This inspection took place on 4 January 2017 and was unannounced.

Henry Cornish Care Centre is a residential home that provides accommodation for 36 older adults. In addition to the 36 residential beds there are 14 Intermediate Care beds (ICU). The intermediate care services are provided to people to help them in rehabilitation and to be as independent as possible following discharge from hospitals. At the time of the inspection, there were 47 people living at the service and 14 of these were on the ICU.

There was a new manager in post who had been in post for one day and told us they would be applying to become the registered manager for the service with the Care Quality Commission. 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 manager worked closely with the deputy manager and area operations manager.

Leadership within the service was well structured, open and transparent at all levels and promoted strong organisational values. This resulted in a caring culture that put people using the service at the centre. People, staff and healthcare professionals were complimentary about the management team and how the service was run.

The provider did not always maintain confidentiality. People’s care records were left in their rooms accessible to anyone. This was general practice in the home without consulting people on their preferences. However, the provider took immediate actions to address these concerns when they were raised.

People who were living at the service told us they felt safe. The staff had a clear understanding of how to safeguard people and protect their health and well-being. People received their medicines as prescribed. There were systems in place to manage safe administration and storage of medicines.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. The service promoted positive risk taking. Staff were aware of people’s needs and followed the guidance in care plans to keep them safe.

There were enough suitably qualified and experienced staff to meet people needs. The provider had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff. Staff benefitted from regular supervision (one to one meetings with their line manager) and yearly professional development reviews (PDR) to help them meet the needs of the people they cared for.

The management team and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA. The management team and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety.

People benefited from a pleasant dining experience and their nutritional needs were met. A variety of meal choices was available and people received their meals in a timely manner. Staff treated people with kindness, compassion and respect and promoted people’s independence and right to privacy. People received good care that was personalised to meet their individual needs.

People were supported to maintain their health and were referred for specialist advice as required. Where people had received end of life care, staff had taken actions

We inspected Henry Cornish Care Centre & Intermediate Care Unit on 6 November 2014. This was an unannounced inspection. The previous inspection of this service was carried out in November 2013. The service was found to be meeting all of the standards inspected at that time.

Henry Cornish Care Centre is a residential care home run by the Order of St Johns Care Trust and provides a home for 36 older adults. In addition to this there is a 14 bedded Intermediate Care Unit (ICU) within the site.  Intermediate care services are provided to people to help them avoid going into hospital unnecessarily or to help them be as independent as possible after discharge from hospital.

People in the ICU did not always experience care that was responsive. This was because accurate and comprehensive information about people’s care had not always been recorded. Care records in the residential home were completed to a high standard.

There was a registered manager in post at 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 2008 and associated regulations about how the service is run. The registered manager was also registered to oversee the ICU, however Oxfordshire Health had taken over the running and management of the in ICU and there were plans in progress to register the ICU separately from the home. Day to day management of the ICU was carried out by a ward manager and Matron.

Although the registered manager was not at the service on the day of our inspection, it continued to run smoothly. A senior manager from the organisation arrived mid-morning to support the staff through the inspection. The registered manager was clearly organised and any documents we required in relation to the management or running of the service were easily located and well presented in an organised way. Staff and visiting health professionals spoke about the registered manager in a complimentary way. They told us they were approachable, open, supportive and professional.

The atmosphere in the home was pleasant and people were cared for in a calm, relaxed and comfortable environment. Although staff were busy, they did not rush people. People told us that staff attended them promptly when required. Staff were caring and supported people in a friendly, respectful and dignified way. Systems were in place to ensure people were kept safe. People were encouraged to be as active and independent as they could be in their day to day lives. There was a positive culture at the home and staff understood and displayed the values of the organisation.

People in the ICU had a tailored rehabilitation plan to meet their specific needs. People in the ICU and residential home were supported to maintain their physical and mental health. A range of other professionals were involved in people’s care to ensure their needs were met. Visiting health professionals praised the level of care provided to people.

The home had effective quality assurance systems in place and the registered manager and staff strived to continually improve the service.

Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions. Where restrictions were in place for people we found these had been legally authorised.

On the day of our visit 31 people were using the service. They were supported by six care workers, the head of care, two housekeepers a breakfast assistant and the manager. The home contained a hospital respite unit. This facility offered care mainly for people who had left hospital and were waiting to go home. 14 people were staying within this unit supported by two nurses, two care workers and the unit manager. This unit existed in addition to the care centre.

We spoke with six people and two relatives of people who used the service. One said "I like it here, it is more like a hotel". Another said "I like my room. It is private and the staff knock on my door before entering". One relative said "this is a lovely place. It is so good to see my relative settled and happy".

We spoke with nine members of care staff. They all told us they enjoyed working at the home. One said "I like it here and I like helping people". Another said "I love working with the residents, I feel proud at the end of the day".

We found that people gave valid consent to care and that their care, treatment and support was appropriate to their needs. We also found that they were safe.

The provider had appropriate recruitment and selection procedures in place and all care workers were trained and experienced to do their job.

The home has a residential wing which can accommodate up to 36 people. There was also a wing for intermediate care which can accommodate up to 14 people. We spoke with seven people. They told us that they felt that they were involved with the running of the home, one person told us “we do have meetings where we can raise points. You have the opportunity to voice your opinion.”

One person told us “They can’t do enough for us”. Another said “I can’t think that they can improve the service.”

We also observed staff support, looked at records and spoke with staff who supported the people living at the home. We spoke with four members of staff during our visit. Staff were very motivated and caring and attentive of the people. One member of staff told us that they received positive feedback from people.

We also observed a communal area and saw that staff were frequently in and out asking people if they were ok or wanted a drink.

We saw that medicines were kept safely and that appropriate arrangements were in place in relation to the recording and administering of medicines.

The home had enough staff on duty to meet the needs of the people. One person told us “we get well looked after”. Another person said “I rather like all the staff.”

There was evidence that learning from incidents had taken place and that appropriate changes had been implemented.