Howard Court Care Home

At the last comprehensive inspection of this service in August 2017 we found the provider had breached Regulations 11, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This was because people's consent had not always been recorded. Also, there were shortfalls in relation to staff training in dementia care; and the provider's quality assurance system was not effective in monitoring the quality of the service.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective and Well-Led to at least good. At this inspection we found the provider had made improvements and had addressed these shortfalls. People's consent was now recorded. Staff had more training opportunities in relevant areas of care. The provider had put in place a schedule of audits as part of its quality assurance check of the service.

Howard Court Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Howard Court Care Home accommodates up to 28 people in one adapted building. There were 24 people living here at the time of this inspection, including people who were living with dementia.

The home had a registered manager who had worked there for several years. 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 and relatives said the home was a safe and friendly place to live. Staff understood how to report any concerns. The provider carried out checks to make sure only suitable staff were employed. People were assisted with their medicines in a safe way. The home was clean and comfortable.

People told us they were happy with the care and felt there were enough staff to assist them. They told us staff responded quickly to any requests for support. People's consent and permission was sought. If people were subject to any restrictions to keep them safe, such as giving medicines in a disguised way, this had been arranged in people's best interests.

Before people moved to the home their needs were assessed to make sure the home could provide the right care. Staff said they had good training and support to care for people in the right way. Staff worked well with

other health agencies and people were supported to access health services.

People said the meals were "very good". They had choices about their meals and where to dine. Staff encouraged people to eat and drink enough and used fortifying drinks to help people to keep their weight up.

People felt the staff were caring and friendly. There were good relationships between people and staff and a warm, positive atmosphere in the home. Staff spoke to people in a respectful and s sensitive way. People's individual choices were respected and their dignity was upheld. People's needs were supported with compassion at the end stages of their lives.

People received personalised care that was based on their unique preferences and needs. Staff were knowledgeable about people's individual care needs and how they wanted to be assisted. People had opportunities to join in activities or go out with staff from time to time.

People, relatives and professionals said the management team were open and approachable. People and staff had opportunities to make suggestions about the service.

The provider had made some improvements to its quality assurance checks to make sure any shortfalls were identified and acted upon. The provider was also introducing new technology to support the service. This included a computerised management tool to check when staff training was due. Computerised care records were also being developed so, in future, staff would have instant access to people's records wherever they were in the home.

The five questions we ask about services and what we found