Knowle Park nursing home provides care and accommodation for up to 49 people some who have physical needs, some people who are living with dementia and some who have to choose to enjoy their retirement years. On the day of our inspection 40 people were receiving care and support at Knowle Park nursing home.

We undertook our unannounced inspection on 9 January 2017.

A registered manager was 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.

People and their relatives gave positive feedback about the service they or their family member received. People were very happy about the care they received.

People were kept safe. Staff had received training in safeguarding adults and were able to tell us about the different types of abuse and signs a person may show if they were being harmed. Staff knew the procedures to follow to raise an alert should they have any concerns or suspect abuse may have occurred.

People told us care staff treated them properly and they felt safe. Staff had written information about risks to people and how to manage these in order to keep people safe. For example people at risk of skin breakdown, had action plans in place detailing guidance for staff to undertake to minimise the risk to the person and to promote skin healing.

Incidents and accidents were fully investigated by the registered manager, and actions put in place to reduce the risk to people of accidents happening again such as people falling.

People received their medicines as they were prescribed and when they needed them. Processes were in place in relation to the correct storage, disposal and auditing of people’s medicines.

Care was provided to people by a sufficient number of staff who were appropriately trained and deployed. People did not have to wait to be assisted.

Staff recruitment processes were robust and helped ensure the provider only employed suitable staff to care for people.

People and their families (when necessary) had been included in planning and agreeing to the care provided. People had an individual plan, detailing the support they needed and how they wanted this to be provided. Staff ensured people had access to healthcare professionals when needed.

Knowle Park Nursing Home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm. Staff understood their responsibilities in relation to capacity and decision making. This was in line with the Mental Capacity Act (2005) Code of Practice which guided staff to ensure practice and decisions were made in people’s best interests.

Care Staff and nursing staff had the specialist training they needed in order to care for people. Staff demonstrated best practice in their approach to the care, treatment and support people received.

People were provided with a choice of freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. Specialist diets to meet medical or religious or cultural needs were provided where necessary.

People were treated with kindness, compassion and respect. Staff took time to speak with the people who they supported. We observed some positive interactions and it was evident people enjoyed talking to staff. People were able to see their friends and families as they wanted and there were no restrictions on when relatives and friends could visit.

People’s views were obtained by holding residents’ meetings and sending out an annual satisfaction survey

We spoke with two people and one person’s relative they were satisfied with the service they received. One person commented “It’s nice” and a person’s relative commented “Very good.”

We found that in relation to the issues that had been identified at the inspection on 8 July 2013 the provider had taken appropriate actions as outlined in their action plan.

Actions had been taken to ensure that people’s privacy and dignity were upheld and that staff ensured people’s confidentiality was maintained.

The provider had ensured that staff had an understanding of safeguarding and whistleblowing procedures.

Measures had been taken to improve the infection control practices in the home.

We reviewed the care and welfare provided to people as concerns had been reported to us. We found that people’s needs had been assessed, care plans and risk assessments were in place and staff showed that they understood the needs of the people they provided care to.

The registered manager was unavailable on the day of the inspection so we were assisted during the course of the inspection by the interim manager.

On the day of the inspection, the service accommodated 37 people. We spoke with eight people and their relatives about the service they received.

Those we spoke with were satisfied overall with the service they received. People said of their experience of the service “Fairly good overall” and “Very impressed.”

We found that people’s dignity and privacy had not always been upheld as not all staff knocked on people’s doors before they entered. We saw that people’s charts had been kept in the corridor outside their rooms.

People’s needs had been assessed and staff were provided with written guidance. We found that not all staff had been using the correct moving and handling guidance and equipment. We found that staff were now following the correct procedures .

Staff were provided with safeguarding training and written guidance was available in the home. We found however, that not all staff had a sound understanding of safeguarding and whistle blowing.

We found that the budget for supplies of some items used for infection control was limited and as a result staff had been required to purchase additional supplies from petty cash.

There were supplies of gloves and aprons in the home; however, they were not always available in the areas that they were needed.

The provider had various systems in place to monitor the quality of the service people received.