Maybury Court is owned and managed by an individual and is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for up to 28 older people, some of whom who may be living with dementia. It is situated close to local amenities and public transport routes in a residential area in the east of the city of Hull and comprises of two houses which are connected by a corridor on the ground floor. There are several communal rooms on the ground floor and bathrooms and toilets are located on both floors. At the time of this inspection there were 27 people using the service.

The service is required to and did have a registered manager. 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.

We undertook this unannounced inspection on the 25 November and 2 December 2016. The last full inspection took place on 14 and 15 May 2015 and we had minor concerns with the notification of incidents, risk assessing and the addressing of shortfalls in the environment. At this inspection we found improvements had been made.

Risks to people's safety had been assessed and staff managed risks in line with individual assessments. Support plans were regularly reviewed, detailed and organised. We found people's health and nutritional needs were met. Staff contacted community health care professionals when required and supported people to visit hospital appointments. The meals provided to people were varied and choices were available. There were special diets for some people as required. Dieticians were contacted for advice and treatment when people lost weight or there were concerns about their food and fluid intake.

People told us they felt safe, were well looked after, happy and would inform staff if they were concerned about abuse. People were cared for by staff who had received training in how to protect them from harm. Staff understood they had a duty to report abuse and protect people from harm and they told us they felt confident to discuss any safeguarding concerns with the managers at the service.

Safety equipment, electrical appliances and gas safety were all checked regularly.

An analysis of all accidents and incidents was undertaken by the care manager to identify any trends or patterns. This meant people’s needs could be reassessed or more training could be provided if any issues were identified. People’s medicines were stored and administered safely.

We found staff supported people to make their own decisions. When people lacked capacity for this, staff acted within the principles of the Mental Capacity Act 2005 and ensured important decisions were made within best interest meetings with relevant people present.

People were involved with initial assessment and reviews of their care and support. Their levels of independence, individual strengths and abilities were recorded. People were encouraged to maintain relationships with important people in their lives and to take part in activities.

We found there was sufficient staff on duty to support people with their assessed needs. Staff provided people with information and spoke with them in a patient way. People's privacy and dignity was respected and their confidential information was held securely.

Staff had access to training which helped them to feel skilled and confident when supporting people who used the service. The training was monitored and refresher courses made available. Their competence was checked to make sure the training was effective. Staff received supervision, appraisal and support.

The registered manager/provider understood their responsibilities to report accidents, incidents and other notifiable incidents to the CQC as required. The service had a quality monitoring syst

We spoke with five people who used the service and two relatives. They spoke positively about the care they received. During the inspection we observed staff explained to people who used the service the care they were giving and the reason for it. Staff we spoke with explained how they encouraged people to make choices even if their understanding and communication was limited.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

There were effective systems in place to reduce the risk and spread of infection. People and relatives we spoke with confirmed staff wore gloves and washed their hands when providing care.

There were enough qualified, skilled and experienced staff to meet people’s needs. People we spoke with told us they received good care and the staff were kind and friendly. We spoke with five people. One person told us “There are sufficient staff here to cater for our needs.” Another person said “When I use my call bell I do not have to wait a long time.”

People were given support by the provider to make a comment or complaint where they needed assistance. People we spoke with confirmed they could raise any concerns with staff and these would be acted on.

People who lived in the home told us they felt respected and were involved in making everyday decisions. They also told us they liked living there and commented, "Yes I have been well looked after" and "The staff are very nice."

People told us they felt safe in the home. They also said they liked their room and the home was clean and tidy.

During our visit we also spoke with two visiting relatives and two health and social care professionals who all confirmed the home offered a good level of care and support.

We saw from documentation that people had their needs assessed and were involved in the planning of their care. We observed that incidents were recorded, however they were not always reported to the appropriate agency and this may place people at risk of abuse.

We looked at training records which showed us staff had not undertaken or updated their skills and knowledge in a variety of areas such as safeguarding adults from abuse, moving and handling, first aid and other essential training that would promote peoples' welfare, health and safety.

We saw the home sought the views of the people who lived there.

We undertook this unannounced inspection on the 14 and 15 May 2015. The last full inspection took place on 4 July 2013 and the registered provider was compliant in all five of the areas we assessed.

Maybury Court is owned and managed by an individual and is registered to provide accommodation and personal care for up to 28 older people, some of whom who may be living with dementia. On the day of the inspection there were 25 people living in the home. The home consists of two adjacent houses connected on the ground floor by a corridor. There is a selection of shared bedrooms and those for single occupancy on both floors. There are several communal rooms on the ground floor and bathrooms and toilets located on both floors.

The registered provider is also the registered manager. A registered manager is a person who has registered with the Care Quality Commission [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.

People who used the service were protected from the risk of harm and abuse by staff knowledge and safeguarding training. However, procedures had not been followed regarding informing the local safeguarding team of incidents between people who used the service. This would have provided them with the opportunity to check out how the incidents were managed and to provide advice. We found one person had unsafe bedrails on their bed, which were removed on the day of inspection. A risk assessment for the bedrails had not been updated.

We found people mostly received their medicines as prescribed although one person had not received the correct medicine for two days and the recording of some directions could be made clearer for staff. This was discussed with the person’s GP during the inspection and the person had not experienced any ill effects.

We found there had been several occasions when CQC had not received notifications of incidents that affected the welfare of people who used the service and on one occasion an incident that had impacted on the running of the service. We had also not been notified when the registered provider/manager changed their email address. This had resulted in the registered provider/manager not receiving an important request to complete a Provider Information Return. It is important the registered provider/manager notifies us of incidents and changes so we can check how they are managed and have accurate and up to date information about the service.

There were some audits and checks completed, for example care files, people’s nutritional status, accidents, medicines and the environment. Some of these were effective in highlighting gaps, however there was no environmental improvement plan to show when specific areas were to be addressed.

We found people’s health and nutritional needs were met. We saw professional advice and treatment from community services was accessed when required. We found people received support in a person-centred way with care plans describing preferences for care and staff following this guidance.

We observed positive staff interactions with the people they cared for. Privacy and dignity was respected and staff supported people to be independent and to make their own choices. There was a range of activities and meaningful occupations for people to participate in. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interest.

We found staff were recruited in a safe way and in sufficient numbers to meet the current needs of people who used the service. Staff had access to induction, training, supervision and appraisal which helped them to feel skilled and confident when providing care to people.

We found there was a complaints procedure and people felt able to complain in the belief issues would be addressed.

We found the service was clean and tidy, did not have any malodours and equipment used was serviced in line with manufacturer’s instructions.