This inspection was unannounced and the visits took place on 26, 31 October and 16 November 2016. The staff and registered provider did not know that we would be visiting.

Kings Park Nursing Home is a purpose built care home and is registered to provide accommodation for up to 40 people who require nursing and personal care. At the time of our inspection there were 38 people living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they were happy with the service and felt the staff did a good job. We heard how people felt the home was well-run and that the registered manager was extremely effective.

We found that a range of stimulating and engaging activities were provided at the home. There were enough staff to support people to undertake activities in the home and community. We saw people went on trips to museums and local pubs as well as the airport. On the day of our visit people were making baubles for the Christmas trees.

People’s care plans were tailored for them as individuals and created with them and their family involvement. People were cared for by staff that knew them really well and understood how to support them. We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful. We saw that they were aware of how to respect people’s privacy and dignity. Staff also sensitively supported people to deal with their personal care needs.

Staff were supported and had the benefit of a programme of training that enabled them to ensure they could provide the best possible care and support. Staff were all clear that they worked as a team and for the benefit of the people living at Kings Park Nursing Home. Their comments and feedback fed into the continuous improvement of the service.

The registered manager understood the complaints process and detailed how they would investigate any concerns. They actively sought people’s views and acted upon suggestions. They had also promoted a reflective learning culture in the home, which allowed staff to look at even the smallest of incident to determine what lessons could be learnt.

The registered manager and staff had a clear understanding of safeguarding. The registered manager acted as a champion for people and would raise complaints and safeguarding matters when this was needed.

We found that there were enough staff on duty to meet people’s needs. The registered manager had closely considered people’s needs and ensured there were sufficient numbers of staff. For the 38 people using the service there were two nurses, a senior carer and six care staff on duty during the day and then a nurse and six care staff overnight.

The registered provider had provided care staff with access to a development programme that allowed them to become competent in providing clinical care such as wound and catheter care. They also became trained to take blood and monitor people’s health. This programme was near completion for some staff and the registered manager told us the intention was that the staff would be employed within the home as a clinical support.

Where people had difficulty making decisions we saw that staff worked with them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations.

We reviewed the systems for the management of medicines and found that people received their medicines safely. Medicines were closely managed and this ensured people re

Some people were unable to fully express their views due to their varying levels of dementia and limited abilities to communicate verbally. Of the people who were able to talk with us they told us that they received kind and helpful support from the staff team. We spoke with seven visitors to the home who made the following comments:

"The staff always keep me up to date with the condition of my relative. I have always noticed that there are enough staff around to help the people living here. A friend recommended this home because of the good staff and the good care they provide and now I have seen it myself."

"They do a lot of activities downstairs, but I would like to see them to do more upstairs."

"The staff are caring and know the people living here very well."

"I feel confident that the staff have the right skills to care for people properly."

"People here need a lot of help, I hope they make sure there are enough staff on duty at all times".

People told us they were satisfied with the care and support provided by staff and that they felt confident in raising concerns with the manager or the staff team.

During this visit we found that improvements had been made since the last inspection visit and this showed the management approach was positive and focused on improving people's experience of care and support.

This inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission inspector joined by a practising professional and an Expert by Experience who has personal experience of using, or caring for someone who uses this type of service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People who used the service suffered with varying degrees of dementia, which limited the number of people we could speak with in order to obtain their views about the service. In light of this we spoke with their relatives to find out what they thought of the service and how their relative was being looked after. However, the people we spoke with said they were happy living at Kings Park nursing home. One person said, “No complaints. They look after you here”. Another person said, ”They (the staff) were always nice”. One person smiled and put his thumbs up when asked what he thought about the home. During the inspection, staff treated people with dignity and respect.

Relatives of the people who used the service said they were happy with the care provided. They said they were always kept informed and involved with their relative’s care and they found the staff “very approachable”. They felt their relative was “safe”. One person said about her relative, that she was quite sure “he wouldn't come to any harm“. Another person said, “The staff will do anything for you. I’m always kept informed about my relative’s care needs and they are very prompt at calling the doctor is she is not well”.

We spoke with two health care professionals involved in the care of the people who used the service. They said staff were aware of people’s care needs and provided dignified care. They said staff followed their guidance correctly and made appropriate referrals to ensure people received the right level of care. They said the staff sought advice and guidance appropriately. One health care professional commented she had a good relationship with the nursing staff which ensured good communication.

Tameside Contract and Commissioning Department carried out a monitoring visit to the home and highlighted some concerns about the way food was presented and training provided to staff. The Department acknowledged that improvements had been made in the training provision, although they are continuing to monitor the home to ensure improvements are brought about.