This inspection took place on 18 and 21 October 2016. The first day of the inspection was unannounced.

Cornmill Nursing and Residential Care Home is a family run business which is located in the centre of Garstang, near to all community amenities. The home has been built within an adapted corn mill and is situated on the bank of the river Wyre. The home is registered for 52 adults, who require support with nursing and personal care needs. At the time of the inspection visit 51 people were residing at the home.

There was a registered manager in place. 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 service was last inspected in June 2013. We identified no concerns and found the service was meeting all standards we assessed.

At this inspection visit carried out in October 2016 people spoke extremely positively about the quality of service provided. People repeatedly told us staffing levels met their needs and staff went the extra mile to help people. Staff were constantly referred to as ‘kind’ and ‘caring.’

People who used the service, relatives and health professionals consistently commended staff knowledge and competence. Relatives repeatedly told us they were confident and assured that people who used the service were supported by competent staff that went the extra mile.

There was great emphasis on creating positive health outcomes for people who used the service. Health care needs were proactively met. Good practice guidelines were constantly referred to when providing care and treatment. People told us their wellbeing had improved since they started living at the home. Relatives praised the ways in which people’s quality of life had increased since their family members moved into the home.

The service worked in partnership with other care professionals to meet needs. Health professionals we spoke with repeatedly praised the standard of care provided and described the service as professional and reliable.

There was a strong emphasis on ensuring people’s dietary needs were consistently met. A health professional with an interest in diet and nutrition spoke confidently about the skills of the staff and their ability to meet people’s dietary requirements. They told us the service worked innovatively and consistently to meet people’s nutritional needs within a person centred way. The service had taken part in a Tele-swallowing project to reduce hospital admissions and to promote safe swallowing. Staff knowledge was praised in regards to meeting people’s dietary needs.

People who lived at the home were supported to attend activities of their choosing. People were enthusiastic about the activities and the opportunities made available to them and repeatedly said there was plenty to do. There were active links with the local community and people were encouraged to be citizens in their own community.

There was a welcoming, homely atmosphere within the home where visitors were encouraged. Links with family members were promoted and nurtured.

The service championed equality and diversity. Staff had received training to enable them to be champions who promoted equality and diversity. Staff were understanding of the needs and committed to promoting people’s individuality.

There was an emphasis on developing staff potential within a positive learning environment to create a high quality service. Staff were encouraged to become champions in their field of interest. There were multiple champions in post at the time of the inspection visit, including champions for dignity, safeguarding, tissue viability, end of life care, moving and handling and equality and diversity. Champions had received additional training and skills in their s

We visited the home in response to the receiving of information from an anonymous complainant which raised concerns about the welfare of people living at the home. The information suggested that the registered manager took no interest in staff training and supervision; no interest in responding to service users call bells and raised concerns about the home's recruitment procedures. An inspector visited the home and reviewed records, spoke with staff and spoke with with the the registered manager and owners of the home. The evidence we gathered did not substantiate any of the claims made by the anonymous complainant.

Is the service safe? Service user call bells were found to be responded to promptly.

Is the service caring? Staff members ensured that service users were quickly responded to when requests were made in order to ensure their needs were met.

Is the service well led? The current manager has been registered with the Commission, and service provider had effective quality assurance, polices and procedures in place.

Is the service responsive? The service provider has installed an effective call bell system to ensure that service user requests for help and assistance were efficiently responded to.

Is the service effective? The service provider had effective and robust systems in place to ensure that service users needs were met, and to ensure service users were supported by staff that were well trained and safe to work with vulnerable adults.

People told us:

"The staff are very good at explaining what they need to do."

"I like it here...They really encourage my independence...I see my care plan each month...They won't hesitate to ring the G.P. if I'm ill...I get to see the optician and the physio comes round often."

"If there was something wrong, I'm happy I could speak with any of the staff...I'm confident they'd sort it out."

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. This included amendments to the recruitment process to ensure candidates were fit to work with vulnerable people.

People were protected from the risk of infection because appropriate guidance had been followed. People were cared for in a clean, hygienic environment and were protected against the risks of unsafe or unsuitable premises.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an effective complaints system available.

During our inspection we were able to speak with a number people living at the home, who all provided us with positive comments. They told us that they felt safe living at Cornmill, with their privacy and dignity being respected and their needs being met by a kind and caring staff team. They said they were able to make decisions and choices about what they wanted to do, whilst living at the home.

We found staff to be well supported and appropriately trained and those living at Cornmill looked comfortable in their presence. We also spoke with several relatives who were all very complimentary about the staff team and the managers of the home.

Methods for monitoring the quality of service provided had been established and systems had been developed in order to protect the health and safety of those living at the home.

Comments from those living at Cornmill and some relatives included:

“The staff are marvellous." One service user commented, who was enjoying a manicure.

“It’s been very successful."

“They are very good. If you need something in the night, you just press the buzzer and they come.”

“The nurses are very good. The care is tremendous.”

During our inspection we assessed standards relating to care and welfare and how people were supported to be involved in the planning of their own care. We also looked at how they were safeguarded from abuse. Standards relating to staff training and monitoring the quality of service provision were also inspected.

People spoken with confirmed that their individual wishes are recognised and promoted; they are supported with their hobbies and interests and are encouraged to be as independent as possible. Comments when asked what was good about the home, included 'Brilliant' and 'I would not like to be anywhere else'. One person was looking forward to being taken out by staff to do some shopping in Preston.

A visitor spoken with was impressed with the fact that when she was looking for a place for her mother, she was able to visit straight away without an appointment.

She was shown round by the owners of the home and able to access all areas. This had not been the case at other homes where she had to make an appointment to look round. She also provided confirmation that she had been fully involved in the process of assessment that ensured the home was suitable and could provide the correct level of care for her mother.

Other people spoken with confirmed that they were very happy living at the home and the care and attention provided by the staff and management was ‘First Class’. Nothing was too much trouble and there was always something going on and so they were never bored. There were trips out and festivals to look forward to such as Easter.

A visitor commented that her mother's religious requirements with regard to food and her individual choices were recognised and that the food was 'delicious'. Other people spoken with commented that the meals were 'very good' and they had 'no complaints'.

Confirmation was received that staff were very attentive and any requirements they had were met straight away. One person was being taken to Preston by two staff and confirmed that he was well supported whenever he wished to go out and about. Staff were observed taking the time to talk to people cared for in the home and staff confirmed they had plenty of time to plan and carry out any social activities.

The people cared for in the home are regularly asked whether the care being provided is meeting their individual needs and whether any improvements could be made to the services provided by the home. All the people spoken with were very complimentary about the attention provided by staff and the management of the home.