Cathedral View is a care home which provides accommodation for up to 60 older people who require nursing or personal care. At the time of the inspection 59 people were using the service. Some of the people who lived at the service needed care and support due to dementia, sensory and /or physical disabilities. The service is divided by two separate buildings consisting of a nursing home which accommodates up to 27 people, and a residential home which accommodates up to 33 people.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage 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. The nursing home is managed by a matron who reports directly to the registered manager.

We inspected Cathedral View on 27 and 28 February 2017. The inspection was unannounced. The service was last inspected in July 2014 when it was found to be meeting the requirements of the regulations, and was overall rated as Good. In addition the Key Question on Caring was rated Outstanding. Therefore at this inspection we confirmed that the Quality of Caring at the home remained at this quality.

People told us they felt safe at the service and with the staff who supported them. Comments we received included: “We have no issues regarding (relative’s) safety. Staff are respectful and considerate about her needs and confusion. Her possessions are carefully looked after and items of clothing for laundry are always named and returned.” An external professional said: “(Cathedral View) seems very safe.”

People told us they received their medicines on time. Medicine administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

Staff training was delivered to a good standard, and staff received updates about important skills such as moving and handling at regular intervals. Staff also received training about the needs of people with dementia. Staff told us they received “Loads” of training, “We always have training courses, training is very good,” and “They are very good at training.”

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults. One person told us: “Staff are very well chosen for their qualities, caring, dedication and sense of humour.”

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals. We were told by a health professional: “I feel that the care received is excellent and the treatment people receive is extremely effective and safe….I have only ever heard of or received positive feedback regarding this home.”

There were enough staff on duty and people said they received timely support from staff when it was needed. People said call bells were answered promptly and we observed staff being attentive to people’s needs. An external professional said: “Residents seem happy and well entertained and looked after. They are complimentary of the care they receive and never complain of having to wait to be attended to.”

Care was provided appropriately and staff were viewed as very kind and caring. We received a significant number of positive comments about people’s care which included: “Staff are very good and helpful,” and “They are very good they make me laugh.” Relatives told us: “We have been delighted with the care and support (our relativ

At this inspection we spoke with thirteen of the people who lived at the residential care home and six of the people who lived at the nursing home. We were also able to speak with some people’s relatives, and some of the staff.

People we spoke with were all very happy with the home’s standards. The comments we received included “I like it here, it is very nice,” and “the staff are exceptional, they are kind and caring…they have become our friends…the standards at the home are very good and the manager is very good.”

People’s personal and health care needs were met to a high standard. The medication system was well organised and operated effectively.

There were satisfactory numbers of staff on duty. Staff recruitment processes were thorough. Everybody we spoke with told us staff were kind, supportive and treated people who used the service with respect and dignity.

The accommodation was furnished, decorated and maintained to a good standard. The home was very clean and there were no offensive odours.

The home had a satisfactory complaints procedure although nobody who we spoke with had any concerns or complaints.

We spoke with people who lived in both the residential and nursing homes at Cathedral View House, to seek their views of the service provided. We were also able to speak with some people’s relatives. People were very positive about the care and support they or their relative received. For example one relative said ‘the staff look after my mother impeccably…I cannot praise them enough’.

When we inspected the home was clean and odour free. Accommodation was decorated, furnished and maintained to a good standard. At the time of the inspection staffing levels were satisfactory, and there was evidence that staff suitable recruitment checks and training were completed. There was a satisfactory quality assurance system in place.

We carried out this announced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Cathedral View House is a care home for people who require nursing or personal care. It comprises of two separate buildings; the residential home provides accommodation and personal care for up to 33 people and the nursing home provides accommodation and nursing care for up to 27 people.  At the time of the inspection there were 54 people living at Cathedral View.

There was a registered manager in post at Cathedral View House. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We inspected Cathedral View over two days.  We saw people were happy living at Cathedral View. The atmosphere was friendly and relaxed and we observed staff and people using the service enjoying each other’s company.  One person told us “Staff are definitely kind and compassionate and treat me with respect.” We saw visitors were welcomed by staff throughout our visit.

On both days of the inspection we saw people looked well cared for and their needs were met quickly and appropriately. People who used the service and their relatives were complimentary about the care they received from staff who they felt were knowledgeable and competent to meet their individual needs. For example one person told us “Staff are very particular, they keep everything to a very high standard and they all treat me like a friend.”

People told us they felt safe. One person told us, “I am secure here and feel so safe.” We found the service was meeting the requirements of the Deprivation of Liberties Safeguards. People’s human rights were properly recognised, respected and promoted.

Staff working at Cathedral View understood the needs of the people and we saw that care was provided with kindness and compassion. People and their families told us they were happy with their care. A relative told us “I would recommend this home to anyone, I was pleased that Dad was cared for here, I would not have wanted him to go to the local hospital. They not only cared for him, they cared for us too.”

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work at the home and fully understood their roles and responsibilities, as well as the values and philosophy of the home. The staff had also completed extensive training to ensure that the care provided to people was safe and effective to meet their needs.

People living at Cathedral View were supported to live their lives in the way they chose. People’s preferences in how they wanted to spend their day were sought, listened to and respected.  We saw people were encouraged to take part in activities both in and outside of the home.

The views of people living at Cathedral View were actively sought out by an independent visitor and by the registered manager. One person told us “The activities lady is lovely. She’s always smiley. We fill out a form to say what we like and what we don’t like.” Another told us “I attend residents meetings where no staff are present. I am able to make my comments and make my own decisions.”  Views of the staff team were actively sought out by the manager.

Care plans were well laid out and regularly updated to reflect people’s changing needs. People and their families were involved in the planning of their care and were treated with dignity, privacy and respect.

The premises were well maintained and comfortable. There were appropriate spaces so people could spend time taking part in activities, chatting together or on their own.

We found there were positive relationships between staff and management. One staff member told us “Everyone is treated respectfully. Staff get good support, the door is always open to management, if you have a problem you can discuss it and they are very supportive.” Everyone who worked at Cathedral View who we spoke with demonstrated compassion and respect for the people they supported.

The provider had employed skilled staff and took steps to make sure the care was based on local and national best practice. Individual staff had taken on special roles, such as tissue viability, continence, dementia awareness and motor neurone disease to make sure that best practice was followed by all staff in the home.

The registered manager assessed and monitored the quality of care consistently. The home encouraged feedback from people and families, which they used to make improvements to the service.