The inspection took place on 12 October 2017 and was unannounced. The service was last inspected in June 2015 and met with legal requirements. Aabletone care home is registered to provide nursing care for up to 42 people. There were 29 people at the home on the day of our visit.

There was a registered manager for the service. 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 were supported by a team of staff who were caring and respectful in their approach to the people they supported. One person said “They are very good to us they are all very kind to me”.

People were positive in their views of the menu options that were available for them at the home. People repeatedly told us “The food is really good.” People were properly supported to eat and drink enough to be healthy. The menus were devised based on the preferences as well as dislikes of people.

The systems in place for managing people’s medicines were safe. There was a quality checking system in place for assurance and people were given the medicines they needed. Staff training for medicines administration supported nurses to give people their medicines safely.

Each person’s range of care needs were identified in their care records and care plans showed how to support people in a way that met their needs. This meant people received care that was planned well and in the way they preferred.

People and staff had positive and warm relationships between them. Whenever possible, people were involved in making decisions about how they were supported. The staff ensured that privacy and dignity were maintained at all times.

People said they felt happy and appreciated enjoyed daily life at Aabletone. We saw that staff interacted effectively with people and supported them to lead meaningful lives.

There was a variety of suitable social and therapeutic activities for people to take part in. We saw individual activities took place as well as group ones. Entertainers performed at the home regularly, including a singer who performed for people. There had also been a recent visit from a local organisation bringing exotic pets, including a snake. We saw how much people living at the home appreciated the entertainments.

People were assisted by staff that were trained and developed in their work to improve their skills. Nurses were encouraged to attend training courses to assist them to deliver nursing care and support based on current best practice. Staff were being properly supported and supervised to do their jobs effectively and provide safe and good quality care. Supervision records of meetings to support staff effectively perform their work were up to date. Staff were supported formally in groups and in one to one meetings.

Quality checks on the overall quality of care and service people received were undertaken regularly. Where needed, they identified actions for the registered manager to improve the service. They had recently picked up that team communication could be developed further. This action had been carried out by the registered manager.

The inspection took place on 27 July 2015 and was unannounced. The service was last inspected in April 2013 and met with legal requirements.

Aabletone care home is registered to provide nursing care for up to 46 people. There were 41 people at the home on the day of our visit.

There was a registered manager for the service. 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 registered manager was on leave on the day of our inspection.

Although they conducted a DBS check the provider’s recruitment systems had failed to pick up that one staff member only had character references, and did not have a reference from their previous employer. This meant there was a lack of assurance that the staff member was suitable to fulfil their role.

We have made a recommendation about the providers recruitment procedures

People who lived at the home told us they always felt safe there and that staff treated them properly. Where risks to people were identified suitable actions were put in place to reduce the risk of people being harmed when receiving care. The risk of abuse to people was minimised because staff were trained to understand what it was and how to report suspected concerns. People were supported by enough staff to provide them with safe care. Staffing numbers were adjusted when needed. For example when people required more support with their care due to changes in their health.

Staff were caring in their approach to people when they assisted them with their needs. One person said “They can’t do enough for you they are all wonderful”.

People were supported to eat and drink enough to be healthy and menus were planned based on what people liked. People spoke highly of the food that they were served at the home. One person said, “It is like proper home cooking”.

People’s legal rights were protected because the provider had a system in place so that the requirements of the Mental Capacity Act 2005 were implemented when needed. This legislation protects the rights of people who lack capacity to make informed decisions.

People were able to take part in individual activities as well as group ones. People told us that entertainers performed at the home regularly and they went out for trips into the local area.

People’s care plans clearly explained how to meet their care and support needs. People were able to be involved in the writing of their care plans. Families were also consulted to find out information needed to ensure people received care and support in the way they preferred.

People were supported with their physical health care needs and the staff consulted with external healthcare professionals to get specialist advice and guidance when required.

Staff felt they were properly supported in their work. People who lived at the home and the staff said they felt they could approach the registered manager at any time.

There was a system in place to properly check and improve the quality of the service. Audits demonstrated that regular checks were undertaken on the safety and quality of the service.

We spoke with twelve people who used the service to find out what they thought of Aabletone and the staff who assisted them. We also spoke with two people's relative's about the home.

People had positive opinions about what it was like to live at Aabletone. Examples of comments made included “they have been really, really good and the staff use everyone’s name” and “it is a very good home”.

We spoke with the new acting manager, two nurses, two care workers and the chef about their roles and responsibilities.

We used a number of different methods to help us understand the experiences of people who used the service, because some people had complex needs which meant they were not able to tell us their experiences. We relied on our observations and discussions with staff to understand the experience of care for those people living at Aabletone.

Peoples were effectively supported with their needs by the staff team who worked at the home.

People’s care plans were up to date and they clearly showed how to assist and support people with their range of personal care and nursing needs.

People had positive views of the quality and the variety of meals that were served at the home. Staff understood what to do to effectively support people to meet their nutritional needs and how to assist those at nutritional risk.

The current system of staff supervision was not being kept up to date which could impact negatively on the staffs performance in their work.

We visited Aabletone Nursing Home on 12 June 2012 and spent the morning at the service. When we arrived we were greeted by the new acting manager who had been in post two days. We were informed that the registered manager had left the previous month. We had not been notified of this change in management arrangements, but a representative from the senior management team made herself available to support the acting manager during our visit. We also met and talked with several members of staff on duty on the day of our visit.

Not all of the people we spoke with were able to tell us whether the care and support they received was to their satisfaction because of dementia or ill health. However, we talked with a number of people who were able to share their general views about the service and the staff who cared for them. We also met with family members of two people who were living at the home.

People told us "Staff are very patient and kind. They are wonderful. It is very cosy and comfortable. We heard that "the staff are good. They are never rude. I get up when I want to and go to bed when I choose to “. A family member told us “I think it is a wonderful place. I like every thing I see. I could not speak more highly of it “

Staff told us they worked well as a team and new staff who had joined in the last few months had settled in well and taken to the role and the team quickly. Staff said they were well supported in their role and felt that they were able to provide safe and effective care.