The inspection took place on 22 march and 7 April 2017 and was unannounced. We last inspected the service in December 2014 and we found the service was meeting all of the regulations we inspected.
Station Court is a care home providing care to a maximum of 63 older people; some of whom were living with dementia. Nursing care is not provided. The accommodation is provided across two floors. People who were living with dementia were accommodated on the first floor. There were 59 people using the service at the time of the inspection.
We found that during our inspection, a high number of DoLS (Deprivation of Liberty Safeguards) applications had been made the day before our second visit to the local authority for authorisation. These had not been submitted in a timely manner. Where people lacked capacity, best interests decisions about the use of lap belts or specialist chairs which restricted people's movement for their safety, were not always recorded. The service was not fully compliant with the principles of the Mental Capacity Act (MCA) 2005.
People had access to a range of care professionals. We found a discrepancy in the care records of one person where it stated they did not have a Do Not Attempt Cardiopulmonary Resuscitation (DNAR) order in place when in fact they did. We spoke with the registered manager about this who rectified the record immediately.
We found the service continued to be safe. There were safe procedures in place relating to the administration of medicines, staffing and recruitment practices, safeguarding of vulnerable adults, prevention of infection, and the management of accidents and incidents.
A registered manager was 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.
There were systems in place to maintain the security of the premises. Staff received training in the safeguarding of vulnerable adults and told us they knew what to do in the event of concerns of a safeguarding nature. Risks related to the premises and individual people were assessed and plans were in place to mitigate these. Accidents and incidents were recorded and analysed for any pattern or trends.
People were supported with eating and drinking and we found that dietary advice had been sought for people deemed at risk of malnutrition. On the first day of the inspection we found the ground floor dining area to be cramped which impacted upon the quality of the mealtime experience. On the second day of the inspection, this had been addressed. The meal was better organised and the dining room was less congested.
A number of improvements had been made to the premises, including the replacement of carpets and furnishings. The home was clean and tidy and well maintained.
Staff received regular training, supervision and an annual appraisal. They told us they felt well supported by the registered manager.
We observed kind, caring and courteous interactions between staff and people using the service. Care and support was provided discreetly and sensitively. The registered manager was keen to involve people that used the service in the running of the home, and had created two 'resident ambassador' roles to help support people living in the home to share their views. End of life care was not being provided at the time of our inspection but staff had received training and guidance in this area, with support from district nurses. We received positive feedback from a district nurse about working closely with staff caring for people approaching the end of their life.
Person centred care plans were in place which reflected people's physical and psychological needs and their personal wishes and preferences. We found gaps in the evaluations of some care plans but noted this had improved of late and at the time of the inspection the care plans we checked had been reviewed. The registered manager and staff knew people well, and information handed over between shifts was detailed.
There were mixed views about the activities available. Some people told us there were insufficient opportunities to engage in social activities and other people were happy with the activities available. We observed a number of activities taking place during the inspection, and the registered manager told us they were in the process of recruiting additional activities staff with a view to increasing the activities available.
There had been no recent formal complaints at the time of the inspection. The registered manager kept records of informal complaints to enable them to identify patterns or trends.
The registered manager had recently returned full time to the home, having been supporting another of the provider's services locally. People and relatives told us they had noticed a slight dip in quality during this time. We found that audits had not picked up all of the issues we found at the inspection but the registered manager recognised the areas for improvement and was working towards addressing these.
The registered manager responded positively to feedback during the inspection and addressed some issues during the inspection. People, staff and relatives told us the manager was friendly and approachable, and staff had clear expectations of the standard of care expected of them.
We found one breach of The Health and Social Care Act (Regulated Activities) Regulations 2014 related to; Safeguarding service users from abuse and improper treatment. You can see what action we told the provider to take at the back of the full version of the report.