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Inspection carried out on 2 March 2020

During a routine inspection

About the service

Melbury Court is a care home providing both nursing and personal care to people. The service accommodates up to 87 people with a range of needs including some living with a dementia. At the time of inspection 83 people were living at the service.

People’s experience of using this service and what we found

The service was homely, well-decorated and clean. People lived in a safe environment. Health and safety checks were regularly conducted. Individual and environmental risks had been identified and mitigated. Staff had received fire awareness training and people had personal emergency evacuation plans to support staff in the event of an emergency.

The provider had an extensive range of quality assurance systems to monitor the quality and safety of the service. The provider also had systems which assisted them to learn from a range of information, including accidents and incidents, falls and safeguarding incidents. They analysed the information for trends to enable them to reduce future occurrences. Clinical data was also reviewed enabling the service to proactively support people to have positive outcomes.

People were supported by suitably trained and skilled staff. The service supported staff with regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The premises had been adapted to meet people’s needs. Signage was available to support people living with a dementia to navigate the building independently.

People and relatives told us they were happy with the standard of care provided. They told us staff were kind and caring. Staff knew people well and were knowledgeable about their backgrounds and care and support needs.

People were offered a range of activities. The provider had an effective complaints process. People and relatives were confident concerns raised would be dealt with appropriately.

The service had established partnerships with healthcare professionals to ensure people received joined up care. Healthcare professionals told us the service was responsive to people’s care needs.

The manager had a strong oversight of the whole service. The service had a robust management team, all were driven to ensure people received good care. The manager had a positive influence on the service, staff told us they now felt listened to.

People, relatives and staff were regularly asked to provide feedback about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 6 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Inspection carried out on 23 June 2017

During a routine inspection

This inspection took place on 23 and 27 June 2017 and was unannounced. This meant the staff and provider did not know we would be visiting.

Melbury Court provides care and accommodation for up to 87 people with nursing or personal care needs. On the day of our inspection there were 81 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last inspected the service in 16 February 2015 and rated the service overall as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff to make sure they were suitable to work with vulnerable adults.

Staff were suitably trained and received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in respect of Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported to attend visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Melbury Court.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Care plans were in place that recorded people’s plans and wishes for their end of life care.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff felt supported by the management team and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.

Inspection carried out on 16 & 18 February 2015

During a routine inspection

We carried out this inspection on 16 and 18 February 2015 and it was unannounced.

Melbury Court Care Home is registered to provide accommodation, personal and nursing care for up to 87 people. The home is set over three floors and has 37 beds for people who have advanced dementia and require nursing care. The home is situated in its own grounds on the outskirts of Durham. The home is owned and run by Helen McArdle Care Limited.

At the time of our inspection the home had a registered manager in place that had been in post since March 2008. 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 who used the service were involved in planning their care and assessing the level of support they needed.

There were robust recruitment and selection processes in place and staff were subject to pre-employment checks and took part in an induction process when they started work.

There were policies in place for prescribed medicines, homely remedies and when required medicines. Body maps were in place and completed to show where topical medicines should be applied.

Staff received regular supervisions and appraisals where they were able to discuss concerns and receive feedback on their working practice.

Care and support provided was person centred and tailored to meet people’s individual needs.

There was a formal complaints procedure in place and information on how to make a complaint was available to people who used the service and visitors to the home.

The provider had invested in a revolutionary gelling agent to assist people who had difficulty chewing and swallowing.

Staff had been trained in special techniques to help people who used the service relax.

Advocacy services were available and information was displayed in the home on how people could access these services.

There was a quality assurance system in place to ensure people who used the service received the best care possible.

Inspection carried out on 7 February 2014

During a routine inspection

We spoke with twenty people who use the service, eight visitors and one healthcare professional on the day of the inspection. Not everyone we spoke to could express their views, and some were not well enough to communicate with; but those that could, told us they were very satisfied with the service they received. One person said, �The staff are lovely, they are very caring.� One relative told us that they were particularly pleased with the care given to their loved one and said, �I cannot praise the home enough.� We also spoke to ten staff members who all spoke highly of the home.

The majority of people told us that they were happy with the food available, but one person added, �You cannot please everyone all the time.� We also found that the home maintained good levels of cleanliness and infection control procedures.

We found shortfalls in the management of medication which caused us concern.

The home had enough regularly maintained equipment to promote the independence and comfort of people who used the service.

The home had an up to date complaints procedure and promoted an environment for people to complain if required. Complaints were followed up and actioned if appropriate.

Inspection carried out on 9 October 2012

During a routine inspection

People said they were happy at Melbury Court Care Home. One person said �It�s brilliant� and another person said �It�s a lovely home.� Before deciding to live at the home people told us they were given the opportunity to look around and the manager visited everyone that was considering moving there.

We spoke to people who used the service and they told us staff were very good. One person told us �They�re very professional� and another said �The staff are great.�

People told us they were given appropriate information and support regarding their care or treatment. People were given information about care that could be provided and were present when care plans were drawn up meaning care and treatment was planned and delivered in a way that ensured people�s safety and welfare.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The staff we spoke with felt they cared for people who use the service appropriately and felt they were able to speak openly to both manager and deputy manager. One person told us �They (the manager and deputy manager) are very approachable.�

Inspection carried out on 4 May 2011

During a routine inspection

People were asked how they felt about living at the home and the staff who looked after them. These comments included "I like it here" and " it is a nice place to stay". They explained that they could choose what they would like to eat and there was always enough food. Several had enjoyed the recent royal wedding celebrations organised at the home.

Visiting relatives were asked about the care the home provided. Everyone we spoke to was very happy with help and support their relatives received. They explained that they were welcome to visit the home at any time.

Reports under our old system of regulation (including those from before CQC was created)