This inspection took place on 27 and 28 April 2017. The inspection was unannounced on the first day and announced on the second. The previous comprehensive inspection of the service was in May 2016. At that inspection we found the service was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

A requirement notice was issued with respect to the breach of Regulation 12 (Safe care and treatment). The registered provider sent us an action plan in June 2016 outlining the improvements they were going to make in order to meet the requirements of the regulation.

The inspection of 27 and 28 April 2017 was a comprehensive inspection to follow up and ensure the requirement notice for Regulation 12 (Safe care and treatment) had been met and to make a judgement about the overall compliance of the service. We found the service had made the necessary improvements to meet the requirements of the regulations.

Thatcham Court Care Home provides accommodation for up to 60 people who may be living with dementia and need personal and nursing care. The service was purpose built as a care home and provides accommodation over three floors. There is a well maintained garden which provides safe outdoor space for people to enjoy.

At the time of the inspection there were 50 people living at the service. The manager had applied to register with the Care Quality Commission to manage the service and was registered on 5 May 2017 following 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.

People living at Thatcham Court Care Home received safe care from staff who knew them well. There were sufficient staff with the appropriate skills and knowledge to support people in a safe and effective manner. People were protected from the risk of abuse by staff who were knowledgeable with regard to safeguarding people and understood their responsibilities. People’s medicines were managed safely and they received their medicines at the required times. Risks relating to people and the environment were assessed and managed. Staff knew how to respond to emergencies, they had received updated fire safety training and taken part in practice fire drills.

Staff felt supported and they praised the manager for the support she provided. They received appropriate training to acquire the skills necessary for their role and they refreshed their knowledge regularly. 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 service supported this practice. Where people were unable to make decisions for themselves staff met with relatives and other professionals to make decisions in their best interests. When people’s freedom had been restricted for their own safety appropriate authorisations were in place under the Deprivation of Liberty Safeguards. People had a choice of food and drink which they enjoyed. When necessary their nutrition was monitored to help ensure their well-being. People received appropriate health care support from health and social care professionals who were contacted promptly when necessary.

People were treated with kindness and compassion. They were respected and had their privacy and dignity maintained by staff who understood these values. Visitors were welcomed at the service. There were no restrictions on visiting times and people were encouraged to maintain relationships important to them. People and staff interacted positively with each other, choices were offered and explanations provided when staff assisted people with daily living activities. There was a relaxed and friendly atmosphere an

This inspection took place on the 4 and 6 May 2016. The inspection was unannounced on the first day and announced on the second day.

Thatcham Court is a detached modern purpose-built home situated in the centre of Thatcham in West Berkshire, close to local shops and other amenities. People have their own bedrooms and use of communal areas that includes an enclosed private garden. The people living in the home live with dementia and other health related conditions and need care and support from staff at all times. The service is registered to provide care and nursing care for up to sixty people. There were fifty-eight people in residence during our visit.

There is a registered manager running 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 not available at the service, which is being managed by an interim manager with support from a deputy manager.

There were systems to regularly assess and monitor the quality of service that people received, but the registered manager had not used these effectively to ensure people’s safety and well-being.

Staff had not received the refresher health and safety training they needed to promote people’s safety. They had not been supported with their development needs until the recent deployment of an interim manager and recruitment of a deputy manager. People, their relatives and staff told us they felt listened to by these two managers, who had endeavoured to improve the overall safety and well-being of people, whilst supporting and developing the staff team.

People’s care plans were not up to date to fully reflect their care needs and/or fully identify individual risks. For example, to promote falls prevention, people’s skin viability and to support people who displayed behaviours that could cause distress or harm to themselves and/or others. Staff did not receive an effective handover to make sure they were fully aware of people’s changing needs. These issues were being reviewed and improved by the interim manager and deputy manager during the two days of our visit. They recognised the need for further improvements. Staff were receiving support to change the ethos of the home to promote person-centred care and improve communications.

There were enough staff to meet people’s needs. Further improvements were being made by the managers to make sure staff numbers promoted person centred care. However, until February 2016, staff absences were not fully covered by agency staff. This left staff short on the floor or having to work excessive hours. From this date the interim manager and deputy manager made sure there were enough staff to promote a safe service.

People’s nutritional needs were met with meals that were appetising and cooked to meet individual needs. Staff treated people with respect and kindness and embraced the support they needed to improve the quality of services to promote person centred care. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families. However, people who remained in their room through choice or frailty were at risk of social isolation and further improvements were needed to make the environment more dementia friendly.

There were robust processes in place to monitor the safety of giving people their medicine. Recruitment and selection process helped to ensure staff of good character supported people. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

The service had taken the necessary action to ensure they were working in a way that recognised and maintained people’s righ

People who lived in the home told us they were happy in the home and felt safe, cared for and listened to by staff. Comments included, “I can’t think of a nicer place to be, this is very much like home to me” and “staff are always accommodating and always come to say hello, it makes a lot of difference”.

People’s care plans detailed how they wanted their needs to be met and supported choices they had made. These included people’s nutritional needs that were continually reviewed. People were provided with a choice of meals and told us they enjoyed the quality of the food.

The home was clean and had effective systems in place to reduce the risk and spread of infection.

Staff received appropriate professional development and support to safeguard and deliver care to the people who lived in the home.

People and their relatives were kept informed, were listened to and given opportunity to provide their views of the services provided. Comments included, “a little hard pressed to grumble here” and “I’ve complained once and the home handled it very well”.

Observation of care practice during our inspection showed people were receiving effective, safe and appropriate care which was individualised and designed to meet their specific needs. The care provided was carried out with sensitivity and patience.

People told us that there were enough staff on duty to support them. We were told that they did not have to wait too long if they called for assistance. We saw that staff were always in attendance in the lounges and communal rooms when they were in use.

People spoke favourably about the staff. One person told us, "They are all very good and are very kind towards me”. Another said, "They are good to everybody here and I would hate to have to leave” A family member told us, "I think they are friendly, caring and very respectful towards my mum”. They also told us that staff answered call bells promptly and responded to requests for assistance quickly.

Equipment used in the home was clean and well maintained.

People were complimentary about the home. They told us they had comfortable rooms which were always kept clean and tidy. They said the food was good and there was plenty of choice and variety. People told us the staff were friendly, courteous and helpful and were quick to respond when they required assistance. They said staff offered them appropriate levels of support and did so with patience and kindness.