An unannounced comprehensive inspection took place on 13 and 19 September 2017. It was carried out by an adult social care inspector.

Pottles Court provides accommodation for up to 17 people and there were no vacancies when we inspected. When we inspected, the service did not have a registered manager as they had resigned in February 2017. 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. A manager, who had previously been the deputy, was working at the service at the time of our inspection. They had been the manager since the previous registered manager resigned. Since the inspection, there application to be a registered manager has been processed by CQC and they are due to be interviewed by CQC. A relative said the promotion of the deputy to the manager “was a great decision…she is a thoughtful lady.”

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection, applications had been made to the local authority in relation to people who lived at the service. Staff understood the importance of gaining consent and their legal responsibilities.

At the last CQC inspection in July 2015, we found a breach linked to recruitment. On this inspection, we saw improvements had been to the recruitment process to ensure staff were suitable to work at the home and there was no longer a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the last inspection, we judged the service was developing a caring approach which they have built on. The service continues to develop a very caring approach, where people were valued and respected. Dementia can create barriers for people to make their feelings and views known. Steps were taken by staff to go the extra mile to understand people’s own individual communication and recognise the importance of body language, for example monitoring pain. The values of the home were promoted by the management team; their approach helped staff transfer the home’s ethos into the way they worked. There was a commitment to learn and develop the service to the benefit of the people who lived there. A visiting medical professional wrote in feedback ‘Pottles Court really is the homeliest of homes.’ Visitors praised the welcome they received and the family feel to the home.

The provider, manager, supported by the deputy manager, held a strong belief of providing people with an enhanced quality of life which took into account individual wishes and beliefs so each person was valued and treated with equality. This inclusive ethos enabled people to feel part of the home’s community and maintain important relationships. The management team acted as role models for the staff team who were motivated to offer care that was kind, considerate and put people at the heart of everything they did.

The provider was proactive in driving the service forward to improve outcomes for living at the home. They worked in partnership with key organisations, both locally and nationally, to support care provision, service development and joined up care. The provider understood the need to provide staff with the skills, knowledge and tools to provide care that followed best practice. They invested in staff development to promote staff motivation and confidence to provide a high standard of care which promoted people's wellbeing and meant they had a mean

The purpose of this inspection was to follow up on a compliance action made by the Care Quality Commission in September 2013. This compliance action was to improve the standard of record keeping. The focus of the inspection was the quality of the records kept in the home, including people’s care records. However, we also completed a tour of the home and met some of the people living at Pottles Court. We also spoke with staff, a GP and a relative as part of the inspection.

There had been significant improvements in the quality of people’s care records, which helped keep them safe and protect their rights. We saw the recording of health professionals’ advice was well recorded and we received positive feedback from a GP and a relative about the quality of the care provided by staff. Changes had been made to improve the auditing of the environment and we saw a policy had been updated to provide guidance on Data Protection and record retention. We judged the service was now compliant.

We spoke with the provider on the day of the inspection and they told us the two named registered managers, which appear on this report no longer worked at the care home, although one still works for the company. They assured us they would ensure both managers cancelled their registrations with the Care Quality Commission so that our records were correct. They explained how they were currently recruiting for a new manager and confirmed the current interim arrangements to manage the home safely.

We found that people at Pottles Court were being well cared for. The majority of the people living at the home had some degree of dementia, or had chosen to live there with their spouse who did. We found staff understood people's needs and cared for them with compassion and respect.

We found the home understood the need to assess people's capacity to consent to care and were taking action to do so. One person living at the home that we spoke with told us the staff did what they wanted them to do. They told us “They listen to what I say. I trust them to do the right thing anyway but they always ask me if it is OK.”

We found people's healthcare needs were being met, and work was under way to develop a more person centred approach to activities and stimulation. We found enough workers on duty with the right skills to meet people's needs. Workers told us they received the training they needed. We saw workers had time to chat and spend time with people, and to respond to their needs in a timely way.

However we found some records or policies were not yet completed, comprehensive enough or left gaps where people's care needs might be missed.

People were not always able to tell us fully about their experiences at the home, because of communication needs they had due to their dementia. So we also observed support they received, their interactions with staff and so on, during our unannounced visit.

We saw some good practices in how some staff spoke and interacted with people. We heard staff being respectful and friendly, acknowledging people with eye contact and words when staff walked past them. We saw staff discreetly and kindly intervening to help individuals with their personal hygiene needs to help maintain people’s dignity. People received personal care in private. We saw staff who moved someone with the use of a hoist involved the person as much as possible, talking to them, explaining what they were doing and so on. Others were assisted to walk without being rushed by staff.

People were asked if they would like a second cup of tea or coffee when hot drinks were served mid-morning. When someone hinted that they might like another biscuit, staff noted this and took them the biscuit box so they could help themselves. Those who wanted to walk around the home were able to do so and were not directed by staff to sit down again.

Occasionally, we observed some less positive approaches, such as staff calling to someone across the dining room so that everyone in the room heard them being told not to do something. Also, cold drinks were served at lunch with little communication from staff involved.

People told us their cups of tea were good, and two agreed positively with each other that the food provided was ‘alright!’. Everyone seemed to be enjoying the lunch served during our visit.

We saw staff spending time sitting chatting with various individuals later in the morning and during the afternoon, including someone who was sitting on an enclosed patio area outside. We saw people came and went from the home’s office as they wished, chatting freely with the staff they encountered.

One person named one of the senior staff, saying they were helpful, and added ‘It’s a nice place to be.’ They confirmed they would feel able to talk to this staff member if something was wrong or they had a concern. We saw this staff member was able to reassure the person when they expressed sad feelings about a matter. Another person described staff as ‘pleasant’.

People's health needs appeared to be well attended to. But there was a risk they might not have the medicines they needed in safe way because there was not always sufficient information or guidance for staff to ensure they used and managed people’s medicines appropriately.

A professional we spoke with described the home as calm. People benefited from effective management of the service, which included monitoring of the quality of the service overall as well as monitoring of the outcome of support that people received as individuals.

An unannounced inspection took place on 15 and 22 July 2015. We returned on 23 July 2015 to give feedback. It was carried out by one inspector who was accompanied by an expert by experience.

Pottles Court provides accommodation for up to 16 people and 16 people were living at the home during our inspection. A registered manager was in post. 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 Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection, applications had been made to the local authority in relation to people who lived at the service.

Improvements were needed in the home’s recruitment process to ensure staff were suitable to work at the home.

Risk assessments were in place for people’s physical and health needs, but improvements were needed for the recording of risks relating to two people’s well-being.

People looked confident as they moved around the home and people told us they felt safe. Accident and incident records were analysed and action taken. Staff knew how to report poor or abusive practice, and the management team responded to concerns appropriately. Staffing levels met people’s care needs and the atmosphere was calm and friendly. Medicines were well managed.

Staff treated people as individuals and checked how they wished to be supported. Staff understood the importance of gaining consent and their legal responsibilities. People told us staff were kind and we saw they had the skills to adapt their approach to each individual. People benefited from a staff group that well trained and supervised. People had access to health services and staff recognised the importance of encouraging and supporting people to eat and drink.

Staff were calm and unhurried in their approach to people. People complimented staff on their approach and compassion. People’s relationships were respected and celebrated. There were a range of interactions with people to help keep them interested in the world around them. Care records were personalised, including information which could be shared if people needed care in an alternative setting, such as hospital.

The values of the home were promoted by the management team; their approach helped staff transfer the home’s ethos into the way they worked. There was a commitment to learn and develop the service to the benefit of the people who lived there.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.