Denehurst Nursing Home provides nursing and residential care for up to 33 older people in Ferryhill. There are two floors and people living with a dementia live on the upper floor and people with general nursing needs living on the ground floor. On the day of our inspection there were 32 people using the service.

The inspection took place on 3 November 2017 and was unannounced. This meant staff did not know we were visiting.

We last inspected the Denehurst Nursing Home in April 2015 and rated the service as Good. At this inspection we found the service remained Good.

The service had a registered manager who was on a day off at the time of our visit. 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 clinical lead was in attendance during the course of our inspection and we saw they were fully involved in all aspects of the day to day running of the home.

Staff and the management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with told us they felt safe at the home.

Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Accidents and incidents were logged and investigated with appropriate action taken to help keep people safe. Health and safety checks were completed and procedures were in place to deal with emergency situations.

The home was clean, and we saw staff followed good practice in relation to wearing personal protective equipment when providing people with care and support. There was an investment programme of replacement windows planned and a new roof had recently been fitted as the exterior of the home looked tired.

Medicines were managed safely. We saw medicines being administered to people in a safe and caring way. People confirmed they received their medicines at the correct time and they were always made available to them.

We found there were sufficient care staff deployed to provide people’s care in a timely manner. We found that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people.

The registered manager shared learning from feedback and safeguarding events with the staff team through recorded meetings.

Staff received the support and training they required. Records confirmed training, supervisions and appraisals were largely up to date. Staff told us they were supported by the home’s management.

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 gave positive feedback about the meals they were served at the home. People received the support they needed with eating and drinking by the chef who was trained in the support of people with nutritional needs.

We saw people’s healthcare needs were well monitored and the visiting nurse practioner we spoke with confirmed they had no concerns with the care provided at the service.

People were supported by care staff who were aware of how to protect their privacy and dignity and show them respect at all times.

People’s needs were assessed before they came to live at the service and then personalised care plans were developed and regularly reviewed to support staff in caring for people they way they preferred.

People were provided with end of life care by trained nursing and care staff.

An activity coordinator provided a range of activities and support for people to access the community.

People and staff were very positive about the management of the home. Many staff had worked at the service for a number of years and this a

This inspection took place on 20 April 2015 and was unannounced, this meant that the provider and staff did not know we would be visitng.

Denehurst provides care and accommodation for up to 31 older people some require nursing care. On the day of our inspection there were a total of 27 people using the service.

The home had 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 and associated Regulations about how the service is run.

During our inspection there was a very calm and relaxed atmosphere in the home and we saw staff Interacted with people in a friendly and respectful manner. People who used the service told us they were very happy with the care they received. All appeared happy and relaxed with the staff on duty. We saw that the staff communicated with people who used the service respectively and in a caring way. One person’s family member described their relative’s care as, “Excellent.” Another said, “It’s a marvellous place especially since the new registered manager and deputy manager took up post.”

Staff and visitors we spoke with described the management of the home as open and approachable.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the provider and looked at records. We found the provider was following the requirements of DoLS.

Staff we spoke with said they had received appropriate training to undertake their role to meet the needs of people who used the service. We saw records to support this. Staff had also received training in how to recognise and report abuse. We spoke with four staff and all were clear about how to report any concerns. Staff said they were confident that any allegations made would be fully investigated to ensure people were protected.

Throughout the inspection we saw staff interacting with people in a caring and professional way. We saw two members of staff supporting one person with their mobility and appropriately using a hoist. They were interacting happily and explaining what they were doing and how. We noted that throughout the inspection when staff offered support to people they always respected their wishes and described how they were going to support them. We saw people smiling and happily engaging with staff when they were approached.

We saw there was a weekly activity programme and records showed that people were able to take part in group activities or on a one to one basis. We saw activities were personalised and there were very regular outings to the local shops and pubs and places of interest.

We saw people were treated with respect and privacy was upheld.

People received a wholesome and balanced diet and at times convenient to them. The manager told us that the menus were being reviewed in line with people’s choices.

We saw the provider had policies and procedures for dealing with medicines and these were adhered to.

The provider had an effective complaints procedure which people and their representatives were able to see and use. We saw all people who used the service could access an independent advocate who could act in their best interests where needed.

We saw people who used the service were supported and protected by the provider’s recruitment policy and practices.

The home was clean and equipment used was regularly serviced. We saw the home had commenced a major refurbishment programme.

The provider had a quality assurance system, based on seeking the views of people, their relatives and other health and social care professionals. There was a systematic cycle of planning, action and review, reflecting aims and outcomes for people who used the service.

Staff told us they received regular supervision. We saw records to support this.