We inspected Eversleigh Nursing Home on 23 November 2016. The inspection visit was unannounced.

Eversleigh Nursing Home is divided into three separate floors and provides personal and nursing care for up to 42 older people, including people living with dementia. There were 35 people living at the home when we inspected the service.

A requirement of the service’s registration is that they have 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 and the associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection visit, however they were on extended leave from the service. An interim manager had been appointed to manage the service in their absence. We refer to the interim manager as the manager in the body of this report. During our inspection visit we also spoke with the development and delivery manager, who was assisting the interim manager three days each week at the home.

Staff received training in safeguarding adults and understood the correct procedure to follow if they had concerns. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.

There were enough staff to care for people safely and effectively. People were supported by a staff team that knew them well. Staff received training and had their practice observed to ensure they had the necessary skills to support people.

People received their medicines as prescribed to maintain their health and wellbeing. People were supported to access healthcare from a range of professionals inside and outside the home and received support with their nutritional needs. This assisted them to maintain their health.

Care records were up to date and provided staff with the information they needed to support people responsively.

The provider, manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made applications to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA requirements. Decisions were made in people’s ‘best interests’ where they could not make decisions for themselves.

Staff knew people well and could describe people’s care and support needs. Staff treated people with respect and dignity, and supported people to maintain their privacy and independence.

People were supported to take part in social activities and pursue their interests and hobbies. People made choices about who visited them at the home, which helped people maintain personal relationships with people that were important to them.

People knew how to make a complaint if they needed to. Complaints received were investigated and analysed so that the provider could learn from them. People who used the service and their relatives were given the opportunity to share their views about how the service was run, and action was taken in response.

Quality monitoring procedures identified where the service needed to make improvements. Where issues had been identified the manager took action to address them to continuously improve the service.

We inspected Eversleigh Nursing Home on 22 December 2015. The inspection visit was unannounced.

Eversleigh Nursing Home is divided into three separate floors and provides personal and nursing care for up to 42 older people, including people living with dementia. There were 35 people living at the home when we inspected the service.

A requirement of the service’s registration is that they have 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 and the associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection. We refer to the registered manager as the manager in the body of this report.

People did not always have social activities offered to them that supported their interests and hobbies and met their needs and their personal preferences. People's care records were not always kept up to date to reflect the care and support they required and received each day from staff. However, permanent staff knew people well and could describe people’s care and support needs. Improvements were being made to the activities offered to people at the home.

People were protected against the risk of abuse as the provider took appropriate steps to recruit staff of good character, and staff knew how to protect people from harm. Concerns regarding people’s care were investigated and responded to in a timely way to ensure people were supported safely. There were enough staff to care for people effectively and safely, and meet people's individual needs.

People received their medicines as prescribed to maintain their health and wellbeing. People were supported to access healthcare from a range of professionals inside and outside the home and received support with their nutritional needs. This assisted them to maintain their health.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Decisions were made in people’s ‘best interests’ where they could not make decisions for themselves.

Care staff treated people with respect and dignity, and supported people to maintain their privacy and independence. People made choices about who visited them at the home. This helped people maintain personal relationships with people that were important to them.

People knew how to make a complaint if they needed to. Complaints received were fully investigated and analysed so that the provider could learn from them. People who used the service and their relatives were given the opportunity to share their views about how the service was run. Quality monitoring procedures identified where the service needed to make improvements. Where issues had been identified the manager took action to address them to continuously improve the service.

Most of the people who lived at the home were not able to tell us about their care and support because of their complex needs. We observed how staff cared for and supported people throughout the day of our inspection. We saw that staff checked that people consented to be cared for or supported before they assisted them

The manager assessed people’s needs and abilities before they moved into the home. People’s care plans identified risks to their health and wellbeing. Instructions for staff minimised the identified risks. A member of care staff told us, “I always read the care plans to learn their needs, likes and dislikes.”

The provider checked that staff were suitable to work with vulnerable people before they started working at the home. Staff told us they had safeguarding training. Staff we spoke with understood their role and responsibilities for keeping people safe from harm.

Staff told us they felt supported by the manager. They told us they had regular opportunities to discuss people’s care needs and their own practice. A relative we spoke with told us, “The staff do a grand job, they are genuinely kind.”

The provider’s regular checks on the quality of the service included asking people and their relatives what they liked most and what they would like to change about the service. We saw that the most recent survey showed a high level of satisfaction.

We spoke with four people who lived at the home and a relative about the care, support and treatment they received. They all told us they were happy living at the home. They told us that the staff were kind and treated them well. They said, “They look after me very well, I can’t complain at all” and “The staff sit and chat when they are not busy. I know them very well they are very nice.”

People told us the food was very good. They said staff always asked what they would like to eat and they had a choice every day. They told us that staff helped them when they needed it, but respected their decisions. They told us they got up and went to bed when they felt like it. One person said, “The staff are very good, they don’t make me join in things if I don’t want to.” Another person told us, "I like to sit in my room; I listen to the radio, walk around the room."

The three care plans we looked at explained people’s needs and how staff should best care for and support people. People’s needs were re-assessed regularly. Records explained the advice other health professionals had given and how staff had followed that advice. Staff records we looked at evicenced how staff were recruited, trainied and supervised to make sure they were able to sprovide the care, support and treatment that people needed. All the records we saw were kept securely and available when needed. Staff followed the provider's policies and procedures to make sure the home was comfortable and hygenic.

People told us that they received their care as they requested and were aware of their care plans. They said that the home was ‘ very pleasant, I’m better here than I should be at home alone’.

People said they saw their GP when they wanted 'You can get one when you need one’ ‘Staff call them if they think there is something wrong’ and that they received their medication as directed by their doctor.

People said that the food was ‘’very good'. They said that they enjoyed some of the activities taking place. ‘’I sit in lounge and watch the TV, I have got my own, but I prefer the lounge. I enjoyed the beach party’’.

Visitors to the home spoken with said thay were ‘’really pleased’’ with the home and the ‘’exceptional care’’ offered by the staff. They told us that ‘’they go the extra mile’’.

We asked people about the nurses and care staff and if they were treated as they would expect and with respect. Generally people said that the staff were very good ‘generally speaking they are very nice people’. One person told us ‘they are very good; I get on well with them’. One person said ‘they vary, some are very pleasant and some are off hand’.

People felt that they could always speak with the manager or the assistant managers. ‘I see them regularly. She is a really nice person and listens to me and what I have to say’. One person said that ‘the manager is always up and down here.’ We asked people if they would like to change anything. One person said ‘not really, if I wanted anything I would ask and see what they had to say’.

A visitor told us that they attended the relative meetings and gave examples of where things had improved or been replaced when issues were raised.