This unannounced inspection took place on 10 January 2018. St Augustines Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Augustines Court Care Home is registered to accommodate up to 40 people in one adapted building. During our inspection, 27 people were using the service, including some people who were living with dementia.

The service did not have a registered manager at the time of our visit. The manager told us they were in the process of becoming registered and we received confirmation that they were registered shortly after our inspection. 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 were supported by staff who understood their responsibility and acted appropriately to keep people safe. Risks to people’s health and safety had been assessed, reviewed and mitigated to reduce the risk of harm as much as possible. People were supported by a sufficient amount of staff, received their medicines safely and lived in a clean and hygienic home.

People were supported by staff who received appropriate training and support. People were supported to eat and drink sufficient amounts and staff monitored and responded to changes in people’s health. People lived in a building which had been designed and adapted to meet their needs. 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 home supported this practice.

People were supported by a friendly, respectful and compassionate staff team. Staff took action to relieve people’s distress and provide comfort. The staff we spoke with were knowledgeable about the people they supported and ensured that people were involved in making decisions about their own care as much as possible. People could be assured that their privacy and dignity were respected by staff.

People received personalised care. An assessment of people’s needs was carried out before they moved to the home which considered the views and preferences of people and their relatives. People were engaged with by staff in appropriate activities and supported to maintain their interests. People were provided with opportunities to make a complaint about their care and these were responded to efficiently. Staff were knowledgeable about what support people required at the end of their life.

People’s relatives were confident in the management of the home and felt they achieved their aim of providing friendly and professional support. People were supported by a staff team who felt supported and invested in the home. People’s views regarding their satisfaction with their care and any areas for improvement were regularly sought and acted upon. Systems were in place to monitor the quality of the service provided at the home.

This inspection took place on 29, 30 November and 1 December 2016 and was unannounced.

Accommodation for up to 40 people is provided in the home over two floors. The service is designed to meet the needs of older people living with dementia. There were 26 people using the service at the time of our inspection.

The registered manager was no longer working at the home. They had left the previous week and a representative of the registered provider was working as the acting manager. They were available during the inspection. 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.

Staff did not always safely manage identified risks to people and safe infection control practices were not always followed. However, people felt safe in the home and staff knew how to identify potential signs of abuse. The premises were managed to keep people safe. Sufficient numbers of staff were on duty to meet people’s needs. Staff were recruited through safe recruitment practices. Safe medicines practices were followed.

People’s rights were not fully protected under the Mental Capacity Act 2005. Staff received appropriate induction and supervision but training levels required improvement. People received sufficient to eat and drink but one person did not receive food that met their cultural needs. External professionals were involved in people’s care as appropriate.

Staff were kind and compassionate and knew people well. There was some evidence to show that people and their relatives had been involved in the care planning process. Advocacy information was made available to people. People’s independence was promoted and visitors could visit without unnecessary restriction. Staff treated people with respect and protected their dignity and privacy.

People received personalised care that was responsive to their needs. People were supported to take part in activities. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

There were systems in place to monitor and improve the quality of the service provided, however, they were not fully effective. People and their relatives were involved or had opportunities to be involved in the development of the service.

Staff told us they would be confident raising any concerns with management and that they would take action. However, some staff felt that they did not receive feedback in a constructive and supportive way.