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Inspection carried out on 25 June 2019

During a routine inspection

About the service:

Drayton Court is a care home, providing personal care and accommodation for up to 45 people. It provides care to older frail people, some of whom are living with dementia. The care home also offers ‘day-care’ on specific days of the week, the day care lounge is separately staffed. Care is provided over three floors. Each floor has communal lounges, dining areas and a kitchenette. At the time of our inspection visit 37 people lived at the home.

What life is like for people using this service:

Risks were not consistently well managed because actions to mitigate some identified risks had not been taken. Risk management plans did not always give staff clear guidance on how they should support people. There were sufficient staff on duty during the day shift. A few staff felt night time staffing was too low and the new manager told us they would look at this.

People had their prescribed medicines available to them and were supported with these by trained staff. Staff did not consistently ensure people’s medicines or prescribed items were stored securely which posed risks to people.

Staff received an induction, training and support from within the staff team, the provider’s trainer and managers. Despite staff being told about the provider’s values and vision, this was not embedded into the culture of the home as staff could not tell us what this was. Overall, the home was clean and tidy, and staff understood how to prevent risks of cross infection. There were some bedrooms with an offensive odour.

People had their needs assessed before they moved into the home. Overall, people had plans of care relevant to their needs. However, plans of care around pain management or future wishes for end of life care had not always been completed. Staff were trained to meet people’s day to day needs and protect people from the risks of abuse.

We received mixed feedback from people about what it was like to live at the home. Those people who required less staff support experienced more positive outcomes. People had opportunities to engage in group activities, however, these largely took place in the day care lounge and meant people who chose to remain on their 'household' or in their bedroom were at risk of social isolation because there were limited opportunities to engage in activities or with staff.

People had access to healthcare when required. People were offered enough food and drink to meet their dietary requirements. However, people’s mealtime experience was not always relaxed or enjoyable.

Some positive caring interactions took place between people and staff. However, some staff failed to follow the provider’s policies which posed potential risks to people and did not consistently reflect a caring attitude.

People made day to day decisions about their care and were supported by staff who worked within the principles of the Mental Capacity Act 2005.

Staff did not consistently ensure people’s private care records were stored securely or confidentially.

Overall, the provider’s quality assurance system identified where improvements were needed, but this was inconsistent and did not always ensure quality and safety.

A new manager had started and was prioritising areas that required improvement.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:

Regulation 12 Regulated Activities Regulations 2014 – Safe care and treatment

Rating at last inspection: The service was rated outstanding. (The last report was published on 18 April 2016).

Why we inspected: This was a planned inspection based on the rating of the last inspection. The service is now rated as ‘Requires Improvement’ overall.

Enforcement: Action provider needs to take (refer to end of report).

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning i

Inspection carried out on 4 February 2016

During a routine inspection

The inspection took place on 4 and 5 February and was unannounced.

There was a registered manager in post. 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 service provides accommodation and personal care for up to 45 older people, who may have dementia. Forty-four people were living at the home at the time of our inspection.

People were at the heart of the service. The provider’s philosophy, vision and values were understood and shared across the staff team. People were supported to maintain their purpose and pleasure in life. People’s right to lead a fulfilling life was enshrined in a charter of rights, which was displayed in the entrance to the home.

People and relatives were delighted with the care and support provided by the staff, which exceeded their expectations. Staff took time to understand people’s life stories and supported and encouraged people to celebrate important personal and national events. People were supported to retain an active presence in the local community and to maintain their personal interests and hobbies.

The provider employed a team of exercise and activity co-ordinators who were dedicated to supporting people to make the most of each day. The group activity sessions were effective and the positive impact on people’s moods was visible; people continued to smile and sing after an exercise session ended.

People planned their own care, with the support of their relatives and staff, to ensure their care plans matched their individual needs, abilities and preferences, from their personal perspective. Care staff showed insight and understanding in caring for people, because they understood people’s individual motivations and responses.

People who lived at the home, their relatives and other health professionals were encouraged to share their opinions in a format that was appropriate to their needs, to make sure their views drove planned improvements. The provider had researched and reflected on how international exemplar services provided care and planned to refurbish the home in accordance with current best practice principles.

The provider was innovative and creative and constantly strived to improve the quality of people’s lives, by working in partnership with experts in the field of dementia care. Planned improvements were focused on improving people’s quality of life.

All the staff were involved in monitoring the quality of the service, which included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence. The provider shared their learning with all the homes in the group.

The home was divided into three ‘households’, each with their own lounges and dining rooms. Each household was individually supported by a care co-ordinator and three care staff. Care co-ordinators were part of the duty management system, which meant there was a named manager available to respond to issues and to support staff, seven days a week.

There were enough staff on duty to meet people’s physical and social needs. The registered manager checked staff’s suitability to deliver personal care during the recruitment process. The premises and equipment were regularly checked to ensure risks to people’s safety were minimised. People’s medicines were managed, stored and administered safely.

Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. Staff understood the risks to people’s individual health and wellbeing and they were clearly recorded in their care plans.

Staff were attentive to people’s appetites, m

Inspection carried out on 22 August 2013

During a routine inspection

People's privacy, dingity and independence was respected, as people understood the care and treament choices available to them. One person said 'The care here is excellent, everyone always seems happy, they look after them so well.'

Care and treatment was planned in a way that ensured people's safety and welfare. One person said 'There are some complex needs required here and they care for them in a way that keeps them safe.'

All staff are subjected to appropriate checks and references were taken up prior to commencement of employment. All staff were trained to be able to deliver the care and support required by individuals. One person said 'All the staff are knowledgable and well trained.'

We spoke to the home manager, the care manager, people who use services their relatives and staff. Comments we received were all positive and included 'I love it here.' and 'It's like home from home.'

Staff members we spoke with told us that they were happy working at Drayton Court, that the managers were supportive and they felt valued and listened to.

Staff spoken to had a good awareness of individuals care needs and the importance of treating people with respect and dignity. This was confirmed by the training provided around respect and dignity and by talking to people who use the services. Comments included 'We are all happy here together, I feel safe.' and 'It is absolutely marvellous here, they look after me and they keep my room spotless.'

Inspection carried out on 23 November 2012

During a routine inspection

When we visited Drayton Court we met with most of the people who used the service and spoke with three people in more depth about their experience of care at Drayton Court. We met and spoke with four relatives, the care manager and the service manager. We spoke briefly with members of staff who delivered care and spoke in depth with two staff members about how they delivered care to people that used the service.

People who used the service told us they were happy with the way staff provided their care. One person told us, “They look after me and know how I like things done. They are all friendly.”

We asked relatives about the care provided to their family and they each told us that the care delivered to people was good. One relative told us, “My mother is always smart and enjoys the meals here.” Another relative told us, “Staff are very good but very busy.”

We saw people's bedrooms were clean, warm and well furnished. People had brought some personal items with them into the care home and this made their rooms "homely".

We saw that mealtimes were a relaxed and social occasion and that people had a choice about what they wanted to eat and drink.

Staff told us they had regular training, which meant they could support the specific needs of people who used the service. Records we looked at showed that staff communicated people’s changed needs to managers so that care needs could be re-assessed promptly.

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