About the service: Whitby Court Care Home is a nursing home providing personal and nursing care to 43 people at the time of the inspection.

People’s experience of using this service: People were happy with the service provided and felt safe. People received support from staff who were trained, supported in their role and encouraged to continuously develop their skills. Staff understood how to identify and report any safeguarding concerns.

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. People told us staff were kind and caring and respected their privacy and dignity. Staff understood the importance of promoting and encouraging food and fluids. Staff spent time getting to know people and their life histories. Activities on offer provided stimulation and social interaction with other people who used the service.

Care plans were in place to give staff the information they needed to support people in line with their preferences. People felt valued by the service. They had regularly opportunities to provide feedback on the service they received; action taken as a result was shared with them.

Regular checks and audits on the quality and safety of the service were completed by the registered manager and the provider. The registered manager was passionate about ensuring the service continuously improved, addressed any concerns promptly and learnt lessons when shortfalls were found. People and staff spoke highly of the management team and their approach.

The registered manager shared their skills and knowledge with other services and participated in pilots to improve the care in the wider area. The service had good links with the local community and other professionals to promote and improve people’s health.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection: Good (report published 8 December 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We inspected Whitby Court Care Home on 28 October 2016. This was an unannounced inspection, which meant the staff and registered provider did not know we would be visiting.

When we last inspected the service in September 2015 we found two breaches of regulations. We found that staffing levels on the nursing floor were not always sufficient to care for people safely or to enable all people to pursue interests of their choice. We also found gaps in records which monitored people’s clinical care needs, for example fluid and nutritional charts and moving and handling charts. Records of people’s involvement about their care were not sufficiently detailed to ensure staff had the information they required.

At our inspection on 28 October 2016 we looked again at staffing levels and found that the registered manager had worked hard to recruit staff to ensure there were sufficient staff on duty to cover all shifts. People and relatives told us there was enough staff on duty to meet their needs. We looked again at fluid and nutritional charts and moving and handling charts. We found that in general staff ensured up to date and accurate information was contained with records; however there was still some improvement needed to ensure the care records of people were person centred.

The home had 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.

Whitby Court Care Home provides residential and nursing care for up to 50 older people, some of whom are living with a dementia. The building was recently built for purpose and presents an attractive living environment. There are a number of communal areas for people to use. On the ground and first floor of the service there is a large lounge area and a dining area. On the lower ground floor there was a beach room and garden room for people to spend time and pot plants. The lower ground communal areas did not have heating so was mainly used in the summer months. On the ground floor there was a small games room and a small café and on the first floor a train room with a working train set. There is a passenger lift to assist people to all floors and the home is located close to transport links and the local park. At the time of the inspection there were 48 people who used the service.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Risk assessments covered areas such as falls, moving and handling, nutrition, risks associated with people’s health and behaviour that challenged. Staff told us how control measures had been developed to ensure staff managed any identified risks in a safe and consistent manner. However, some risk assessments were generic and not individual to the person.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. People subject to DoLS had this recorded in their care records. However, mental capacity assessments were not decision specific. Best interest decisions were not recorded in care plans. We have made a recommendation about this.

People were protected by the services approach to safeguarding and whistle blowing. People who used the service told us they felt safe and could tell staff if they were unhappy. People told us staff treated them well and they were happy with the care and service received. Staff were aware of safeguarding procedures, could describe what they would do if they thought som

Whitby Court Care Home provides accommodation for up to 50 people who requiring nursing and personal care. The home mainly provides support for older people and people who are living with dementia. The accommodation is arranged over two floors and there is a passenger lift to assist people to get to the upper floor. There were 24 people living at the home at the time of our inspection.

This was an unannounced inspection, carried out on 17 November 2014 following concerns raised about the quality of care people received at the service by people who did not wish to be named.

The home had 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. The registered manager had recently within days of our inspection terminated there employment with mutual agreement by the provider.

This was the first inspection since the provider was registered on 18 February 2014.

Although people told us that they felt safe in this home we looked at incident records and found where incidents had occurred sufficient action had not been taken to prevent further incidents occurring again. We also found medication was not safely recorded and administered which placed people at possible risk of harm. Support plans we looked at to manage complex behaviours did not contain sufficient detail to ensure people’s safety and well-being.

People told us that they, and their families, had been included in planning and agreeing to the care provided. We saw that people had an individual plan, detailing the support they needed and how they wanted this to be provided.

Staff we spoke with told us they had not received any training or induction since working at the service and equally had received no supervision from the registered manager. This had been highlighted during the providers’ review of the service and the operations manager had commenced in addressing the areas of concern.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home but also saw instances where staff struggled to engage people in any meaningful activity.

People’s health, care and support needs were assessed. Individual choices and preferences were  discussed with people who used the service and/or a relative. Care plans were reviewed on a monthly basis or when there had been a change in people’s needs.

People who use the service and their relatives spoke very positively about the operations manager. However staff told us they did not always have the skills to work with people who had complex behaviours and needs. And they lacked appropriate training to ensure people’s needs were appropriately met.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to planning care effectively, managing medication, staff training.

You can see what action we told the provider to take at the back of the full version of the report

This inspection took place on 1 and 4 September 2015. It was unannounced on the first day and announced at short notice on the second day. Whitby Court Care Home is registered to care for up to 50 older people with nursing needs. On the day of inspection there were forty five people living at the home. The building was recently built for purpose and presents an attractive living environment. There is a passenger lift to assist people to the upper floors and the home is located close to transport links and the local park.

The home had a registered manager in place. 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.

At the last inspection on 17 November 2014 we found three breaches of regulations. We received an action plan from the provider setting out how they would meet the relevant legal requirements.

We found that the registered person had not protected people because of shortfalls in the way they assessed and managed individual risk. This was in breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection on 1 and 4 September 2015 we found this area had improved with risk management plans in place to protect people. This meant there was no longer a breach of regulation 9.

At the last inspection on 17 November 2014 we found that the registered person had not protected people against the risks associated with the safe handling of medicines. This was in breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection on 1 and 4 September 2015, we looked at the management of medicines and found that this had improved. People received their medicines as prescribed and when they needed them. This meant there was no longer a breach of regulation 12.

At the last inspection on 17 November 2014 we found that the registered person had not protected people against the risks associated staff who were insufficiently trained to deliver effective care. This was in breach of regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection 1 and 4 September 2015 we found that staff training had improved so that they had the skills to give effective care. Regulation 18 was no longer in breach with regard to staff training.

Staff were safely recruited. However, staffing levels were not always sufficient to care for people safely or to enable all people to pursue interests of their choice. This was a breach of Regulation 18 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.

We noted gaps in records which monitored people's clinical care needs, for example fluid and nutritional charts and moving and handling charts. Records of people's involvement in decisions about their care were not sufficiently detailed to ensure staff had the information they required. This meant there was a breach of Regulation 17(2) 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.

People had their clinical care needs met, however, people sometimes had to wait for staff to attend to them in terms of these needs, for example in relation to repositioning or receiving drinks. Required charts to monitor this care were not consistently completed. We have made a recommendation about this.

Staff were kind and usually offered compassionate care, including when people reached the end of their lives. People had written thank you cards and letters praising the kind and compassionate care offered by the service. However, staff were sometimes rushed which led to care being task led at times.

The environment, though attractive and well decorated was under used and its potential not fulfilled. People did not feel encouraged to use certain areas of the home. The environment was not well adapted to the needs of people with memory impairment. We have made a recommendation about this.

Staff and people who lived at the home told us that the culture of the home did not always put each person at the heart of care. Lines of communication between the providers, the registered manager, staff and the people who lived at the home and visitors were not sufficiently transparent or responsive. People and staff were not sufficiently involved in developing the service. Although surveys and meetings took place, there was insufficient evidence that people were consulted in a meaningful way over how the service was run. We have made a recommendation about this.

People were protected with regard to seeking consent before undertaking day-to-day care and treatment, however, they had not always received assessment for their mental capacity when this was needed to ensure their rights were upheld and their freedom to make decisions maximised. We have made a recommendation about this.

People told us they felt safe at the home. Risks to people were assessed and acted upon. Staff were trained in safeguarding and understood how to recognise and report any abuse.

People were protected by the infection control practice within the home. The home was clean and fresh throughout.

Most staff were supervised and trained effectively to feel supported to offer good quality care. However, nurses felt that they needed more clinical supervision support.

People had access to health care support and the service was proactive in referring to specialist professionals and acting on their advice.

People received well balanced nutritious meals. They were offered freshly cooked breakfast and tea time meals. Main meals were pre- prepared frozen meals which the service re heated. People told us they enjoyed the food, however, some people told us they would have preferred a choice of a freshly cooked main meal and staff confirmed that at the time of inspection people did not have this option for main meals.

People were supported to take part in activities and daily occupations. However, some people were at risk of being under stimulated because staff did not have time to work with everyone in this way, particularly those on the nursing floor.

If people raised concerns or complaints these were usually dealt with promptly and recorded with actions.

The registered manager carried out a system of checks and monitoring audits to ensure the service was safe and that plans could be drawn up for improvement.