Huntingdon Court

Huntingdon Court is a care home providing accommodation and personal care for up to 43 people aged 65 and over who may also be living with dementia. At the time of our inspection 30 people were using the service. Accommodation is provided over the ground and first floor with communal lounges and dining areas being located on both floors.

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

Potential risks related to people’s care, health and welfare were assessed and kept under review. People’s records included clear guidance for staff, as to how people’s needs were to be met to promote their health, welfare and safety. There were sufficient staff to meet people’s needs. Staff had undergone a robust recruitment process and had the necessary skills and experience.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible and in their best interests. However, one person’s record did not include a best interest decision for a specific aspect of their medicine management. People’s medicines were managed safely, supported by clear guidance and protocols.

Lessons were learnt and improvements made through the analysis and reporting of accidents and incidents. Systems and processes for the reporting of safeguarding concerns, were in place and were understood by staff. There were safe infection and preventions measures in place.

People’s needs were recorded in personalised care plans, considering all aspects of their care, which included information as to people’s wishes regarding end of life care, and clinical decisions should their health deteriorate.

Opportunities were available for people to take part in group or individual activities. We saw people laughing and speaking with each other and joining in with the activities. Relatives spoke of the positive impact on their family member of spending time with others. People expressed confidence in raising concerns, and complaints were investigated as per the provider’s policy.

The appointment of a registered manager, supported by a wider management team had brought about improvements to the quality and safety of the service people received. Quality monitoring through internal audits and oversight had improved. Plans were put into place where improvements were needed and were monitored for progress.

People spoke positively about the care they received, which included the kind and caring approach of staff. Staff spoke positively of the inclusivity of approach adopted by the registered manager, which enabled them to have a good understanding of the improvements required and why, along with receiving praise for the changes successfully implemented.

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 inadequate (published 15 August 2022).

At the last inspection we found improvements were needed to keep people safe. This included improvements to how risk was assessed and monitored, the provision of sufficient staff to meet people’s needs and improved reporting of abuse to relevant agencies. In addition, the previous inspection identified a lack of consistent and effective leadership had negatively impacted on the assessment and monitoring of the service to improve quality and safety.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 16 October 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Huntingdon Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Huntingdon Court is a care home providing accommodation and personal care for up to 43 people aged 65 and over who may also be living with dementia. At the time of the inspection people were using the service. Accommodation is provided over the ground and first floor with communal lounges and dining areas.

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

People were not always safe because risk was not managed effectively. Risk management plans were not robust. Systems and processes to manage risks of malnutrition and dehydration were haphazard and risked delays in identifying when people did not have enough to eat and drink and therefore delays in taking action and seeking medical attention. Some people identified at risk of falling continued to fall and sustain injuries.

Some people had complex needs and required supervision to keep them safe and to provide reassurance. Staff did not always have time provide this support and reassurance. Staff did not always have time to ensure people had a shower or bath at their preferred time.

Care and support did not always meet people's needs and preferences.

Leadership and governance was not effective and did not identify risk, drive improvement or seek and act on feedback from people.

The service was clean and fresh, and staff followed infection prevention and control and government guidance about the control of COVID-19.

Staff were recruited in a safe way because pre employment checks were carried out.

Staff had training and managed people’s medicines in a safe way.

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.

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

Rating at last inspection

The last rating for this service was requires improvement (published 27 July 2021) The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last five consecutive inspections.

Why we inspected

We received concerns in relation to the care and support provided to people and the leadership and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safety, the management of risk and oversight and leadership.

Please see the action we have told the provider to take at the end of this report.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

We found the following examples of good practice

• An isolation lounge had been created to support a person at risk of falling so they could remain safe, feel less isolated and could be monitored by staff.

• Communication between managers, people, staff and families was good. Changes were quickly communicated so that people knew and understood the correct guidance to follow to reduce the risk of spreading any infections.

• Cleaning schedules and checklists were in use to make sure the premises and equipment were clean and any high touch areas were cleaned at least four times in every 24 hours.

Huntingdon Court is a residential care home providing care to up to 40 people with a range of support needs. There were 19 people living at the service at the time of our inspection. The service provides support to older people some of whom are living with dementia. Huntingdon Court is purpose built. It is split over two floors with communal areas on each floor.

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

Risk was assessed and managed so that people were supported in a safe way and protected from avoidable harm. Staff knew how to identify signs of abuse and how to report it. Staff were confident action would be taken if they raised any concerns. Infection prevention and control procedures and government guidance about COVID 19 were followed. People’s medicines were managed in a safe way. Lessons were learned when things went wrong, and improvements had been made since our last inspection.

Quality monitoring and governance had improved and was effective in identifying risks and seeking feedback from people, staff and relatives. Action was taken to make changes and to improve in response to feedback provided. Staff had the training and support required to do their jobs and meet people’s needs. People had access to the healthcare services they required. We have made a recommendation about tools to support staff in recognising deteriorating health.

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.

People and staff had positive respectful relationships. Staff were kind and caring. People had their privacy, dignity and independence respected and promoted. Care and support had become more person centred since our last inspection so that people received care and support in the way they preferred. Some people were able to follow their hobbies and interests such as gardening and growing vegetables. We have made a recommendation about staff training and activities for people with dementia.

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 inadequate (published 18 May 2021) and there were breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since November 2019. During this inspection the provider demonstrated that improvements have been made. The rating awarded at this inspection was ‘requires improvement’ because the service had not yet demonstrated improvements made were fully embedded or could be sustained. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

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.

Huntingdon Court is a residential care home providing care to up to 40 people with a range of support needs. There were 19 people living at the service at the time of our inspection. The service provides support to older people some of whom are living with dementia.

Huntingdon Court is purpose built. It is split over two floors with communal areas on each floor.

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

Risk was not always managed to ensure people were safe and protected from harm. Staff did not always follow people's care plans and risk assessments. Infection prevention and control procedures did not fully protect people, staff and visitors from the risk of infection. Staff were not always recruited in a safe way. We have made a recommendation about safe staff recruitment.

There was not a registered manager in post. There had been frequent changes of manager. While some improvements had been made, continued significant shortfalls and breaches to regulations remained. Quality assurance systems and processes failed to identify concerns relating to safe care. Leadership and governance were not effective and had not taken sufficient action to make the improvements required.

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.

Rating at last inspection

The last rating for this service was inadequate (Published 20 November 2020) and there were multiple breaches of regulation. The rating for the service has remained inadequate. This is based on the findings at this inspection. This service has been rated inadequate for the last three consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about people’s care and support and infection control. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Huntingdon Court on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified repeated breaches in relation to safe care and treatment, infection prevention and control and governance and quality monitoring. We will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

Huntingdon Court is a residential care home providing care to up to 40 people with a range of support needs. There were 23 people living at the service at the time of our inspection. The service provides support to older people some of whom are living with dementia.

Huntingdon Court is purpose built. It is split over two floors with communal areas on each floor.

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

People did not always feel safe because staff did not always support or respect their freedom to make choices. Risk was not always identified or managed. Staff did not always follow people’s care plans and risk assessments.

Staffing numbers were not sufficient to meet people’s needs or keep them safe. Staff did not always have time to spend with people to meet their needs and keep them safe. Opportunities for people to follow their hobbies and interests were very limited and some people were bored and unoccupied for the majority of the time.

People were not protected from the risk of avoidable harm. There were a number of unwitnessed falls and opportunities to learn from accidents and incidents were missed.

Some people told us they not like the meals provided and no action had been taken to address this feedback.

Infection prevention and control procedures were not following expected government guidance and requirements. Staff did not routinely clean hoists between use for different people and shared hoist slings without cleaning in-between use. This meant people were put at increased risk of infection, this was of particular concern during the COVID 19 pandemic.

There was not a registered manager in post. There had been frequent changes of manager since our last inspection. There were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high quality care. Quality assurance systems and processes failed to identify concerns relating to safe care. The provider was in breach of our regulations for the last two inspection and had failed to make the necessary improvements.

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

Rating at last inspection

The last rating for this service was inadequate (Published 24 January 2020) and there were multiple breaches of regulation. The rating for the service has remained inadequate. This is based on the findings at this inspection.

We received concerns in relation to the management of the service and peoples care needs. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led.

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. We also checked whether the Warning Notice we previously served in relation to breaches of regulation had been met. The overall rating for the service has remained the same following this focused inspection and is inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about care and support provided to people at Huntingdon Court. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this report.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding service users from abuse and improper treatment, staffing and good governance.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Huntingdon Court is a residential care home providing personal care to 36 people aged 65 and over at the time of the inspection. The service can support up to 41 older people.

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

People were not always safe because risk was not identified or managed. Systems to protect people from abuse were not effective because concerns were not always identified, acted on, investigated or referred to appropriate authorities such as the local authority safeguarding team. Staffing numbers were not sufficient to meet people’s needs or keep them safe. Some people were at risk of falling or had fallen when staff were not available to provide supervision and support.

People and staff were not always supported because the culture of the service was not person centred or open and did not always achieve good outcomes for people. Systems in place to monitor the quality of the service were ineffective. They did not fully seek or listen to the views and feedback from people, relatives and staff. The provider had failed to make enough improvements since our last inspection where we identified concerns.

People usually received their medicines in the right way and at the right time but there was a difference in staff understanding regarding when a person’s ‘as required’ medicine should be administered.

Staff received induction training and ongoing training the majority of which was completed on-line and in the staff members own time. Records for staff induction training were not available so we could not be sure all staff had received all the training they required.

People had their risk of malnutrition assessed. However, action was not always taken when records showed they had insufficient amounts to eat and drink. People had access to healthcare services.

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. There was an ongoing investigation at the time of our inspection which included concerns about deprivation of liberty. The provider had planned further training for staff about the Mental Capacity Act.

Most people and relatives praised the staff and said they were kind and caring. We saw staff supporting people in a kind and sensitive way and interactions were positive and respectful. However, staff did not always have the time to spend with people they required to meet their needs. Staff were extremely busy and often in a hurry. People were not fully involved in making decisions about their care and were not routinely asked about their care plan or preferences. People had their privacy and dignity respected.

Care and support was not person centred because care plans were not fully reflective of people’s physical, mental, emotional and social needs. There were a range of activities on offer but these were not planned around people’s preferred hobbies and interests. Complaints were not always taken seriously, acted on or used as an opportunity to learn and improve.

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 requires improvement (Published June 2019) and there were multiple breaches.

Previous breaches

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about risk and allegations of abuse and there was an ongoing police and safeguarding investigation. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the relevant key question sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to the identification and management of risk, staffing numbers, safeguarding people from abuse and quality monitoring. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Huntingdon Court is a care home and offers care and support for up 41 older people, some of whom are living with dementia. There were 39 people using the service at the time of our visit. We inspected the service on 30 April and 1 May 2019. The inspection was unannounced and was carried out in response to information of concern we received.

People’s experience of using this service

Risk was assessed but management plans were not always sufficient to protect people from harm or were not always followed. Some risks in the environment had not been identified, the registered manager took action on the day of our inspection to address these environmental risks.

Staffing numbers and skill mix were not always sufficient to meet the needs of people who used the service or keep them safe. Many people were up during the night or getting up very early in the morning and there were only three staff on duty. This number of staff was not sufficient to monitor people at risk of falling or to attend to people’s needs.

People mostly had their medicines managed in a safe way. Records were accurate and up to date and staff made sure people had their medicines at the right time and in the right way. However, one person’s cream was past its expiry date and staff had some difficulty maintaining the room temperature of the medicine storage area at 25 degrees centigrade or below as per manufacturers guidance.

Slings for use with hoists to support people with mobility needs were used communally and this posed a risk of cross infection. Action was taken in response to an accident or incident such as providing assistive equipment such as pressure mats to alert staff when people were up and walking when they were at risk of falling. However, lessons had not been sufficiently learned in response to the high number of falls that occurred in March 2019.

People, staff and relatives were engaged and involved. However, people and staff views were not always acted on. The registered manager had not been aware that people’s meals were not hot enough until we pointed this out. Staff were disappointed about the changes made to the medicine management and care planning systems and felt the new systems were less efficient and user friendly.

Staff were recruited in a safe way and checks were carried out to make sure as far as possible that only staff with the right character and skills were employed.

Staff understood their responsibilities to protect people from abuse and knew how to report their concerns.

The service was clean and fresh. Housekeeping staff followed cleaning schedules and staff had access to the protective equipment such as gloves and aprons.

The registered manager and area manager carried out regular audits to check that staff were working in the right way to meet people's needs and keep them safe. These checks were not always effective because they had not identified the risks and concerns we found during our inspection.

People and staff felt supported by the registered manager. They told us they were open, accessible and would listen to them.

The registered manager and staff worked in partnership with other authorities and healthcare providers to ensure that people benefited from joined up care.

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

Rating at last inspection

At the last inspection we rated this service Good (report published on 20 June 2018).

Why we inspected

This was a focused inspection based in response to information of concern. We received information about low staffing numbers and staff getting people up very early in the morning. We were also concerned about four specific incidents resulting in serious injuries which the provider had notified us about.

We have found evidence that the provider needs to make improvements. Please see the safe and well led domains in this report. You can see what action we have asked the provider to take at the end of this report.

Follow up

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

Huntingdon Court is a residential care home that provides care and support for up to 43 older people. At the time of our inspection 37 people were using the service and many were living with dementia.

There was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe. Staff understood their responsibilities to keep people safe from avoidable harm. The provider had followed safe recruitment practices. Staff were not always deployed in the most effective ways to provide people with the support they needed particularly during the busy morning period.

Where risks were identified for people while they were receiving support these had been assessed and control measures put in place. People received their medicines in line with their prescription.

Staff had access to the support, supervision and training that they required to work effectively in their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People had enough to eat and drink to maintain good health and nutrition. People were supported to access health professionals when required.

Staff treated people with dignity and respect and supported them to be as independent as possible.

People had care plans in place that focused on them as individuals. This enabled staff to provide consistent care in line with people's personal preferences.

Activities were limited and people did not feel they received enough stimulation.

The service had a positive ethos and an open culture. Staff felt supported by the registered manager to meet the standard expected of them. The registered manager was approachable and accessible to staff and people.

The provider had sought feedback from people and their relatives about the service they received. They had taken action based on this feedback.

The registered manager had implemented systems to monitor the quality of the service.

Huntingdon Court is a residential Home for older people, at the time of the inspection 40 people were using the service.

It is a requirement that 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. The service had a registered manager in place at the time of our inspection.

People told us they felt safe. Staff were able to explain how they kept people safe from abuse, and knew what external assistance there was to follow up and report suspected abuse. Staff were trained and understood how to look after people and protect them from harm and abuse. Staff were aware of whistleblowing.

Staff were recruited following the provider’s recruitment procedures that ensured staff were suitable to work at the home. We observed there to be sufficient staff available to meet people’s basic personal care needs and were deployed effectively.

Medicines were ordered, stored and administered safely and staff were trained to provide the medicines people required.

Staff received an induction and on-going training that supported them in their job role. Staff had access to people’s care records and were understood how to meet people’s needs and what was important to them.

People had been asked for their consent to care and treatment and their wishes and decisions respected. The provider adhered to the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards 2008.

People's dietary needs were met. People were provided with a choice of meals. The catering staff were provided with up to date information about people’s dietary needs. People had access to regular snacks and drinks throughout the day.

People had access to appropriate medical advice and support from health care professionals. Care plans were up to date and included the changes to peoples care and treatment.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. People had access to a variety od activities during the week.

People knew how to make a complaint and were given information about the service. Feedback about the quality of the service offered had been sought. Although people were involved in developing and reviewing their care plans this was not always recorded.

There was a registered manager in place who understood the requirements of their role. They had worked with the provider and staff team to regularly assess the quality of the service.

During our visit we observed staff giving care and support. We saw evidence of good interactions between staff and the people who used the service. For example, we saw evidence of choices being given to people and verbal consent gained before carrying out care.

We also spoke with a number of people who used the service and asked them their views in relation to the care they received. All spoke with high regard for the quality of care and kindness displayed by the staff. One person told us: 'My key worker knows me well and my care is very good.'

We spoke with a number of staff and asked them their views on whether there were enough qualified, skilled and experienced staff to meet people's needs. The staff told us they felt there had been a significant improvement in the numbers of staff. All the staff explained that staffing had improved since the recruitment of a new manager six weeks previously.

We asked the staff we spoke with to describe to us how supported they felt. Their responses indicated they were very well supported. One member of staff told us: 'Working here is brilliant. The new manager is very approachable and has made significant improvements.'

One person told us 'the staff do all what they can; I don't envy them.' This person told us they thought Huntingdon Court was understaffed. Another person told us 'the staff look after me well.' A relative told us Huntingdon Court 'is brilliant. They always keep us informed of what is happening with [their family member] and always sort out any problems.'

We found that care and support was not always delivered in a way that met people's needs and ensured their safety and welfare. We found inconsistencies in the way people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The care records did provide sufficient information about the care provided to meet people's needs. Important information to be used in the event of an emergency was not available in some files. We found there was a lack of meaningful activities and social stimulation available for people using the service.

On the day of our inspection, we found there were an insufficient number of suitably qualified, skilled and experienced staff to meet the needs of people using the service. There was no dedicated manager, administrator or activities co-ordinator available.

We found the provider had policies and procedures in place relating to people who did not have the capacity to consent. However, it was not clear if these had been followed.

We found people experienced care and support that met their needs and protected their rights. We found people's care needs had been assessed. Care and support was delivered in a way that met people's needs and ensured their safety and welfare. People were protected from the risk of abuse and staff knew how to raise any concerns.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

We found that there were enough appropriately trained, skilled and experienced staff to meet people's needs. We saw that staff had received relevant training for their job. However, we found the provider did not have formal systems in place to regularly provide supervision and appraisal to staff.

We found systems were in place to regularly obtain people's views about the care and service they receive. We found the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.