About the service: Cosham Court Nursing Home provides care and accommodation for up to 47 people. The home specialises in providing care to older people. At the time of the inspection there were 32 people living at the home.

Rating at last inspection: Good (published 17 September 2016).

Why we inspected: This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People were happy with the care and support they received at Cosham Court Nursing Home. Feedback from visitors and involved professionals was positive and we observed kind, compassionate interactions between staff and people during our inspection.

People received a safe service because the provider had systems and processes which helped to minimise risks. This included safe recruitment procedures and training for staff about how to recognise and report suspicions of abuse.

Staff were well trained and knew people and their individual needs. This meant that care was planned and delivered effectively.

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.

People’s care records showed that their support was reviewed at least monthly and was therefore responsive to changing needs. People were supported by staff to engage in a range of social opportunities which included some group activities, one to one time with staff and a range of visits from external providers.

Leadership was visible and promoted good teamwork. People, professionals and staff spoke positively about the management and staff had a clear understanding of their roles and responsibilities.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out an unannounced inspection of this home on 24 August 2016. The home is registered to provide accommodation, nursing and personal care for up to 47 older people, some of whom live with dementia. Accommodation is arranged over two floors with lift access to the second floor. At the time of our inspection 39 people lived at the home and the provider told us they had used several of the accommodation rooms to provide additional recreational facilities for people who lived at the home. This meant the home always accommodated less people than they were registered to support.

A registered manager was 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. The registered manager was on holiday at the time of this inspection.

People were supported by staff who had a good understanding of how to keep them safe, identify signs of abuse and report these appropriately. Robust processes to check the suitability of staff to work with people were in place. There were sufficient staff available to meet the needs of people and they received appropriate training and support to ensure people were cared for in line with their needs and preferences.

Medicines were administered, stored and ordered in a safe and effective way. We have made a recommendation about how records are kept for medicines which are given as required or in a varied dose.

Risk assessments in place informed plans of care for people to ensure their safety and welfare, and staff had a good awareness of these. Incidents and accidents were clearly documented and investigated. Actions and learning were identified from these and shared with all staff.

People were encouraged and supported to make decisions about their care and welfare. Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. Where people were legally deprived of their liberty to ensure their safety, appropriate guidance had been followed.

People received a wide variety of nutritious meals in line with their needs and preferences. People had access to fresh fruit and snacks throughout the day and were encouraged to take fluids especially in the hot weather. Those who required specific dietary requirements for a health need were supported to manage these.

People’s privacy and dignity was maintained and staff were caring and considerate as they supported people. Staff involved people and their relatives in the planning of their care.

Care plans in place for people reflected their identified needs and the associated risks. Staff were caring and compassionate and knew people in the home very well. External health and social care professionals were involved in the care of people and care plans reflected this.

Effective systems were in place to monitor and evaluate any concerns or complaints received and to ensure learning outcomes or improvements were identified from these. Staff encouraged people and their relatives to share their concerns and experiences with them.

The service had a good staffing structure which provided support, guidance and stability for people, staff and their relatives. Relatives spoke highly of all staff.

Cosham Court can accommodate up to 47 people who require nursing care. On the day of our inspection 34 people were accommodated and one person was in hospital. Of these, we were told most, but not all people had a diagnosis of dementia.

During this inspection we spoke with twelve people, including those with dementia and one relative and five staff members including the manager. Comment cards were received from five people. One professional wrote, “I have never had any concerns about the home looking after individuals with dementia. They show compassion, a caring manner and treat people with respect and dignity”

People's needs were assessed and care was planned accordingly. All people spoken with told us they were happy with the care they received. They told us they felt able to exercise choices about their care and how they spent their days.

People were supported and had access to a range of services to ensure their overall needs were met. The manager had built good relationships with other professionals to ensure people received access to a range of health and social services.

The manager had an effective way of monitoring and assessing the service provided to people with dementia.

There were 32 people living in the home on the day of the visit. We spoke to visitors and observed how care was being provided to help us understand the experiences of people using the service. We found that the majority of people's likes and dislikes were recorded in order and influenced the delivery of care.

On the day of the inspection many people were suffering a gastroenteritis type illness and we saw that this was being managed to ensure that people received care, treatment and support that met their needs. Through observation we had concerns that one person did not have their care needs met and we spoke to the manager to ensure this was addressed.

People we spoke with said that they felt safe in the home and that they would "have no problem" to speak to a member of staff if they felt concerned. Staff were knowledgeable on safeguarding matters and recognised that many of the people they cared for were vulnerable and relied on them to protect them.

Care was delivered by sufficient numbers of staff. The records of staff training were incomplete however staff told us that they had received training relevant to peoples care needs.

Systems and procedures were in place to monitor the quality of the care. People’s views were sought through a number of systems.