The inspection visit at New Thursby Nursing Care Home took place on 15 August 2017 and was unannounced.

New Thursby Nursing home is a large detached home set on the main road between Blackpool and St Annes on Sea. The home is spacious and set over two floors, on which bedrooms and bathing facilities are situated. There are thirty-two single rooms and four shared rooms. Seventeen rooms are equipped with en-suite facilities. There is a choice of communal lounges and seating areas. At the time of our inspection there were 37 people living at the home.

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.

At the last inspection the service was rated Good. At this inspection the service remained Good.

During this inspection, we received comments that demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing good care and support to people who lived at the home.

Records we looked at indicated staff had received safeguarding from abuse training. Staff we spoke with told us they were aware of the safeguarding procedure and knew what to do should they witness any abusive actions at the rest home. One relative told us, “I go home at night and do not worry about my [relative’s] safety.”

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the home. This was confirmed from discussions with staff.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who lived at the home. The deployment of staff was structured to meet the needs of people who lived at the home.

Staff responsible for assisting people with their medicines had maintained their professional qualifications to ensure they were competent and had the skills required. Medicines were safely managed and appropriate arrangements for storing medicines were in place.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. One person told us, “I do enjoy the meals, and I am a very good eater.” A second person said about the meals, “There is always enough choice and plenty to eat.”

We found people had access to healthcare professionals and their healthcare needs were met. We saw the management team had responded promptly when people had experienced health problems.

Care plans were organised and had identified care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People told us they were happy with the activities organised at New Thursby Nursing Home. The activities were arranged for individuals and for groups.

A complaints procedure was available and people we spoke with said they knew how to complain. People and staff spoken with felt the registered manager was accessible, supportive and approachable.

The registered manager had sought feedback from people who lived at

People told us what it was like to live at The New Thursby. They described how they were treated by staff and their involvement in making choices and decisions about their care. People also told us how they had access to a range of care and support services and how they made their views known about the quality of care delivered. This was because the inspection focused on these important topics along with what systems were in place to enable people to raise concerns and complaints as well as making comments.

People spoke positively of the care they received and described staff as, “Very kind and caring”. One relative told us, “Staff are very helpful. They are always around when we visit. Nothing is too much trouble”. One person living at the home said, “I really do like it here, I can do my own thing it really has given me a good life”.

Another person said that staff listened to what they were saying and acted on what they requested. We were also told that staff had supported them in attending hospital appointments. One comment included, “When I had my diagnosis the staff were very good and supported me through the operation and when I came back here. It was a bad time for me but they were there for me”.

Staff we spoke with told us they felt supported and told us the recruitment system made sure all the necessary checks had taken place before they began working in the home.

We spoke with a range of people about the home. They included the director of nursing, registered manager, some of the staff members on duty, people who lived at the home and some visiting relatives. We also had responses from external agencies including social services in order to gain a balanced overview of what people experienced using the services delivered at The New Thursby.

Residents spoken with told us they could express their views and were involved in decision making about their care. They told us they felt listened to when discussing their care needs. Staff confirmed to us they also involved relatives where possible to ensure people received the right care and support. One relative told us, “As a family we are kept informed about everything, the staff are very good.”

During the inspection we spent time in communal areas in order to observe how staff and residents communicated. We saw staff speaking with people respectfully. We saw they spent time with people on an individual basis, were patient and took time to listen to residents. One staff member told us, "I have been here for a long time and respect all the residents. They are all different and we respect that.”

During the course of the visit we spoke individually with the manager, five people living at the home, two visitors, two qualified members of staff and a number of care assistants, ancillary staff and the maintenance employee. Short informal chats also took place with some other residents and members of staff throughout the course of the day.

People living at the home told us staff were respectful and treated them with dignity, one resident said, "They are all so patient", another said, "They are busy but they are kind and always have time for us". All people we spoke to said good things about the way they were treated by all members of staff.

When asked, one person we spoke with said, "I feel safe and comfortable living here". A relative told us that she felt her father was, "Getting everything they need living at the New Thursby”.

New Thursby Nursing home is a large detached home set on the main road between Blackpool and St Annes on Sea. The home is spacious and set over two floors, on which bedrooms and bathing facilities are situated. There are thirty-two single rooms and four shared rooms. Seventeen rooms are equipped with en-suite facilities. There is a choice of communal lounges and seating areas. There are a range of aids and adaptations in place to meet the needs of people using the service.

At this inspection we found the service was consistently well led. The registered manager carried out checks of the quality and safety of people’s care. Results of the provider’s checks relating to people’s health status, such as accidents and incidents, were always formally analysed to check for any trends or patterns.

People felt safe in the home and they were happy living there. People and their relatives knew who to speak with if they had any concerns or worries about their care. Potential or known risks to people’s safety were identified before they received care and they were reflected in people’s written care plans, which staff followed and understood. Action was being taken to make sure that all people’s risk assessments and care plans were kept up to date and accurately maintained. This helped to mitigate any risks to people from receiving unsafe care.

Staffing arrangements were sufficient for people’s care needs to be met. The provider’s arrangements for staff recruitment were robust and helped to make sure that staff would be suitable to work with people receiving care. Emergency plans were in place for staff to follow, such as in the event of a fire alarm or loss of energy power supplies. Reports of recent visits from the local fire and environmental health authorities, found satisfactory arrangements for fire safety and food hygiene and handling at the home.

The registered manager explained that the home was involved in a new scheme to undertake speech and language (SALT) assessments using new technology such as Skype (internet based communication software). SALT assessments are used to assess and treat speech, language and communication problems in people of all ages, to help them eat and communicate. People who needed to have a SALT assessment were supported to use a computer connected to Skype so that they could have a private consultation with a speech and language therapist based at the local hospital. This was seen to be very innovative and useful in that people were able to access an assessment a lot quicker, and receive professional advice and support.

People’s health care needs were met in consultation with relevant health professionals when required. People were supported to maintain a balanced diet in a way that met with their assessed needs and choices. Staff supported people safely and effectively and they promoted people’s choice and control of their care. For example, with their mobility, meals and nutrition. People’s medicines were safely managed and arrangements were in place to enable people to retain and administer their own medicines, should they choose to do so.

Staff received the training and support they needed. Staff understood and followed the Mental Capacity Act 2005 to obtain people’s consent or appropriate authorisation for their care when required.

People were happy with their care and felt that staff treated them with respect and kindness and that they maintained their dignity, privacy, choice and independence. People and their relatives were appreciative of, and appropriately involved and informed in the care provided, which met with people’s needs and wishes. Staff knew people well and had good relationships with them and with relatives or representatives. Staff supported people to maintain their known daily living preferences and personal routines and their interests and beliefs, which were shown in their written care plans.

People received prompt assistance from staff when they needed it. People were informed how to raise any concerns or complaints and their views about the service and those of their relatives were regularly sought. Findings from these were often used to improve people’s experience of their care and daily living arrangements.

People, their relatives and staff found the registered manager accessible and approachable and were positive about some of the changes being made to improve people’s experiences of their care and the upgrading to one of the main lounges.

Arrangements were in place for the management and day to day running of the home. Staff understood their roles and responsibilities and the provider’s aims and values for people’s care, which they promoted. Staff were all confident to raise any concerns they may have about people’s care. The provider’s policies and procedures supported and informed them to do so when required.

The home was found to be a Gold Standards Framework (GSF) accredited service. GSF is a systematic, evidence based approach to optimising care for all people nearing the end of life. The home had a dedicated end of life suite where people and their families could be cared for at the end of life. There were end of life care drugs in place for those people approaching the end of life to ensure people could be cared for, avoiding inappropriate emergency admission to hospital.

We previously inspected this service on 25 October 2013. The service was found to be compliant with the regulations we inspected at the time of the visit.