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Inspection carried out on 4 December 2018

During a routine inspection

What life is like for people using this service:

• People enjoyed living at Housman Court and felt safe and comfortable around staff who understood their personal circumstances and how to recognise and report abuse.

•Staff recognised the risks to people’s health, safety and well-being and how to support them safely. Where relevant, specialist equipment was used.

•People had access to support from staff when needed.

•Staff recruitment processes included a check of their background to review their suitability to work at the home.

•People received support with the medicines. Regular checks were undertaken to ensure people received the correct support by staff who were competent to support them.

•Staff understood and practised infection control techniques.

•The registered manager ensured people’s care was based on best practice and staff had the correct training to meet people’s needs.

•Staff training was reviewed and guidance on people’s needs was also shared through supervision and staff meetings.

•People were offered choices at mealtimes and encouraged to share ideas for their menu. Where people had specific nutritional requirements, these were also catered for.

•People were supported to attend healthcare appointments and advice from healthcare professionals was incorporated into people’s care.

• People were treated with dignity and respect and their independence was promoted.

•People and their families were involved in planning their care with support from staff.

•Staff supported people to enjoy a range of activities which reflected people’s individual interests.

•People and their families understood how to complain if they wanted to.

•Staff felt supported by the registered manager and felt part of a newly established team that were keen to develop people’s care further.

•Staff worked together with the registered manager and families to ensure people’s care was continually monitored, reviewed and reflected people’s needs.

• The registered managers and staff worked with other stakeholders to improve people’s experience of care. .

• We found the service met the characteristics of a “Good” rating in all areas; More information is available in the full report

Rating at last inspection: Good (published 09 June 2016)

About the service: Housman Court is a is a residential care home, providing personal care and accommodation. There were 28 people living with dementia. The service provides accommodation and personal care to older adults.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

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 information is received we may inspect sooner.

Inspection carried out on 9 June 2016

During a routine inspection

The inspection was unannounced and took place on 9 and 10 June 2016.

The home is registered to provide accommodation and personal care for a maximum of 30 people. There were 29 people living at the home on the day of the inspection. There was 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.’

People told us they felt safe and well cared for. Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People were cared for by staff that demonstrated knowledge of the different types of potential abuse to people and how to respond to actual or suspected abuse.

People got the assistance they asked for or staff ensured they were available to help people when needed. People told us they enjoyed meals times and where they were joined by staff and relatives were helped to eat and drink enough to stay well. People told us they were happy with choice of food they received. Staff gave people their medicines and recorded when they had received them.

People’s rights and freedoms were respected by staff. Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them. There were good links with healthcare professionals and staff sought and acted upon advice received, so people’s needs were met.

People and relatives consistently praised staff and the registered manager and the support they provided, which they described as ‘excellent.’ This high standard of care enhanced people's quality of life and wellbeing. The staff were extremely passionate about providing people with support that was based on their individual needs, People demonstrated to us that they valued their relationships with the staff and relatives told us they felt valued and supported by staff too. We observed that people were comfortable in the staff's presence. Conversations were friendly and there was a lot of laughter. Relatives told us there were no restrictions on when they could visit and they were always made welcome by staff and often enjoyed meals their family members.

Relatives and a visiting healthcare professional praised end of life care provided by staff and said it went above and beyond. Staff were highly motivated and followed the example of the registered manager in providing care with kindness and dignity. Relatives told us the registered manager was very caring and they led staff to provide care that focused on people and took account of their individual needs and preferences.

People had developed in confidence because of how the staff cared for them and we saw people had a sense of purpose. People said their privacy and dignity was maintained and staff were respectful of their belongings. We made observations that supported this and saw staff responding to people in a timely and respectful way.

People received care that met their individual needs. People were encouraged to join in activities and social events which they enjoyed. People said staff listened to them and they felt confident they could raise any issues should the need arise.

Staff spoke highly of the management team and felt supported. Staff told us they enjoyed working at the home and spoke positively of the teamwork of the staff team. The quality of service provision and care was continually monitored and actions taken where required.

People were very positive about the care and support they received, the management of the home and the service as a whole.

Inspection carried out on 9 August 2013

During a routine inspection

When we carried out this inspection 30 people used the service. We spoke with the registered manager, the deputy manager, a senior carer, three members of the care staff and the cook. We spoke with eight people who used the service during our inspection and two visitors. Comments made by people who used the service included: �Treated well here� and: �Couldn�t get a better place if it was a palace. I have never been so happy�. A visitor described the staff as: �Very competent.�

We observed how staff interacted with people. We saw that staff spoke with people in a respectful manner. From our observations we saw that people were provided with care that met their individual needs. Staff knew about the needs of the people they were caring for.

We found that people were able to have a choice of suitable food and drink in sufficient quantities to meet their needs.

We found that the equipment that was used in the home was maintained appropriately and that staff had been trained in its use.

Staff had been recruited in an appropriate way and checks had been undertaken that ensured they were suitable to care for vulnerable people.

Systems were in place so that people could make comments and complaints about the service provided.

Inspection carried out on 16 October 2012

During a routine inspection

When we visited Housman Court 29 people were using the service. During our inspection we spent time with people who used the service while they were in the dining room and in the lounge.

The manager designate, who has been officially in post for six months, was preparing documents to register with the Care Quality Commission.

We saw people who used the service engaging in a range of activities during the day and they told us about other things they do outside of the home such as shopping and going for a coffee.

We found that staff on duty had a good understanding of the needs of people and that they supported them in meeting their needs.

People who used the service indicated that they were happy and felt safe. Some people were able to tell us that they would tell the manager if they were worried or had any concerns. Staff had knowledge about safeguarding procedures in the home and the actions they would take.

The management of medication had improved although the provider needs to ensure that medication is not left unattended.

We were assured that staffing numbers particularly at night were sufficient

Suitable systems were in place to assess and monitor the quality of care provided and as a means to identify any improvements needed.

Inspection carried out on 23 January 2012

During an inspection looking at part of the service

We visited Housman Court to review the care and welfare offered to people using the service. We spoke with people living at the home as well as a visiting relative. We spent time with the manager (not yet registered with the Care Quality Commission) and other members of staff.

We saw that staff treated people kindly and with respect. People were complimentary about the care that they received. One person said about the service �it�s very good�. Other comments included �well looked after�, �have no regrets about moving in here� and �pleased to have someone to look after me�. We saw that people were appropriately dressed taking into account the weather conditions. People�s clothing and hair appeared neat indicating that staff knew the importance of helping people look at their best.

People told us that they enjoyed their lunch. We saw staff discreetly helping people as necessary or encouraging people to eat their meal. Staff did not rush people giving them the time they needed.

We saw evidence of contacts with professionals such as GP�s, community nurses, specialist nurses, chiropodists and physiotherapists. These showed that medical and physical concerns were brought to the attention of relevant people.

We found that the computerised care plans did not always provide consistent information and in some cases we found conflicting information. We checked whether some details recorded within the care plans was correct. This was not always the case and at times we needed to speak to staff to seek clarification.

Medication Administration Records (MAR) were largely completed well. We checked a number of these and found them all to be correct. In addition we checked whether the correct amount of antibiotic medication was recorded as administered and found that it was.

On one sheet we saw that staff had recorded for a period of six days that a prescribed medicine was out of stock. This was not brought to the attention of a medical practitioner for this period of time. We saw that another laxative also ran out for two day. The manager told us that she had been aware of this situation and had introduced a new system to prevent a reoccurrence.

We viewed records to evidence when creams are applied and found gaps or a high frequency when the cream was recorded as �not required�.

We saw evidence that audits take place. This means checks are done on certain aspects of service delivery.

We saw minutes of a meeting held during 2011 and proposed dates for meetings with residents and relatives during 2012. During a meeting in October 2011 people�s likes and dislikes were discussed and therefore changes to the menu were agreed.

The area manager visits Housman Court on a regular basis and carries out checks on certain aspects of the home as well as speaking with residents, staff and visitors. A written report is prepared following these visits containing any necessary improvements as well as positive feedback received.

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