The inspection took place on the 12 June 2018 and was unannounced. Abbots Leigh Manor Nursing Home is a nursing home. People in nursing homes receive accommodation for nursing and 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.

Abbots Leigh Manor Nursing Home is registered to accommodate up to 66 people in one adapted building. On the day of our inspection there were 57 people using the service with a range of support needs including older people and some people living with dementia. At the last inspection on 7 January 2016, the service was rated as good in the areas of Safe, Effective, Caring, Responsive and Well-led. At this inspection we found the evidence continued to support the overall rating of Good. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Abbots Leigh Manor Nursing Home on our website at www.cqc.org.uk.

People told us that they felt safe.

Staff demonstrated they continued to have a good understanding of their roles and responsibilities for identifying and reporting allegations of abuse and knew how to access policies and procedures regarding protecting people from abuse.

Risks to people were assessed and monitored during their stay and communicated with other healthcare professionals involved in their care.

Staffing levels were assessed and amended based on the needs of the people using the service and there were arrangements in place for covering if staff were unable to come to work at short notice.

The building was well maintained and there were systems in place for ensuring that regular checks of the environment and equipment were carried out.

Medicines were managed safely and people were supported to take their medicines.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People's capacity to make decisions had been assessed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). People were supported to make choices about their support and were able to maintain their independence.

Staff supported people to eat and drink and they were given time to eat at their own pace. People's nutritional needs were met and people reported that they had a good choice of food and drink.

Staff were trained in subjects relevant to the needs of the people who used the service and received regular supervision which enabled them to develop in their roles. Staff said they felt supported.

Staff spoke to people respectfully and treated them with dignity and respect.

People felt that their privacy was respected and staff kept information confidential.

People were involved in planning their support.

People's individuality was respected and people's preferences were taken into account when planning their care such as religion.

There was an accessible complaints process in place which people knew how to use if they needed to however people told us that they hadn't needed to make a complaint.

People said that the registered manager was approachable and listened to them. Staff felt that the registered manager was open and they could raise any concerns and put forward suggestions for improvement.

Staff were proud to work at the service. The registered manager worked with other healthcare professionals to ensure that people received care that met their needs

Quality assurance audits completed by the registered manager were embedded to ensure a good level of quality was maintained. We saw audit activity for areas such as infection control, care planning and training.

Abbots Leigh Manor Nursing Home was a Victorian mansion set in well-kept gardens. The home was very well decorated throughout with several communal areas available to people and their families.

We saw that people were involved in care planning and made choices about the treatment and that they could refuse if they did not want to have an action undertaken.

People were supported to do hobbies and activities they enjoyed both in and away from the home. We observed that people were offered a choice at mealtimes and were asked if they would like a glass of wine with their meal. People told us that they chose what time they got up and whether they wanted to eat in their room or in a dining room.

We reviewed staff training records which showed that staff were up to date with training. We observed training sessions and spoke with staff who told us that they found them very helpful. We saw records of staff appraisals and also sat in a group supervision session where a care plan audit and improvements which could be made were discussed. People told us that staff were always helpful and professional in delivering their care.

We saw equipment that was well maintained and clean. We observed that the home provided specialist equipment to support people when needed.

The provider had systems in place for monitoring quality and acted when they identified areas for improvement. This included involving people and their families in quality assurance.

We talked with 21 people who used the service and with two visitors to the home. We talked with the provider, the manager, three nurses and three care workers about their roles and responsibilities at Abbots Leigh Manor.

People had very positive views to share about what daily life was like for them to at Abbots Leigh Manor. Examples of comments we were told included, “I think it is excellent here and there is nothing they could improve on”. “I’m very happy here”. “There is nothing bad here”. “We are so well cared for”.

People felt safe living at Abbots Leigh Manor. One person explained to us there was “nothing bad going on here”. Everyone we spoke with had confidence in the manager. They said if they ever did feel they were at risk of abuse the manager would take action to immediately address matters.

People were effectively supported with their nursing and personal care needs at Abbots Leigh Manor. There were enough suitable and competent staff to properly support people who used the service.

People felt confident to make complaints about Abbots Leigh Manor. Prompt action was taken by the service to satisfactorily address concerns and complaints when they were made about Abbots Leigh Manor.

We visited Abbots Leigh Manor Nursing Home on Monday 19 December 2011 and spent the day at the service. We met and talked with a number of the people who live at the service. We also met and talked with visitors to the home and members of the staffing team. We were joined at the visit by an expert by experience from Age UK who talked with people about their experience of care and support at the service.

We toured the home in the company of the managing director of the provider organisation. The home was ranged over four floors with 65 bedrooms. The entrance had a reception which was staffed during the day. We looked at lounges, dining rooms, bedrooms, the kitchen, laundry and conservatory. We also looked at care records for people living at Abbots Leigh Manor and discussed with staff how they planned and assessed people's needs. We looked at the management of medicines and talked with the nursing staff about administering medication to people. We talked with staff about how they were supported in their roles.

People that we met and talked with included people living at the home, and also their families. We were told that Abbots Leigh Manor is "fantastic" and "it is lovely here". One person said "I am extremely happy here". A relative said "I am made very welcome" and another said "the manager is brilliant with people".

We talked with people about activities that they could take part in and if they had enough peace and quiet. One person said "there is always something going on but I can be quiet in my room as much as I want to be." People also told us that their dignity was maintained and they were treated with respect. People said the care was centred on them as individuals.

Abbots Leigh Manor provided for people who came to live at the service for nursing care and support. The service also accommodated people who needed short-term respite care, or people who needed palliative care at the end of their life. All areas of the home were clean, tidy and uncluttered. There were no noxious smells and the home was in good decorative order. The home was also decorated throughout for Christmas and staff, people who live there, and their relatives had recently enjoyed a Christmas party laid on by the home.

The expert by experience that accompanied us on the visit reported that people had said "I am very happy here" and "everyone is helpful". The expert also saw that the notice boards around the home were advertising the timetables of activities for the week. People also had timetables in their rooms. Some of the people who lived at the home said they were not aware of the activities or were not able to remember always that they were taking place. We did, however, observe staff asking people if they wanted to join in with activities and encouraging them to do so.

We found the home compliant with the five essential standards that we inspected.

This inspection was unannounced and took place on 7 and 8 January 2016.

Abbots Leigh Nursing Home is a large detached property in a quiet residential area. It provides personal care, support and nursing care for up to 66 older people, some of whom are living with dementia. There were 62 people living at the service when we visited. Extensive communal spaces are available in the service for people to meet with friends or family or carry out activities. A passenger lift is available for access to the two upper floors.

An extensive landscaped secure garden is available for people to use throughout the year. The home also has two rescue donkeys for people to visit and pet.

There is a registered manager 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.

People felt safe using the service and staff were able to tell us how they would protect people from harm and knew the signs and indicators associated with abuse. Staff knew what processes to follow if they had any concerns. People told us that they felt safe within the service.

Effective recruitment processes were in place, and staff received on going training to ensure that their knowledge was kept up-to-date and in line with best practice.

People’s medication was effectively managed, stored securely and audited on a regular basis.

People had choice and control over their daily routines and staff respected and acted on the decisions people made. Where people lacked the mental capacity to make certain decisions about their care and welfare the provider knew how to protect people’s rights.

People said they liked the food that was available. People were offered a choice of meals. Appropriate meals were available for people with specialist dietary requirements.

Staff adopted a kind and caring approach towards people and offered reassurance and support where needed. Staff were responsive to people and families told us they felt confident their relatives were being well looked after. The atmosphere within all floors of the home was very cheerful and staff had time to chat with people and their visitors.

People, relatives and visiting professionals spoke very highly about the support and care that was given. They said the dedication and attitude of the managers and staff was “over and beyond the call of duty”. People told us they received care that was personal to them. They felt staff understood their specific needs well and had good relationships with them.

People were settled, happy and contented. Relatives told us they only had positive experiences within the home and praise for the staff. Staff treated people as individuals with dignity and respect. Staff were familiar with people’s life stories and were very knowledgeable about people’s likes, dislikes, preferences and care needs. They approached people using a calm, friendly manner which people responded to positively.

When people were nearing the end of their life, the management and staff made sure their dignity was maintained and they received the specific care to meet their needs. The managers and staff had a strong commitment to providing support to people, and their family members, to ensure a person’s end of life care was as peaceful and pain free as possible.

A wide range of activities were available, based on people’s suggestions and requests, which people’s family and friends were invited to take part in. Spontaneous activities took place and entertainment was provided. During our inspection people were entertained by completing a reminisce book and by poetry readings. People joined in the poetry readings and with the making of the book. People were supported to do what they wanted when they wanted. People and relatives thought they led a fulfilled and meaningful life. Staff spent quality time with people to give them emotional support and comfort. Staff reminisced with people about their life and discussed what was happening in the world.

The manager and staff engaged well with people and their families and had made changes following recommendations being made. People told us that they would complain if they felt they needed to and felt confident that they would be listened to.

The registered manager completed quality audits of the service which produced actions and changes that needed to be made. This contributed towards the delivery of good quality care and support.

There was a strong emphasis on continually striving to improve. The manager recognised, promoted and regularly implements innovative systems in order to provide a high-quality service. They looked into new and creative ways to include everyone in developing and improving the service.

Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Safety checks were done regularly throughout the building and there were regular fire drills so people knew how to leave the building safely.

Everyone we spoke with which included, people who lived at the service, staff, relatives and healthcare professionals involved with people, told us Abbots Leigh Nursing Home provided very good or excellent care to people who lived there.