The New Victoria Nursing Home is situated in a residential area of Blackpool. The home is purpose built and provides care and accommodation for up to thirty people. People are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single accommodation.

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

People who lived at the home told us they were happy with their care and liked the staff who looked after them. One person said, “Yes I am happy here. The staff are very nice and they look after me.”

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards people in their care.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them.

People who lived at the home and their visitors told us they enjoyed a variety of activities which were organised for their entertainment.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

We saw staff assisting people with mobility problems. They were kind and patient and assisted people safely.

People 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.

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

We found staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

The service had sufficient staffing levels in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People who lived at the home told us staff were responsive to their needs.

Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived at the home. We found staff were knowledgeable about support needs of people in their care.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

People are 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.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. We saw the registered manager had listened and responded to issues of concern raised by of one person who lived at the home. The concerns were being investi

The inspection team was made up of two Inspectors. During the inspection the team gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. We also spoke with Blackpool council’s contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff understood when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The service was clean and hygienic. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after.

We looked at the recruitment of new staff. The information retained in the files we were given showed that some required recruitment checks had not been undertaken. We found gaps in employment history were not being explored at interview. This meant the home did not have a full employment history of the people employed. Of the three files we looked at two had no references from previous employers. We also found information about when the person’s Disclosure and Barring Service checks (DBS), (formerly CRB checks) had been received had not been recorded. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to recruiting new staff.

Is the service effective?

People’s health and care needs had been assessed with them. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found the care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were happy with the care being provided. One person said, “They look after me really well. We only have to ask if there is anything we want. I enjoy the meals and I am happy with my care.” Another person said, “I am quite happy. The food is good and I find the staff are kind. My only negative comment is I would like to get out more.” Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

Records showed admissions to the home were well planned. Information about people’s care and dietary needs had been recorded. We also saw potential risks to people’s health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care.

We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

A number of people we spoke with said there was very little going on in the home and social activities were limited. One person said, “We have an entertainer visit us occasionally but other than that we have nothing going on. The days just seem to roll into each other. It would be nice if the staff could find time to spend with us but they are always too busy.” Another person said, “It would be nice if we had some activities to keep us entertained. Most people spend their time asleep in the lounge.” We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to meeting people’s individual needs.

After lunch we saw one person who had a stained cardigan after spilling some of their meal on themselves. We noted staff had not changed the person’s cardigan or made any attempt to assist in cleaning them when we last saw them at 4.30pm. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to meeting people’s individual needs.

Is the service well-led?

There were limited records available to show how identified problems and opportunities to change things for the better were addressed promptly. There were no procedures in place to gather information about the safety and quality of service provided. People supported were not asked for feedback about the quality of service they received. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having systems in place to monitor the home.

CQC had not been notified of any incidents or issues relating to the home since October 2013. This meant that we did not receive all the information about the home that we should have done. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to providing information as required.

Although registered for the regulated activity personal care the service was not providing this activity when we undertook this inspection.

This inspection was undertaken to review the improvements the provider had made following our last inspection undertaken on 4th June 2013. During the inspection the provider had been assessed as being non- compliant with assessing and monitoring the quality of service provision. This was because we identified no audits of the medicines were carried out by the home.

Throughout the inspection we found shortfalls in medicines handling such as inaccurate recording keeping, disorganised medicines records, lack of medicines disposal records, insecure medicines storage, missed medicines and lack of information about when required medicines. The manager was unaware of these issues so there was a risk medicines handling would not improve. This placed the health and wellbeing of residents at unnecessary risk.

During this inspection we found the home's medicine policy had been reviewed and regular audits had been completed to help ensure that medicines were safely handled. The manager had also introduced spot checks to record the competences of nursing staff administering medicines within the home.

At this visit we found that medicines handing had improved. The home’s medicine policy had been reviewed and regular audits were completed to help ensure that medicines were safely handled. The three people we spoke with did not raise any concerns about their medicines with us.

Two people we spoke with did not raise any concerns about their medicines with us. However, the home’s medicines policy was not available for staff reference and we found that the medicines records were not consistently clearly presented to support and evidence the safe administration of medicines, increasing the risk of mistakes.

During our inspection we looked at care, staff and medication records, observed care practices and undertook a tour of the premises. We did this to confirm people were being supported safely and the home was well maintained. We also spoke with people living at the home and interviewed staff and the manager.

The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, “I looked around a few homes with my family and we liked this one. The staff are pleasant and I have no issues with my care”. Another person said, “The girls are all nice. I find them kind and helpful”. We observed the routines within the home were being arranged around people’s individual and collective needs. We saw the staff were kind and caring when providing support.

Overall we found medicines were not safely handled potentially placing people at risk.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the care being provided by the home.

People told us they could express their views and were involved in decision making about their care. They said they had been involved in the assessment of their care needs and had agreed with the care to be provided. They said they were treated with respect and dignity. We were told the staff team provided sensitive and flexible personal care support and they felt well cared for. The people we spoke with said they felt safe and protected from potential harm. They said they were happy with their care and the staff were responsive to their needs. We were told they were consulted about the service being provided and felt their views were listened to.

"I find all the staff are very helpful and friendly. I am very happy with my care".

"I prefer to stay in my room as I like to watch television and read. I have a call bell to request assistance if I need anything. The staff are always popping in to check on me and respond quickly if I call them".

"The care is very good here. I have stayed in other homes but this one is much better. I find the girls are hard working and very kind. They look after me very well".

"I am very happy with my choice of home. I don't want for anything and I am being well looked after. The staff can't do enough for me. The manager is always calling in to check on me and ask if I am alright".

This inspection visit took place on 18th March 2015 and was unannounced.

When we last inspected the service we found breaches of legal requirements relating to the care and welfare of people who use services, requirements relating to workers and assessing and monitoring the quality of service provision. This was because we identified some issues with care delivery and a lack of social activities being organised to entertain and stimulate people. The services recruitment procedures were unsafe because required recruitment checks had not been undertaken.

The service had limited records available to show how identified problems and opportunities to change things for the better were addressed promptly. There were no procedures in place to gather information about the safety and quality of service provided. People supported were not asked for feedback about the quality of service provided. The Care Quality Commission (CQC) had not been notified of any incidents or issues relating to the home since October 2013. This meant that we did not receive all the information about the service that we should have done.

The provider responded by sending CQC an action plan of how they had addressed the breaches identified. We found the improvements the provider told us they had made had been maintained during this inspection

The New Victoria Nursing Home is situated in a residential area of Blackpool. The home is purpose built and provides care and accommodation for up to thirty people. At the time of our visit there was twenty four people who lived there. People are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single accommodation.

There was a registered manager in place. 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 registered manager had arrangements in place to protect people from abuse and unsafe care. The registered manager and her staff had received safeguarding training. Staff we spoke with understood their responsibilities to report any unsafe care or abusive practices. People we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, “I have no concerns about any of the staff or the care they provide me with. They are nice people.”

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required.

Equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We observed staff being kind and patient when supporting people. One person requesting to go to the toilet was assisted by two staff members. We observed the person was assisted on to a stand and turn aid and safely transferred from their armchair into a wheelchair.

We looked at how the home was staffed. We found sufficient nursing and care staff levels were in place to provide the support people required. We saw the deployment of care staff throughout the day was organised. People who had been identified as being at risk from poor nutrition had a care worker allocated to assist them to eat their meals.

We saw staff members were responsive when people required assistance. Call bells were answered quickly and people in the lounge requesting help were responded to in a timely manner. A visiting relative told us they visited the home most days and always found plenty of staff on duty. They told us they never had to wait long if they wanted to speak with a staff member or request assistance for their family member.

People told us they were happy with the variety and choice of meals available to them. During the morning we observed the cook going around the home informing people about the meal choices for the day. We saw an alternative meal was offered if people wanted something different. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.

People’s care and support needs had been assessed before they moved into the home. We looked at the care records for three people receiving nursing care. We found the care plan records were informative and enabled us to identify how people were being supported with their nursing needs. The records were up to date, being kept under review and updated if a persons care needs had changed. This ensured staff supporting people with their care had appropriate information about the level of care people required.

The environment was generally well maintained when we visited. However we did notice some areas where improvements were required. These included a window in one person’s room which couldn’t be opened because it had been sealed with silicone to prevent drafts.

We found medication procedures in place were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place. People told us they received their medicines at the times they needed them.

We found recruitment procedures were safe with all appropriate checks undertaken before new staff members could commence their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.

The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. When we undertook this inspection no applications had needed to be submitted.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included annual satisfaction surveys, house meetings, relatives meetings, care reviews and audits. We found people were satisfied with the service they were receiving.