Our unannounced inspection at Court House took place over one day on 28 March 2012. The visit lasted nine hours and 50 minutes and we left the home at 8pm. We spent the majority of our time in communal areas or met people in their bedrooms. We spoke with seven people living at Court House who were able to comment directly on their care. We also spent the afternoon in the main lounge with a group of six people; four people were not able to comment directly on their care so we spent time with them to help us understand what life was like at the home. This meant we spent time observing care and people's interactions with staff to see whether they had positive experiences.We visited 14 bedrooms to see how they were maintained and looked at a range of written records including care assessments, care plans, training records for staff, minutes of meetings, menu records and surveys.
We were given a list that showed 19 people were living at the home and the manager told us that two people were in hospital. During the inspection, we spoke with the manager, who is registered with the Care Quality Commission and the operations manager. We also spoke to three staff members about their training and their roles. We gave detailed feedback to the manager and the operations manager at the end of the inspection to ensure that they could begin improvements immediately.
After the inspection, we also contacted the local adult social care team to advise them of the serious concerns we had regarding the non-compliance levels at the home.
People who spoke with us had a mixed opinion about whether their dignity was always promoted by staff working at the home. Some staff members were more skilled than others in responding appropriately to people's individual needs. We saw that people looked well cared for and were dressed appropriately.
People told us they could decide where they spent time and we saw people making choices and being listened to by staff. One person said they liked to get up late and said that staff respected this decision; another person said they preferred to eat their meals in their room and that this happened. However, some basic choices were not promoted, such as drinks and meals. And people were not routinely involved in how they care and social needs would be met.
We saw that people generally seemed at ease with staff and that most staff knew people well and could pick up on their moods and were attentive. For example, making sure someone was comfortable, offering reassurance and explaining about the moving and handling equipment they were using to assist people.
We heard activities staff checking with people about what they would like to do and encouraging a group of people to join them in the garden. We heard people laughing and chatting while they were outside. We saw that people generally seemed at ease with staff, and that staff knew people well and could pick up on their changing moods. However, staffing levels did impact on how much time staff could spend in communal areas with people to help ensure their care needs were being met and that they were safe.
We asked people if they could contribute their views about the running of the home and the quality of the care they experienced. Several people told us about residents' meetings and one person said they attended a meeting but that they were not a regular event. In the three care plans we looked at, there were no examples of people being involved in reviews of their care.