Firtree House Nursing Home is a privately owned and managed establishment accommodating a maximum of 35 older people and people living with dementia or physical disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of our visit 25 people lived at the home.

The home was previously registered under a different provider and was rated Requires Improvement. A new provider has taken over the service and registered the home with the CQC. We carried out this inspection to ensure the new provider had taken action to address the issues at the home, and that people were receiving a good standard of care. Feedback from service commissioners was that the service had greatly improved under the new management.

This was the first inspection of Firtree House Nursing Home under the new provider. This inspection took place on 31 May 2018 and was unannounced. During this inspection we found that the concerns identified at our previous inspection under the previous provider had been dealt with.

There were two registered managers 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 at the home during the time of our inspection.

People were very positive about the new management. The described how real changes had been made to their lives and they were much happier and satisfied with the care they received. People were complimentary about the staff, describing them as caring and happy in their work.

People were safe at Firtree House Nursing Home. Risks around people’s health and safety had been identified and clear plans and guidelines were in place to minimise these risks. Staff understood their duty should they suspect abuse was taking place, to keep people safe.

There were sufficient staff deployed to meet the needs of the people who lived at the home. Under the previous provider the majority of staff had been agency. NHS NRS Healthcare Limited, the new provider, had stopped this, and the home was now fully staffed by permanent carers and nurses. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received an induction when they started working at the home and had ongoing training. This was tailored to the needs of the people they supported, and also gave the nursing staff the training and clinical supervision to keep their registration with the Nursing and Midwifery Council up to date.

Staff managed the medicines in a safe way and were trained in the safe administration of medicines. The home was clean and staff practiced good infection control measures, such as hand washing, hygienic cleaning of the environment and equipment and correct use of personal protective equipment.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Accidents and incidents were reviewed to minimise the risk of them happening again.

Before people moved into the home, their needs were assessed to ensure staff could provide the care and support they needed. People told us they enjoyed the food. They received a balanced diet and they were encouraged to keep hydrated. People