Ebor Court

The home had been inspected four times between November 2015 and July 2017 and on each occasion was rated Requires Improvement. At our last inspection in July 2017 there were breaches of Regulation 12, 17 and 19 of the Health and Social Care Act (Regulated Activities) Regulations 2014. This was because of concerns in relation to the management of medicines and because robust recruitment procedures had not been followed. We issued a warning notice in respect of Regulation 17, Good Governance, because the quality assurance systems in place were not being used effectively to assess, monitor and improve the quality and safety of the service provided. The systems had been ineffective in driving sufficient improvement to demonstrate sustained progress and achieve a rating of Good. At this inspection we found improvements had been made and the home was now meeting all legal requirements.

Ebor Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ebor Court does not provide nursing care.

The service is registered to provide support for up to 64 older people and people living with dementia. The home is spread across three floors. The Guy Fawkes area is on the ground floor, the Dame Judy area on the first floor and the George Hudson area on the second floor. At the time of our inspection 54 people were using the service.

The registered provider is required to have a registered manager and there was a registered manager in post, who had been working at the service for about five months. 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.

Improvements had been made in relation to the management of medicines. Medicines were now safely stored, administered and recorded and the provider was working with their pharmacy suppliers to maximise the effectiveness of the systems in place.

Recruitment records showed that staff only commenced working with people on their own once all appropriate safety checks had been made. This included previous employment references and a check with the disclosure and barring service (DBS).

At our last inspection in July 2017 the provider had failed to ensure that Deprivation of Liberty Safeguards authorisation applications had been submitted for all people who needed one. At this inspection we found that action had been taken to address this and the provider had submitted appropriate applications for all those who required them. Staff worked within the principles of the Mental Capacity Act 2005.

Staff knew how to identify and respond to any signs of abuse, to protect people using the service from harm. There were mixed views about staffing levels at the service, but the majority of people and relatives we spoke with felt there were sufficient staff to meet people's needs. We found that the provider had recruited new staff, and agency staff were used where required, in order to maintain staffing levels.

There were systems in place to identify and minimise risks to people's safety. The provider was taking action to try and reduce the number of falls at the service and staff had worked with the local clinical commissioning group to access pressure ulcer prevention training. People received appropriate support with their nutrition and hydration needs.

People told us that staff were caring and we observed staff treated people with respect. People's privacy and dignity was upheld. People's diverse needs were catered for.

Staff had access to end of life care training and we received positive feedback from a visiting healthcare professional in relation to the support people received at this stage of their lives.

Care plans were in place to guide staff on how to meet people's needs and preferences. The provider had recently introduced a new electronic care monitoring system. The system enabled the registered manager to monitor the care that was delivered. We noted some errors recorded on the new computer system in relation to people's care requirements, but the provider addressed this by the second day of our inspection to ensure that staff had the information they needed.

Activities were available to people who used the service and the provider had recently appointed a new activity coordinator to develop the opportunities on offer.

There was a system in place to investigate and respond to complaints. Resident and relatives' meetings were held, and surveys conducted, to give people opportunity to comment on the quality of service provided.

Staff received induction, training and support. There was a plan in place to ensure all staff supervisions were up to date.

Infection control measures were in place, but greater vigilance was required to ensure bathrooms were maintained in a clean and hygienic state at all times.

Quality assurance systems were in place. The provider had made sufficient improvement to achieve an overall rating of Good at this inspection. However, some of the improvements made were still relatively recent and further time was required to fully imbed these systems and demonstrate consistent, sustained progress. There were also a number of minor issues that the registered manager was continuing to address, such as ensuring all supervisions were up to date, consistency of record keeping and improvements to cleaning and laundry arrangements.

The five questions we ask about services and what we found