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Inspection carried out on 20 September 2017

During a routine inspection

This inspection took place on the 20 and 21 September 2017. The inspection was unannounced on the first day and announced on day two.

Scarbrough Court is a purpose built care home registered to provide personal care with nursing for up to 58 people, including people who live with dementia. At the time of our visit, 56 people were using the service. The home is not far from the shops and amenities of Cramlington and was maintained and furnished to a high standard. People had their own spacious rooms with ensuite bathrooms and use of communal areas throughout the home, which included landscaped gardens and a roof top garden.

The service has 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.

People had not always received safe care. Staff were knowledgeable about how to keep people safe from harm. Risks to people's safety were assessed and plans were in place to manage and reduce risks. However, due to staff absence a shortfall of staff was created on one of the days of our inspection. This had placed people at risk. We saw that a person on Windsor (a residential unit that supported people who lived with dementia) had fallen on the floor. There were no staff available in the area, until we had alerted them; the person had not sustained an injury. The service had taken immediate action that ensured sufficient staff and had began the process of recruitment to cover any future staff shortfalls, such as annual leave and training. Additionally we found that at times Windsor was left with only one staff member due to staff breaks and meetings. We had discussed this with the registered manager who had taken immediate action to improve.

We have made a recommendation about the assessment of staff numbers and delegation of staff to meet people’s individual needs within the environment they live.

People’s needs were met by staff who were recruited safely using robust procedures. Staff had received the appropriate training, and had their skills monitored. People’s medicines were managed safely by staff that had their competencies measured regularly. Health and safety assessments of the environment were completed that provided people with surroundings that were safe and comfortable.

People were supported to maintain their health and wellbeing. Advice was obtained from healthcare professionals when necessary. However, one person's blood pressure had elevated to a concerning level without being referred quickly to relevant health services. Staff had not sought immediate medical advice. This had placed the person at risk of further healthcare complications developing. We brought this to the attention of staff and immediate action was taken for the person to be reviewed by their GP. The registered manager proceeded to investigate why this had happened and also reviewed the daily processes used to monitor people’s health.

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

People were supported to eat a choice of freshly prepared meals and were complimentary of the meals provided. They were supported with special diets if required and when necessary their dietary intake was monitored.

Staff received an induction to their role and training to meet the assessed needs of people who use the service. Training updates were provided that included dementia awareness, equality, diversity, and personal care. Staff were supported in their job roles through one to one meetings, appraisals and team meetings.

The service was caring. Staff were kind, considerate and compassionate in the way they delivered support t