We carried out an unannounced inspection of the service on 30 January 2017.

Clifton Manor Nursing Home provides accommodation to older people in the Nottingham area. The home is registered for a maximum of 30 people. There were 21 people receiving care and support at the home at the time of our visit.

On the day of our inspection there was not a registered manager in place. However the manager at the service was in the process of submitting their application to become a registered manager. 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 we spoke with told us they felt safe at the home. They were supported by staff who understood how to report allegations of abuse. Risk assessments were in place to identify and reduce the risk to people’s safety. Sufficient staff were in place to keep people safe and medicines were stored and handled safely.

People were supported by staff who received appropriate induction, training, supervision and appraisals. Staff were supported by management team. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.

People were treated with kindness and compassion by the staff. People and their relatives reported positive and caring relationships were made with them and the people they cared for. Staff were respectful and spoke in a calm way. People were treated with dignity and compassion by staff who understood the importance of this. Staff gave examples of how they maintained people’s dignity when providing assistance.

People received the care they needed. Staff were responsive to people’s health needs. Care records were written in a way that focused on people’s wishes and respected their views. Care plans provided information for staff so people could receive personalised care. A complaints process was in place, and people felt able to make a complaint and that staff would respond in a timely manner.

People were confident to speak to the manager and felt they were very approachable. People and their families had the opportunity to be involved with how the home was run. People were encouraged to share their experience of the service and feedback on those experiences. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

This inspection took place on 30 November 2015 and was unannounced. There were no breaches of legal requirements at our previous inspection in November 2014, but we did ask the provider to make some improvements to the service.

Clifton Manor Nursing Home provides accommodation and nursing care for up to 30 people who have nursing or dementia care needs. There were 29 people living there at the time of our inspection.

There was no registered manager at the service; a manager is required to register with us by law. 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 and associated Regulations about how the service is run.

At our last inspection in November 2014 we found that improvements were required in relation to a registered manager. Management and safe storing of medicines, activities reflecting people’s needs and monitoring the quality of the service provided. At this inspection we found that the provider had made some improvements.

People felt safe and well looked after by the staff who cared for them. Risk management had improved and risks were managed more safely. There were mixed comments about the number of staff on duty. Staff were not always deployed appropriately. Recruitment processes were robust and appropriate to ensure staff were safe to work with older people. Medicines were safely managed.

People gave positive feedback about the staff skills and knowledge to do their job. Staff had a good understanding of people’s needs. The requirements of the Mental Capacity Act (2005) were adhered to. People were supported to have sufficient to eat and drink. People were supported to maintain good health and wellbeing and this was supported by having access to healthcare services.

People experienced a positive caring relationship with the staff who supported them. People were involved in making decisions about their needs and felt they were given choices and preferences. People were treated with dignity and respect at all times. Staff interaction was not always of a good enough standard, but this had been identified by the service and they were in the process of addressing the issue.

People participated and were supported to follow their individual interests and social activities, but work was required to improve the consistency and quality of activities available. People’s feedback was positive about the care they received, but staff were not consistently responsive to people’s personalised needs. Systems were in place for people to share their views and experiences. Complaints and incidents were monitored to ensure the service minimised reoccurrence.

The manager of the service was not registered with CQC at the time of our visit. We received positive feedback from people, their relatives and staff on the approachability of the manager and how they felt supported by them. Improvements had been made in regards to the quality monitoring of the service. There had been a number of issues addressed since our last inspection, however to ensure this was consistent further monitoring was required. Management had discussed shortfalls and concerns in staff meetings to try and address some of the issues we had identified. The vision and values of the home were positive.

This inspection took place on 30 November 2015 and was unannounced. There were no breaches of legal requirements at our previous inspection in November 2014, but we did ask the provider to make some improvements to the service.

Clifton Manor Nursing Home provides accommodation and nursing care for up to 30 people who have nursing or dementia care needs. There were 29 people living there at the time of our inspection.

There was no registered manager at the service; a manager is required to register with us by law. 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 and associated Regulations about how the service is run.

At our last inspection in November 2014 we found that improvements were required in relation to a registered manager. Management and safe storing of medicines, activities reflecting people’s needs and monitoring the quality of the service provided. At this inspection we found that the provider had made some improvements.

People felt safe and well looked after by the staff who cared for them. Risk management had improved and risks were managed more safely. There were mixed comments about the number of staff on duty. Staff were not always deployed appropriately. Recruitment processes were robust and appropriate to ensure staff were safe to work with older people. Medicines were safely managed.

People gave positive feedback about the staff skills and knowledge to do their job. Staff had a good understanding of people’s needs. The requirements of the Mental Capacity Act (2005) were adhered to. People were supported to have sufficient to eat and drink. People were supported to maintain good health and wellbeing and this was supported by having access to healthcare services.

People experienced a positive caring relationship with the staff who supported them. People were involved in making decisions about their needs and felt they were given choices and preferences. People were treated with dignity and respect at all times. Staff interaction was not always of a good enough standard, but this had been identified by the service and they were in the process of addressing the issue.

People participated and were supported to follow their individual interests and social activities, but work was required to improve the consistency and quality of activities available. People’s feedback was positive about the care they received, but staff were not consistently responsive to people’s personalised needs. Systems were in place for people to share their views and experiences. Complaints and incidents were monitored to ensure the service minimised reoccurrence.

The manager of the service was not registered with CQC at the time of our visit. We received positive feedback from people, their relatives and staff on the approachability of the manager and how they felt supported by them. Improvements had been made in regards to the quality monitoring of the service. There had been a number of issues addressed since our last inspection, however to ensure this was consistent further monitoring was required. Management had discussed shortfalls and concerns in staff meetings to try and address some of the issues we had identified. The vision and values of the home were positive.

This inspection took place on 11 November 2014 and was unannounced. There were no breaches of legal requirements at our previous inspection.

Clifton Manor Nursing Home provides accommodation and nursing care for up to 30 people who have nursing or dementia care needs. There were 30 people living there at the time of our inspection.

There was no registered manager at the service; a manager is required to register with us by law. 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.

We found people felt safe with the people that cared for them. The provider had suitable arrangements to keep people safe. We saw appropriate information was available to ensure people and their relatives were aware of what abuse was and how to stop abuse from happening. All risks to safety were minimised, but although people received their medicines as prescribed the medicines were not always managed or stored safely.

People told us that they had plenty to eat and drink and we saw that people were well supported at mealtimes. We saw that the home involved outside professionals in people’s care as appropriate and the requirements of the Mental Capacity Act were fully adhered to.

Staff received supervision and appraisals, which ensured they developed the right skills and knowledge suitable to their role.

People and their relatives told us staff were very caring and treated them with dignity and respect. They were encouraged to form relationships with in the home and with others. People were encouraged to be independent where possible and fully supported by staff when needed.

People were proactively supported to express their views and be involved with decisions relating to their care. Staff communicated effectively and interacted well with people.

People did not always participate in activities that were relevant to their interests and hobbies. Staff were not considerate to all people’s requirements or conditions when implementing group activities, such as bingo. Risk assessments were in place and care plan reviews had taken place, but there were inconsistencies to records being Updated. People and their relatives were able to voice their concerns and raise complaints, which we found were dealt with in a timely manner and in line with the provider’s policies and procedures.

We found quality assurance systems were in place, but were inconsistently applied. Staff felt generally felt supported and reported an open and transparent culture.

There was no registered manager at the service, but people, their relatives and staff told us the culture of the home was open and transparent. People told us they felt the person in charge was approachable.

We spoke with six people who used the service, six staff and one relative during our visit.

We saw staff speaking to people politely and in a respectful manner. Staff interacted with people and supported them when required.

We saw care records provided clear guidance for staff to help support people who used the service to maintain their health and wellbeing.

We found medicines to be stored in line with the homes policy and procedures. Temperatures were recorded on a daily basis. We saw people received their medication safely and administration records were kept accurate.

We found staff recruitment checks were fully carried out and appropriate information was obtained prior to new staff starting work at the service

People said that staff members were polite, kind and respectful. They confirmed that their privacy and dignity was respected. They stated they were involved in reviewing their care plan and were supported to make decisions regarding their immediate care needs and wishes.

People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members, although evaluations of care plans were not always completed.

People were provided with a choice of meals and staff members assisted them appropriately with eating and drinking if this was required. One person told us that their meal was, “Delicious”.

Medicines were stored appropriately and records were maintained to show all storage areas were kept at the correct temperature. Administration records were kept and people received their medicines in a safe way.

The service had a policy and procedure to guide people in how to make a complaint but there was inadequate information about taking complaints further. We observed that staff members took people’s concerns seriously, even if they were not able to easily identify the nature of the concern or resolve it.

Recruitment checks were not fully carried out or obtained prior to new staff members starting work with the service.

People who use the service told us that they felt their needs were being met “the staff are very good, if I feel unwell they would always call my doctor, the chiropodist comes to see to my feet and I have recently had a new pair of glasses from the optician”.

A visitor told us “the treatment and care provided here excellent, the staff are all lovely. The manager is very good, I have a good rapport with her”.

People told us that the registered manager was available to discuss any areas of service provision on a one to one basis and they felt confident that she listened to, and respected their wishes.

People told us they felt their safety was promoted “I have been here for just over a year, I have always felt safe, the staff are so nice”.