This inspection took place on the 23, 28 and 30 September 2016 and was unannounced. One inspector visited the service on all three days of the inspection. On the first day they were accompanied by a specialist nurse advisor.

Gorselands Nursing Home provides accommodation, nursing care and support for up to 39 people. At the time of the inspection the service had 39 people living there.

The service had 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 2008 and associated Regulations about how the service is run.

The caring ethos of the service was outstanding. People were extremely happy with the care and support they received. One person said, “I couldn’t think of anything that could improve” and another person told us, “I am very happy here. The staff are extremely helpful and kind. The food is absolutely delicious. I have nothing to complain about. I'm very very comfortable and so fortunate to be here”.

Staff told they were well supported and had the right knowledge and skills to provide caring and effective care or support and described how they provided individualised care and support. For example, one member of staff said, “We provide very good care by forming a personal relationship with people. Its very person centred here. For instance, if somebody comes in with a very set routine as we have just had, we alter the daily allocations to incorporate her own routine”.

The service had safe systems in place that ensured people were protected from harm and received care that met their needs.

People were supported and provided with an extensive choice of healthy food and drink ensuring their nutritional needs were met. Menus took into account people’s dietary needs and people told us they really enjoyed the food and could ask for different choices if they did not like what was on the menu.

There were lots of individual and group activities. People told us there was enough going on and they didn’t get bored.

People told us that staff responded promptly to their requests for assistance and that staff supported them to see healthcare professionals quickly when they needed to.

People knew how to make a complaint and felt confident they would be listened to if they needed to raise concerns or queries. There was a clear system in place for people to raise concerns and complaints.

There was an effective approach from the manager that supported staff to provide very person centred, effective and responsive care. There were comprehensive quality assurance mechanisms in place that meant people and staff were able to express their views and these were acted upon to drive continuous improvements.

People told us they were very happy with the care and support provided at the service. One person told us "the staff are very considerate - I couldn't ask for more". Another told us "there are lots of activities for us to do, if we want to get involved - but we don't have to." A large number of 'thank you' cards from relatives and people who had used the service previously were displayed on walls, which showed many more people also had a positive experience of the service prior to the inspection visit.

People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.

We reviewed care plans for five people and they were person centred and contained essential details about people's care and support needs. Staff were observed supporting people using the service and always used their first names. During the inspection we observed one person being spoken to using their surname and title and upon checking their care plan we saw that they prefered to be addressed this way rather than the use of their first name. This showed that people's choices were respected and acted upon.

Staff were well supported and received on-going training and development to be able to effectively meet people's support needs.

We used a number of different methods such as reviewing records, we observed staff supporting people, we talked to staff, the manager and we talked with relatives to help us understand the experiences of people using the service.

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Observation during the inspection showed staff supporting people to make their own choices.

People experienced care, treatment and support that met their needs and protected their rights. Care plans were person centred and documented people's wishes in relation to how their care was provided. We observed that people chose how to occupy themselves in the home.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We spoke with staff and staff demonstrated an understanding of the safeguarding procedures and the different forms of abuse.

During our inspection we did not see evidence that staff had been provided with adequate and appropriate supervisions, personal development and an induction to the home.

People that we spoke to were happy living at the home and enjoyed the variety of activities and food choices on offer.

People's relatives that we spoke to were happy that their relatives lived in such a welcoming and friendly home.

On this visit we checked to see if compliance actions made in our last compliance review report had been addressed. On this occasion medicine administration and records were not discussed in general with people using the service. However, one person spoken with was satisfied they regularly received their prescribed medicines. Two people spoken with were aware of records being held about their needs. One person told us they had been involved in planning their service and another was aware of recording and monitoring taking place.

All comments received from people receiving a service were positive.

Staff told us that improvements had been made in the monitoring of the administration of medicines and that checks are made for accuracy. Qualified staff members have a role in ensuring any errors are picked up are addressed.

Staff also told us about improvements to some of the recording and this included their role in updating and reviewing care plans.

People gave us positive feedback about the service provided. They said that they are able to make day to day decisions about their lives and are consulted about the care they need. Some relatives told us that are consulted and are kept informed. They gave examples of changes in support provided when the needs of people had changed.

People told us that they are supported with health and personal care and are aware of care plans. Social stimulation is also provided. A range of activities are offered in groups and for individuals.

Feedback was very positive about the staff who are reported to be generally attentive friendly, helpful, aware of needs and well organised. Staff told us about recent changes made to the organisation by allocating key workers to ensure that individual needs are followed and reviewed.

People told us that staff are busy but generally available to meet their needs. Sometimes they had to wait but reasons were explained.

People told us that the food is generally very good. Choice of food is always provided and people are asked in advance but if they change their mind alternatives are available. People can choose where to eat, are helped and relatives can stay for meals. Staff told us that food and fluid intake is monitored.

People are confident that they can ask for things they need, can raise issues and that these will be addressed and they gave us examples of these.

People and relatives told us about being consulted about the home and about recently being asked to complete a questionnaire. Staff can also give feedback.

People and relatives told us that the home is always clean and free from odours.

People are aware that staff are provided with equipment for infection control. They were positive about the internal and external environment which is pleasant to look at. They are comfortable and warm. Equipment needed is available and staff told us they are trained in moving and handling.