We inspected this service on the 19 & 20 December 2016. This was an unannounced inspection.

Mount Elton nursing home provides care for older people with nursing and personal care needs. At the time of the inspection there were 22 people living at the home. Accommodation is arranged over three floors. It has a lounge, a dining area, nurse’s station, a conservatory, kitchen and offices. There is a drive way at the front with parking and front lawns with a patio area.

There was a registered manager 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 lived in a clean and tidy home although records relating to checks around the home needed improving. People had their views sought relating to the décor of the home. People were happy with the meal choices and could choose where they ate their meals. The home provided a social environment for visitors and was part of the community. Relatives were welcome to sit and spend as much time as they wished with their family members.

People’s care plans were detailed and personalised and contained informative risk assessments. However people at risk of their skin developing sores required confirmation in their care plan and charts of how often they should be turned. The registered manager took action during the inspection to update the care plan to reflect this information.

People felt safe in the home and received support from staff who had appropriate checks in place prior to commencing their employment. People’s care plans confirmed if people were unable to make decisions relating to their care and treatment and the principles of The Mental Capacity Act were being followed. People received their medicines when they needed then and from staff who were competent to do so.

People were supported by adequate staffing levels and staff supported people in a kind and caring manner. Staff received regular supervision and training to ensure they were skilled to meet people’s individual care needs although some staff’s knowledge around safeguarding and equality needed improving. Staff felt happy and supported by the management of the home.

People were supported to maintain relationships with friends and family. People were supported by staff who gave people choice and control in their care and support. People had access to activities and social events that were important to them. Activities included quizzes and songs, social morning, reading, exercises to music and poetry.

People felt able to make a complaint to the registered manager should they need to do so. People and relatives were involved in planning their care. The provider had quality assurance systems in place that identified areas for improvement. People, relatives and professionals views were sought so that improvements could be identified, feedback received was overall positive about the care provided and received.

This inspection was to follow up on the findings from our previous inspection of 13 January 2013 to ensure that appropriate action had been taken by the provider to address our concerns. We asked the provider to send us a report of the changes they would make to comply with the standard they were not meeting.

We found people received care, treatment and support that met their needs and protected their rights. One person told us “I am happy here. I have a choice of when to get up and retire. They are very flexible here”.

We found 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. One person told us “I feel safe here. I have no complaints”.

The provider demonstrated that people were cared for in a clean, hygienic environment.

The provider was able to demonstrate that staff were provided with on-going training and that staff were supported by regular supervisions and yearly appraisals.

We found the provider had an effective system in place to monitor the quality of the service to ensure people received safe care.

The provider had an effective complaints system to meet people’s needs.

The provider notified the Care Quality Commission of important events that affected the health, welfare or safety events of people who used the service so that, where needed, action could be taken.

People we spoke with told us that they were happy with the care and support provided by the home. People told us they were assessed before they came to live at Mount Elton. They said they were involved with developing their care and support plan and that staff treated them kindly and politely. For example one person said “I feel safe here I have no complaints”.

We observed staff interacting with people who used the service in a respectful manner. However, we observed a staff member did not ask people who were sat in the lounge for their consent before putting on music on after lunch. When we asked one of the people in the lounge if they liked the music they said “no that’s not my kind of music I like classical music”.

We found people were protected from the risks of inadequate nutrition and dehydration.

We saw the provider had a policy on safeguarding people from abuse. The staff had attended training to ensure that people who lived in home were protected from the risk of abuse.

We saw the provider had an effective system in place to regularly monitor the quality of service that people received.

.We found from speaking to people who used the service and staff as well as looking at the training and supervision records that staff were trained and supported to deliver care to an appropriate standard.

We found the provider did not report important events affecting people’s health to the Care Quality Commission so that where needed, action could be taken.

People who spoke with us were able to discuss their life at the home and what they enjoyed about living there. Everyone has individual accommodation contracts that they have signed, and people confirmed to us that it was discussed with them.

One person told us that they have visits from the chiropodist, dentist and opticians. She said ‘’I have everything I need here, we do yoga and have music’’.

A relative told us that the staff communicate well and will let her know if they are going to call the GP for her mother. She told us that when her mother arrived she was given a choice of room and also has been able to have her own pictures put up on the walls.

We observed people in the lounge and saw that the television was not on and there was appropriate music playing in the background. The overall impression of the home was that the staff adopted a person centred approach relevant to the age group of the people who lived at the home.