This inspection was unannounced and took place on 25 November 2016.

Castle House Nursing Home is registered to provide accommodation and nursing care and is situated in rural surroundings at the edge of a village. The home specialises in the care of older people including people living with dementia.

The home now has 47 beds, comprising of 46 single rooms and 1 double room. 18 of the bedrooms have en-suite private wet-rooms and all the others have en-suite facilities. The house was extended in 2016 providing new bedrooms and communal facilities. The new accommodation has been completed to a very high standard.

The last inspection of the home was carried out in January 2014. No concerns were identified with the care being provided to people at that inspection.

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. The registered manager of Castle House Nursing Home is also the registered provider. They are resident on the site of the home and family members are also registered providers and contribute to the running of the service. 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.

Feedback from people about all aspects of the service was very positive. One person said “I have been here a while. I am doing fine. It is very pleasant.” A relative said “Staff are incredibly warm and patient. Care is very, very good.” A doctor who visited the home regularly said “It is fabulous. There is not a bad word I can say about the place. I would live here myself.”

The staff morale at the home was high which led to a happy relaxed place for people to live. Staff were proud to work for the Castle House Nursing home and had great respect for the people they cared for.

The was an excellent activities programme and ad hoc activities offered people entertainment and ensured they received social stimulation and companionship when they wanted it. Activities were arranged in accordance with people’s interests and abilities and were continually reviewed and developed.

The building was designed and maintained to promote people’s independence. There was a range of social and quiet spaces. The newly completed environment had been completed to a very high standard to promote people’s well-being and comfort. There was access to garden areas with innovative design to keep people safe.

There were sufficient numbers of well trained and experienced staff to support people safely and ensure they were not rushed with their care. The training staff received enabled them to deliver excellent care which promoted people’s health and well- being. Staff told us there was good team work and support from senior staff and management.

People’s nutritional needs were assessed and met and mealtimes were considered important social occasions. The variety of food offered and the attention to the quality of food provided people with a hotel standard provision. Where people were identified as requiring support and encouragement to have a good diet skilled staff were readily available.

People received effective care and treatment which took account of their preferences and needs. Care plans gave staff clear information about how people wished to be supported. This enabled staff to provide very individualised care to people.

People and/or their representatives felt involved in all aspects of their care and support. There were systems in place to make sure people had an active voice in the running of the home.

People told us they would be comfortable to make a complaint and were confident any concerns would be listened to. The registered manager told us they valued feedback from people and used it to continually improve the service offered.

People’s health needs were monitored and changes were made to people’s care in response to any changes i

Overall from the evidence we reviewed we found people were supported and assisted to have their needs met in a manner which ensured their safety and well-being. The home provided personal and nursing care to people and was able to support them at the end of their lives.

People's dignity and privacy were respected in the home. All people spoken with were pleased with the care they received and felt staff treated them with respect. One person told us "I am very satisfied. If I have to come into a care home I couldn’t be in a better one.”

People were supported to be as independent as possible and to enjoy the time they spent in the home. We saw there was an emphasis in care plans on what people could do for themselves and the help they required to maintain their daily living skills. Staff made adjustments to the care they provided and the person’s daily routine so they could live as comfortable a life as possible.

People lived in an environment that was safe and attractive. The surrounding grounds were accessible and attractive and contributed to people’s welfare.

During this inspection we spoke with five people who lived in the home, two visitors, one healthcare professional and five members of staff.

People spoken with told us they were very happy with the care and support they received at Castle House Nursing Home. One person told us, “I can’t complain, they treat us all very well. They are all very good”. A visitor to the home told us, “They are brilliant, it’s a lovely home. They look after dad really well, I can’t fault them”.

We observed staff organised meaningful activities and treated people who lived in the home with respect and dignity.

We found care planning was person centred and agreed by the individual, a family member or an advocate. Regular reviews were carried out and involved the individual.

We found people were protected from harm or abuse by the systems in place. These ensured staff received appropriate training in safeguarding vulnerable people. The systems for recruiting staff included all the relevant checks to protect people from harm.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the registered manager. The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.

People told us they were very happy with the home and felt safe living there. People felt there was plenty of room to move around with ease and lots of areas to sit.

People told us staff were cheerful, kind and caring. They felt they were treated respectfully and said that staff were patient. People told us staff talked to them about their likes and dislikes. They said they were asked how they like to be treated, what activities they enjoyed and the types of food they preferred. People said they could talk to the staff about any concerns they had and felt confident they would be listened to and the issue would be resolved quickly. Staff met with people regularly to discuss their care and recorded monthly updates on changes or issues raised.

During our inspection we found the atmosphere to be relaxed and cheerful. We observed staff supported people in a caring and respectful manner. Staff were seen to knock on people’s doors before they entered and used hoists in a sensitive manner. Staff were observed spending time with people, reading magazines together, chatting and doing activities.

Relatives were very happy with they care their relative received. They told us they found the home was always clean and smelt pleasant. Relatives said staff were friendly and welcoming. They said they were fully involved in the assessment process and the care and treatment of their relative.

We observed people at lunchtime and spoke with the cook. We saw that people were offered choices in food and drink. The atmosphere was relaxed and cheerful. Staff took their time assisting people in a patient and respectful way. The cook had a good knowledge and recorded information on people’s special dietary needs.

The home employs an activity coordinator and social companion who spend time with people and or their relatives to find out people’s interests to help them plan suitable activities. They also arranged one to one time for people who did not like to be involved in group activities. During the inspection we saw activities of quizzes, exercises and one to one time.

We noticed throughout the home there were signs about treating people with dignity and respecting people’s privacy.