This inspection took place on 5 March 2018 and was announced.

McGowan 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. McGowan Court accommodated eight people at the time of the inspection.

The service was last inspected on February 2016 and the rating for this inspection was Good. At this inspection we found the service remained Good.

The service had a manager in place who was going through the process of registering with the Care Quality Commission (CQC). They started in post in December 2017.

People's care records contained clear and easy to understand information about people's needs and risks and how to support them effectively. We saw people were provided with one to one support meetings on a weekly basis and more often if their mental health was declining.

We found some concerns regarding the recording of medicine administration. The manager had also found the same concerns and produced an action plan. This demonstrated that the recording of medicine administration would be improved. We have made a recommendation with medicines.

People were supported to access health care professionals when needed. The provider had taken steps to minimise the risk of abuse because staff knew how to identify and report it.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal.

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. People were supported to achieve their goals and aspirations.

People received a varied and nutritional diet and were complimentary of the food provided.

The interactions between people and staff showed that staff knew the people really well. Staff we spoke with had a good knowledge of people's needs and talked about people with genuine affection. The atmosphere at the home was homely, relaxed and nurturing. It was clear that people felt relaxed and comfortable in the company of staff.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. Processes were in place to assess and monitor the quality of the service provided and drive improvement.

Further information is in the detailed findings below.

This inspection took place on 2, 3 and 4 February 2016 and was unannounced. This meant the staff and the provider did not know we would be visiting.

McGowan Court provides care and accommodation for up to 12 people with enduring mental health problems. On the day of our inspection there were eight people using the service.

The home had a registered manager in place. 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.

McGowan Court was last inspected by CQC on 17 June 2014 and was compliant with the regulations in force at that time.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and staff and described potential risks and the safeguards in place. Staff had been trained in how to manage behaviour that challenged and in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and training sessions were planned for any due or overdue refresher training. Staff received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act and was following the requirements in the Deprivation of Liberty Safeguards.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.

People who used the service, and family members, were complimentary about the standard of care at McGowan Court. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they moved into McGowan Court and care plans were written in a person centred way. The provider sought alternative methods in supporting people with their care needs.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

People who used the service, and family members, were aware of how to make a complaint however there had been no formal complaints recorded at the service.

The service regularly used community services and facilities and had links with other local organisations. Staff felt supported by the manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service. Family members told us the management were approachable and understanding.

We found that action had been taken to improve medicines arrangements and make sure people using the service received their prescribed medicines safely.

We found that the provider had implemented a Mental Capacity Act (MCA) policy. Where there were doubts about a person's capacity to make decisons the provider had undertaken MCA assessments and where appropriate had made decisions in people's 'best interests.'

The provider had implemented a new risk assessment tool. We found that each person had been assessed using the new tool and potential risks had been identified and measures put in place to manage the risks.

Medicines were not always managed safely due to recording errors and a lack of robust audits. We spoke with two people who used the service. One person said, “I know what medicines I take and I always get them regularly”. The other person said, “Staff seem very confident when they handle my medicines, they know what I need”.

People told us staff asked for their consent before delivering any care. We found the provider did not have appropriate arrangements in place where there were doubts about a person's mental capacity to make decisions.

People had their needs assessed and the information gathered was used to develop personalised support plans. We found that some people's support plans had not been updated to reflect their changing needs and minimise potential risks to the person.

The provider did not have appropriate records of each individual medicine administered to people. We found medication audits were not effective in identifying gaps in signatures on Medication Administration Records and ensuring appropriate action was taken to address the gaps.

We found there were enough staff to meet people's needs. People commented, “Very nice staff, talkative”, and, "The staff are okay.”

The provider gave people information about how to complain. People told us they knew how to complain. One person commented that they received, “Excellent care.”

We spoke to six people who use the service and four staff. People told us that they were supported in promoting their independence and community involvement. People gave examples of activities they were involved in including going on outings, volunteering, shopping and attending various support groups and some people accessed the community independently. People commented “I like the staff”, “Staff are excellent “and “Staff suggest things and ask my opinion”.

We saw from care records and from talking with people that they were involved in assessments of their needs and support planning. People told us that they met with their key worker regularly to evaluate and update their support plans. They also told us they were being supported to maintain and developed their life skills.

We saw from training records that staff had completed safeguarding training and had a good understanding of safeguarding. We also saw that the provider had taken action to deal with incidents and had systems in place to review safeguarding concerns.

Staff told us that they are well supported and have opportunities for further development. We saw from training records that all statutory training was up to date.

People told us they met with their key worker regularly and were confident about expressing their views. We saw that the provider undertakes a range of audits to ensure that standards are maintained.