About the service: Croston Park Nursing Home is registered to provide 24-hour care and support for up to 56 people who have a range of residential and nursing needs. The home also carers for people who are living with dementia. At the time of inspection there were 47 people living in the home.

The premises are in a seventeenth century grade II listed building in its own grounds, in the village of Croston. Bedrooms are located over two floors with lift access to the first floor. Most of the bedrooms are ensuite. All but three bedrooms are of single occupancy. The ground floor included the dining room and several communal lounge areas, there is access to outside grounds.

People’s experience of using this service

We received consistently positive feedback from people and visitors. They told us the home was warm and homely, people felt safe and the staff were excellent, kind and competent in their roles. Accidents and incidents were managed safely and risks had been considered. Medicines were managed safely. Relevant environmental checks were carried out and the service had relevant signage in place to support people who lived in the service.

Staff were recruited safely and duty rotas confirmed staffing was sufficient. Training records and staff we spoke with confirmed staff received training which supported them in their role. Relevant professional registration checks had been completed.

People were supported to have maximum choice and control of their lives and staff supported this in the least restrictive way possible, the policies and procedures were in the service supported this practice. Authorisations to restrict people’s liberty had been sought where necessary. The meal time experience was overall positive. Choices were available and reflected people’s individual dietary needs.

People and visitors were positive about the care they received and they were treated with dignity, respect and their privacy considered. There was evidence of working together with relevant professionals. Care planning was person-centred and reflected people’s current and individual needs. End of life care plans had been completed. The service used technology in a number of ways to enhance the service. There was a complaints policy which was followed in practice.

The registered manager had established good governance systems and records confirmed senior oversight was in place. The provider engaged with residents and staff. The provider used satisfaction surveys to assess and monitor the service.

Rating at the last inspection: At the last inspection the service was rated good (published 6 October 2016).

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

Follow up: We will monitor as part of the inspection profile as a good service. We may inspect earlier If any concerning information is received.

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

The inspection took place on 04 and 06 July 2016 and was unannounced. We last inspected the service in July 2013, when we found the provider was meeting the requirements of regulations we inspected against at that time.

Croston Park Nursing home is registered to provide 24 hour care and support for up to 44 people who have a range of residential and nursing needs. At the time of our inspection, there were 37 people living at the home. The home also cares for people who are living with dementia. The premises are located in a 17th century grade II listed building in its own grounds, in the village of Croston, Lancashire. Most rooms within the residential and nursing areas are ensuite and share ground floor lounges and a dining room. The smaller area on the top floor has a separate lounge where most of the people also eat.

The service had a long-standing registered manager 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.

People were safe living at the home because they were supported by a sufficient number of staff who had the right skills and knowledge to meet their needs. Staff understood their responsibilities with regard to reporting suspected abuse, in order to safeguard people.

The service followed safe recruitment practices to ensure only suitable candidates were employed to work with people who lived at the home.

The service had ensured risks to individuals had been assessed and measures put in place to minimise such risks. A comprehensive plan was in place in case of emergencies which included detail about how each person should be supported in the event of an evacuation.

Staff received induction and on-going training to enable them to meet the needs of people they supported effectively. Staff were supported by way of regular supervision, appraisal and access to management.

Effective systems were in place to ensure people's medicines were managed safely. Only trained staff were allowed to administer medicines. We observed one member of staff did not follow published national guidelines when administering medicines. We have made a recommendation about this.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). The provider had identified some issues with regard to the completion of records for mental capacity assessments and was in the process of implementing new paperwork and procedures. Where people's liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person's rights were protected.

People were supported to eat and drink enough to maintain their health. People's dietary requirements were explored and the information was readily available to kitchen staff to ensure these were met.

People could access external healthcare services as they required and were supported to do so. People had access to a wide range of activities which were provided seven days a week.

Staff were kind and caring and treated people with respect. We witnessed many positive and caring interactions throughout or inspection. Staff knew people's likes and dislikes which helped them provide individualised care for people.

Plans of care were based around the individual preferences of people as well as their medical needs. People and their relatives were involved in reviews of care to ensure it was of a good standard and meeting the person's needs.

The provider had implemented effective systems to assess, monitor and improve the quality of care and support that was delivered to people. People, their relatives and staff were involved in developing the serv

Staff spent time ensuring people understood what was being asked of them and gave people time to make considered responses. One person said, “I am always asked if I’m ok or need anything and they (staff) are always checking on me.”

Everyone we spoke with that lived in the home spoke positively about living there. One person said, “The building is lovely, if I want to be with people I can but there is always somewhere I can go if I just want quiet time too.”

Everybody we spoke to including people living in the home, staff and people’s relatives were all confident that people were kept safe. One person said,” I like being here; I know I’m looked after and am confident that the staff would deal with any emergencies as required.”

Staff working at the home we spoke with said they enjoyed it. One said, “When people asked me what I did for a job I used to say ‘I’m just a carer’, now I say I’m a carer and I say it with pride.”

People we spoke with living in the home generally were content and felt listened to. We spoke to the management of the home who confirmed that regular resident and relative meetings continued to take place. Annual surveys collected the views of relatives and residents and the results of these were used to improved provision. A survey for residents and staff was currently being developed.

People living at the home and their relatives said, that staff were always respectful of their wishes. We were told that staff would work with them to provide the best care, them or where appropriate their relatives wanted. One relative said, “In general things are lovely, there is a real homely feel and mum’s hair always looks how she would have done it herself”.

People we spoke with told us their care needs were being fully met by the staff team. People felt safe and secure within the home with one saying simply, “It’s all good”.

Two people living in the home were concerned about the amount of time it took staff to respond to them when they needed help. One said “When I fell, I called for help and another resident went and got someone”.

We saw that people living in the home were able to personalise their bedroom with pictures and other belongings. The decoration and furnishings in the home were of a good standard. Decoration was generally of a standard that could be described as home from home. The provider may find it useful to note that developing the environment and improving signage can stimulate people living with dementia and aid greater independence.

People living in the home said staff were excellent. One relative said, “Everybody is brilliant and the managers door is always open if I need to talk to someone”.

Relatives had been involved in an annual collection of comments and there was a suggestion box on site.