.

The service had been operating under new ownership for nearly six months, since December 2016. In that time many vital repairs to the structure of the building had been completed. This included a new roof and the servicing of the boilers, to ensure safe and effective heating and hot water systems could be maintained in the service. Any repair work that presented an immediate safety risk to people had been rectified such as uncovered pipework, unsafe electric heaters and unlocked boiler rooms.

An extensive plan to upgrade and improve all areas of the premises had started. Major redesign and redecorating work to the bungalow, to provide a more suitable environment for people with dementia, was nearing completion at the time of the inspection. It was anticipated that people would be able to use the new facilities within two weeks of the inspection date. While these works were taking place people who lived in the bungalow spent their day in the main house. This had resulted in more people using a communal lounge which was not the most suitable either in its design or location. The registered manager had decided not to take any new admissions until the bungalow was re-opened to help manage the situation. While any disruption to people’s lives had been well managed, until these works were completed the premises were not entirely suitable to meets people’s needs.

Three people, who were cared for in bed and unable to call for assistance, were in bedrooms on the first floor of the main house. While staff carried out regular safety and care checks, these three people had little interaction or stimulation. The registered manager told us work was in progress, in consultation with people, to understand how best to use different areas of the premises and these rooms would be part of that review.

Where people needed to have specific aspects of their care monitored staff completed records to show when people were re-positioned, their skin was checked or their food and fluid intake was measured. While there was no evidence to suggest that checks were not being completed appropriately, records to evidence the care people received were not always consistently completed. We also found there were no written records of the daily handovers that took place. This meant there were no records for staff to read, about people’s needs, if they were not present at a handover. We judged that staff were knowledgeable about people’s needs and the gaps in some records had not impacted on the care provided for people. We have made a recommendation about care records.

People and their relatives told us they were happy with the care they received and believed it was a safe environment. Comments included, "The staff are so good, it's them that make it safe”, “I've got a nice room and the staff make me feel safe”, “I know my partner is safe, because I visit nearly every day.