This inspection was carried out on 15 May 2018 and was unannounced.

At the previous two inspections on 31 January 2017 and 17 October 2017 the service was rated as ‘Requires Improvement’ because the provider was found not to be meeting the required standards. At the last inspection in October 2017 we found that people had not consistently received person centred care that took account of their health, care and social needs and were not involved in planning or reviewing their care. We also found that people had not always received safe care and treatment and that the provider’s governance systems were not effective because they had not identified the shortfalls we had found.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve all the key questions Safe, Effective, Caring, Responsive and Well-led to at least good. The action plan was submitted 21 November 2017 and stated that actions would be completed by 01 March 2018 in order to ensure the provider was meeting identified breaches of regulations 9, 12 and 17 of the Health and Social care Act (Regulated Activities) Regulations 2014.

Providence 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. On the day of this inspection 45 people were living at Providence Court in one purpose built building.

The service had a manager who was registered with the Care Quality Commission (CQC). 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. However, at the time of this inspection the registered manager was absent from the home with no clear date for their return. In the interim a deputy manager from a sister home was undertaking management responsibilities with support from the regional manager and the quality team.

We found significant improvements from our previous inspection in October 2017. However, these need more time to be embedded into the everyday culture of the home. People were not aware of who was managing the home in the registered manager’s absence. Staff gave us mixed views about how effectively communication worked within the home. Staff felt supported by the current management team. The manager had developed an information sharing tool that was used to cascade learning from accidents and incidents through the staff team. There were quality assurance systems in place which included audits undertaken by the home’s management team and representatives of the provider. The management team worked closely with external organisations for the benefit of the people who used the service.

People told us that they felt safe living at Providence Court. Staff demonstrated an understanding about reporting incidents of concern. Potential risks to people's health, well-being or safety had been identified and reviewed regularly to take account of people's changing needs. We observed safe moving and handling practice. A successful recruitment campaign had resulted in more permanently recruited staff available to provide people with consistent care and support. People were supported by sufficient numbers of safely recruited staff. People’s medicines were managed safely. People had personal evacuation plans in place for in the event of an emergency such as fire and we saw that regular safety checks were completed. The home was clean and fresh and infection control practices were appropriate.

The service worked in accordance with the Mental Capacity Act 2005 (MCA).People told us they enjoyed the food provided for them. Assessments had bee

This inspection was carried out on 17 October 2017 and was unannounced. At their last inspection on 31 January 2017, they were found to not be meeting the standards in relation to management of medicines and the overall management of the service required improvement. At this inspection although we found that the registered manager had made improvements in relation to management of medicines, however we found that they were not meeting all the standards we inspected.

Providence Court provides accommodation for up to 61 older people, some of whom live with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 56 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run

People, relatives and staff felt that the management of the service needed improving. There were quality assurance systems in place; however these had not identified the issues found on inspection. Improvements were needed on how feedback was sought from people and their relatives and responded to.

People, relatives and staff felt that the lack of permanent staff was an issue. People felt safe but staff were not clear on how to report safeguarding concerns externally. Individual risks to people`s well-being were assessed but there was a risk of these not being adhered to by staff.

People did not always receive prompt support from health professionals in relation to reviews and updates to medicine needs. We found that people enjoyed their food but some people needed more support than they received. Staff were trained but there were mixed views about if they felt supported. People were supported in accordance with the principles of the Mental Capacity Act 2005.

People’s dignity and comfort was not always promoted and people were not involved in planning their care. However, people and their relatives told us staff were kind. We saw some positive interaction between staff and people. People were encouraged to make day to day choices where staff felt they were able.

People did not always receive care that met their needs and their care plans did not always include person centred information. Activities did not take into consideration hobbies and interests people had and were infrequent. People and relative knew how to make a complaint but felt they were not always listened to.

This inspection was carried out on 31 January 2017 and was unannounced. At their last inspection on 9 February 2015, they were found to be meeting the standards we inspected. At this inspection we found that they had not continued to meet all the standards.

Providence Court provides accommodation for up to 61 older people, including people living with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 57 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

People’s medicines were not always managed safely. Although there were regular audits and checks in place, we found shortfalls in relation to accurate quantities, practice and record keeping.

People were supported by staff who knew how to recognise abuse and worked safely. There were sufficient staff who were recruited robustly. Staff had received the appropriate training and felt supported.

People had their rights respected and the service worked in accordance with the principles of the Mental Capacity Act 2005. People were supported to eat and drink well. We found that there was regular access to health and social care professionals.

People were treated with dignity and respect. They told us that staff were kind and attentive. People were involved in planning of their care and confidentiality was promoted.

People received care that met their needs and their care plans gave staff clear information on how to support them. Activities were an area that was under development. New activities organisers had been recruited and they were working on a plan to meet people’s social needs. People’s complaints were listened to and responded.

There were quality assurance systems in place and for the most part these were effective but these had not identified or therefore resolved the issues found in relation to medicine management. People and staff wanted to see the registered manager around the service more often to get to know them. Staff knew what was expected of them and worked to ensure they promoted the provider’s values.

This inspection took place on 09 February 2015 and was unannounced. Providence Court is registered to provide accommodation and personal care for up to 61 older people, some people may also be living with dementia. On the day of the inspection, there were 59 people living in the home.

The service has a registered manager. 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.

People felt safe and they were protected against the possible risk of harm or abuse. Risks to individuals had been assessed and managed appropriately. There were sufficient numbers of experienced and skilled staff to care for people safely. Medicines were managed safely and people received their medicines as prescribed by their doctors.

People received care and support from staff who were competent in their roles. Staff had received relevant training and management support for the work they performed. They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. They were aware of how to support people who lacked mental capacity to make decisions for themselves. People’s nutritional and health care needs were met. They were supported to maintain their wellbeing and had access to and received support from other health care professionals.

The experiences of people who lived at the care home were positive. They were treated with kindness and they had been involved in the decisions about their care and support. People were treated with respect and their privacy and dignity was promoted.

People’s health care needs were assessed, reviewed and delivered in a way that promoted their wellbeing. They were supported to pursue their social interests outside the home and to join in activities provided at the home. An effective complaints procedure was in place.

There was a culture and effective systems in operation to seek the views of people and other stakeholders in order to assess and monitor the quality of service provision.

During our inspection on 30 July 2013, the people we spoke with told us they were very happy with the care and support they received. We saw that staff encouraged and supported people to be independent. One person told us: "I love it here, the staff are great". We observed staff supporting people in a kind and calm manner.

Care records were personalised and gave staff clear guidance on how to meet each person’s individual needs. Potential risks to people had been assessed and plans put in place to minimise the risks. Medicines were managed well.

On the day of our inspection there was a very relaxed, atmosphere at the home. The environment was well maintained and clean.

The recruitment procedures were robust and the staff files we looked at contained all the required information.

We spoke with seven people including people who lived at the home, relatives and a visiting community nurse. Their feedback was overwhelmingly positive. It was the unanimous view that people who lived at the service were treated with respect and dignity. People said that they were, “Well looked after” that the staff were, “A great bunch” and, “Very good staff”. They told us that the food was good with two choices every day, and that the environment was stimulating because, “There is something happening all the time”. One person said, “I get on very well here”.