About the service:

Little Court Nursing Home is a residential care home providing accommodation, nursing and personal care for 35 older people. At the time of this inspection 32 people were living in the service.

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

People's experience of using the service:

People were positive about the service. A person said, "I’ve got what I need here and I’m okay.”

People were safeguarded from the risk of abuse.

People received safe care and treatment in line with national guidance from nurses and care staff who had the knowledge and skills they needed.

There were enough nurses and care staff on duty to meet people’s needs and medicines were managed safely.

Lessons had been learnt when things had gone wrong.

People had been helped to receive medical attention when necessary.

People and their relatives were consulted about the care provided and their consent had been obtained.

Nurses and care staff were courteous and polite and confidential information was kept private.

Equality and diversity was promoted and people were supported to pursue their hobbies and interests.

There were robust arrangements to manage complaints.

People were treated with compassion at the end of their lives and supported to have a pain-free death.

People and their relatives had been consulted about the development of the service and quality checks had been completed.

Good team work was promoted and regulatory requirements had been met.

Rating at last inspection:

The service was rated as ‘Good' at the inspection on 31 October 2016 (the inspection report was published on 12 December 2016). At this inspection in May 2019 the overall rating of the service has been maintained as ‘Good’.

Why we inspected:

This was a planned inspection based on the rating we gave the service at the inspection in October 2016.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 31 October 2016. Little Court is a nursing home that provides accommodation and personal care for a maximum of 35 older people. There were 30 people living in the service at the time of our inspection, some of whom lived with dementia.

There was a manager in post who was registered with the Care Quality Commission (CQC) since June 2014. A registered manager is a person who has registered with the 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 knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place which included the checking of references.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered. Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about particular decisions. When applicable, meetings were held to make decisions in people’s best interest, as per the requirements of the Mental Capacity Act 2005.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People told us they enjoyed the food and their meal times. Staff knew about and provided for people’s dietary preferences and restrictions.

People’s individual assessments and care plans were person-centred, reviewed monthly or when their needs changed. Clear information about the service, the facilities, and how to complain was provided to people and visitors.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves. A wide range of meaningful activities and outings were provided. People were involved in the planning of activities that responded to their individual needs.

Staff told us they felt valued and supported by the manager, the management team and the provider. The manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service and promoted links with the community.

There was a robust system of monitoring checks and audits to identify any improvements that needed to be made. The management team acted on the results of these checks to improve the quality of the service and care.

When we last inspected this service in September 2014, concerns had been identified in regard to the storage and administration of medicines. At this inspection we saw that improvements had been carried out satisfactorily. Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.