This comprehensive inspection took place on the 28 May 2018 and was unannounced. Southlands Court provides accommodation and personal care. Any nursing needs are met through community nursing services. The service can accommodate up to 25 people in a detached two storey building sat in beautiful grounds surrounded by countryside views on the Cornish border. There are two large lounges with small clusters of chairs for people to sit privately or with others and a separate dining area. People can access a courtyard at the centre of the building with a large pond which has been made safe so people can use this area as they choose. There were 25 people living at the home at the time of the inspection. Two of these were staying at the service for a period of respite.

Southlands Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

We had previously carried out an unannounced comprehensive inspection of this service in September 2017. That inspection was the provider’s first inspection since they registered the service with CQC in October 2016. Following the inspection the service was rated as “Inadequate” overall and placed into special measures. Six breaches of legal requirements were found. We found concerns relating to people’s health, safety and welfare. This was because people were not protected from unsafe and unsuitable premises. The provider’s quality assurance systems did not effectively assess and monitor the quality and safety of the service. There were no systems to monitor fire safety and health and safety. There were not sufficient numbers of suitably qualified, skilled and experienced staff on duty at all times to meet people’s needs. During the last inspection the provider increased staff levels after we raised our concerns with them. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

On 6 December 2017 we then undertook a focused inspection to check that the provider had followed their plan and to confirm that they now met legal requirements. We looked at the key questions, ‘Is the service safe?’ and ‘Is the service well led?’ to ensure people were safe and improvements were being made. At the focused inspection the provider had made improvements and was no longer in breach of Regulation 12 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This meant the rating has changed for the safe and well led question from Inadequate to Requires Improvement. We made that decision because we needed to ensure the improvements made were sustained over a longer period of time.

At this comprehensive inspection we found the provider continued to make improvements.

The service had a new registered manager who was registered with CQC in January 2018. 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 said they were happy to approach the registered manager, staff and the provider if they had a concern, and were confident that actions would be taken if required.

People were protected from unsafe and unsuitable premises. Risks for people were reduced by an effective system to assess and monitor the health and safety risks at the home. Records contained accurate and up to date information and were stored in a locked office to protect people’s information.

There were sufficient and suitable staff to keep people safe and meet their needs. Although there were times when staff were rus

Southlands Court provides accommodation and personal care for up to 25 people. Any nursing needs are met through community nursing services. There were 18 people living at the home at the time of the inspection.

Southlands Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

We carried out an unannounced comprehensive inspection of this service in September 2017. The service had been rated as “Inadequate” overall and placed into special measures. This had been the provider’s first inspection since they registered the service with CQC in October 2016. Six breaches of legal requirements were found. We found concerns relating to people’s health, safety and welfare. This was because people were not protected from unsafe and unsuitable premises. The provider’s quality assurance systems did not effectively assess and monitor the quality and safety of the service. There were no systems to monitor fire safety and health and safety. There were not sufficient numbers of suitably qualified, skilled and experienced staff on duty at all times to meet people’s needs. During the last inspection the provider increased staff levels after we raised our concerns with them. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

The CQC used urgent enforcement powers to impose conditions on the provider’s registration under section 31 of the Health and Social Care Act 2008 to set out what actions we required the provider to take and the timescales required. We issued an urgent Notice of Decision to impose conditions on the provider’s registration. We told the provider that they must not admit people to the service without the written permission of CQC. They must have a tool in place to determine the number of staff and range of skills required in order to meet the needs of the people using the service. We also said they must complete this assessment and keep it under regular review and send CQC the assessed numbers of staff identified each week. We also told the provider that they were required to undertake health and safety audits and send CQC each month the actions they were taking in response to these audits.

The provider had followed the imposed condition issued by CQC by sending in the required information. This included;

• A dependency tool which had been completed to assess people’s needs and the staff levels required to meet those needs

• Weekly staff rota’s to demonstrate the staff level was maintained.

• Each month the outcome of health and safety audits carried out and the actions taken.

Since the last inspection we have regularly spoken with the provider and manager and received further assurances that people were safe. They made two formal requests for people to be admitted to the service, which CQC agreed.

This unannounced focused inspection took place on 6 December 2017. We undertook this focused inspection to check that the provider had followed their plan and to confirm that they now met legal requirements. We looked at the key questions, ‘Is the service safe?’ and ‘Is the service well led?’ to ensure people were safe and improvements were being made. At this inspection, we found improvements to the service, which meant the provider was working to meet the regulations. However, we could not judge that these were fully embedded and effective due to the short time since our last visit. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Southlands Court Residential Home on our website at www.cqc.org.uk”

This service has been in Special Measures. Services that are in Special Measures are k

This unannounced comprehensive inspection took place on 18, 20 and 26 September 2017. Southlands Court provides accommodation and personal care for up to 25 people. Any nursing needs are met through community nursing services. There were 24 people living at the home at the time of the inspection. The service had a new provider who had registered the service with the Care Quality Commission (CQC) in October 2016. This was the provider’s first inspection of the service.

The service is required to have a registered manager as a condition of registration. Southlands Court did not have a registered manager at the time of inspection; the previous registered manager last worked at the home in June 2017 and had since left the employment of the provider. The assistant manager had taken up the position of manager in August 2017. They have submitted an application to CQC to become the registered manager 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.

People’s health, safety and welfare were put at risk because there were not sufficient numbers of suitably qualified, skilled and experienced staff on duty at all times to meet their needs. The CQC wrote a letter to the provider on 21 September 2017 because of the inadequate staffing levels at the service. We were so concerned about some of the findings during the first two days of our inspection visits that, on 21 September 2017, we wrote to the provider setting out our concerns. We asked them how they planned to ensure people living at Southlands Court were being kept safe. The provider’s response acknowledged the concerns raised and gave a commitment to addressing them. They said action was being in some areas. The provider gave CQC assurances in their response that they would increase the staffing at the service. On the third day of our inspection the provider had increased the staffing levels at the home. However they had not undertaken any assessment to demonstrate how the new staff levels were adequate to meet people’s needs.

However, CQC did not feel the response gave adequate assurance to improve the safety systems. The CQC therefore used urgent enforcement powers to impose conditions on the provider’s registration under section 31 of the Health and Social Care Act 2008 to set out what actions we required the provider to take and the timescales required.

On the 28 September 2017 we issued an urgent Notice of Decision to impose conditions on the provider’s registration. We told the provider that they must not admit people to the service without the written permission of CQC. They must have a tool in place to determine the number of staff and range of skills required in order to meet the needs of the people using the service. We also said they must complete this assessment and keep it under regular review and send CQC the assessed staffing levels identified each week.

Since CQC issued the conditions on the provider’s registration the provider has undertaken the required audits and risk assessments and has submitted the actions they have taken to CQC as required. We have since the inspection spoken with the provider and manager and received further assurances that audits have been completed and systems have been put into place to undertake regular monitoring in order to mitigate further risks.

People were not protected from unsafe and unsuitable premises. The provider’s quality assurance systems did not effectively assess and monitor the quality and safety of the service. There were no systems to monitor fire safety and health and safety. The provider had not completed any environmental risk assessments or monitoring checks to ensure the environment was safe. In particular, we