North Shore provides nursing care and support for a maximum of 25 people who live with dementia and/or a physical disability. At the time of our inspection there were 25 people living at the home. North Shore is situated in a residential area of Blackpool close to the promenade. There are three floors with 23 single rooms and a double room, of which sixteen are en-suite. There are on-site gardens and several communal areas for the use of people who live at the home.

North Shore is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.

A registered manager was 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.

At the last inspection on 20 October 2015, the service was rated Good. At this inspection, we found the service had improved to Outstanding.

During this inspection, a relative told us, “The place is perfect. It demonstrates high quality care and should be used as an example to other homes.” We found the provider accessed systems, tools and partnerships known to benefit the person’s welfare and treatment. Care delivery centred on excellent communication systems and highly detailed records about each person. A wide range of models were utilised and reviewed to ensure people received the best possible support. We saw multiple examples where this enhanced their lives and optimised their welfare.

The registered manager was proactive in ensuring people accessed healthcare services quickly. Their pioneering techniques greatly improved people’s lives because they assisted staff to implement treatment before problems deteriorated.

The management team had exceptional procedures for the preparation of meals, delivery of nutritional support and monitoring of associated needs. For example, food moulds and observational review of staff support greatly improved people’s nutrition intake and enjoyment of their meals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. We found for each area of people’s support staff completed additional decision-specific, individual deprivation of liberty care plans. Staff maintained up-to-the-minute documentation to assure they continuously met the person’s changing capacity and support requirements.

The registered manager had an exceptional initiative for training and to assist staff to apply their learning in practice. They used team meetings, handovers, supervision and group discussions to follow training up with observation, question and answer sessions, competency testing and role-play. The review of staff skills assisted them to provide remarkable support for people who lived with dementia. A relative told us they were highly reassured by this and said, “I know the staff are well trained because there’s a list up on the wall of the courses they have to attend.”

We observed the provider deployed very high staffing levels and skill mixes at the home to deliver care that flowed smoothly and effortlessly. People and their relatives said this was very reassuring because it meant staff had time to provide compassionate, dignified care. The registered manager had implemented a ‘Dignity Challenge Initiative.’ The project focused on how staff should provide dignified support that improved people’s self-confidence and independence.

Staff had a very good grasp of the Human Rights Act 1998 and implemented this in their work. They had relevant training and demonstrated an in-d

The inspection visit at North Shore was undertaken on 20 October 2015 and was unannounced.

North Shore provides nursing care and support for a maximum of 25 people who live with dementia and/or a physical disability. At the time of our inspection there were 24 people living at the home. North Shore is situated in a residential area of Blackpool close to the promenade. There are three floors with 23 single rooms and a double room, of which sixteen are en-suite. There are on-site gardens and several communal areas for the use of people who live at the home.

A registered manager was in place. 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.

At the last inspection on 23 April 2014, we found the provider was meeting all the requirements of the regulations inspected.

During this inspection, we found people were supported in a safe environment. Accidents and incidents were properly assessed to reduce the risk of harm to people, staff and visitors. Care records contained risk assessments intended to protect people from the risks of receiving unsafe care and treatment. Staff demonstrated a good understanding of how to protect people from potential harm or abuse.

We observed staff worked in a patient and unhurried way in their duties. The provider had ensured North Shore was well resourced with high staffing ratios and good skill mixes. There were 16 day staff to support up to 25 people, with a range of skills to meet their needs. The management team had followed safe recruitment procedures to protect people from unsuitable personnel. A range of training was provided for all levels of staff to assist them in their roles. This included support for nurses to sustain the requirements of their professional registration.

We observed medicines were administered to people in a safe, discrete and appropriate manner. These were stored in a secure, clean environment. All processes were regularly audited to assess and maintain the safe management of people’s medicines.

Staff had been trained to assisted people to meet their nutritional requirements. We observed they did this in a caring and supportive manner and ensured they were offered choice of meals.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. We observed people were not deprived of their liberty during our inspection. We found care records contained documented evidence of their consent to care.

We found people were respected and involved in their care planning. Staff were kind, friendly and courteous when they engaged with individuals who lived at the home. Care records were tailored to people’s wishes and we observed staff consistently promoted their privacy and dignity. One staff member told us, “I’ve got to know the residents and them me, which is very important to their care needs.”

Care records we checked were tailored to the needs of each person who lived at North Shore. The management team had regularly assessed people’s requirements to guide staff to their ongoing support. Staff had involved individuals and their representatives in care planning and review to ensure support was responsive to their needs.

Staff told us the registered manager and provider were supportive. They said there was good leadership and the management team worked closely with them to maintain people’s quality of care. There was a variety of audits in place to check the safety and welfare of people, staff and visitors. Individuals and their representatives were assisted to comment about their experiences of living at North Shore.

North Shore Nursing Home provides accommodation for up to 25 people who require nursing or personal care. At the time of our visit the home was fully occupied. The home provides care and support for people with dementia or physical disabilities.

The manager at North Shore Nursing Home had been in post since March 2014. They had commenced the process to apply to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We used a number of different methods to help us understand people’s experiences of the care and support they received. This was because some people had complex needs and were not able to tell us about their experiences. During our visit, we spent time in all areas of the home, including the lounge and the dining areas. This helped us to observe the daily routines and gain an insight into how people's care and support was managed. During our visit we saw that staff had developed a good relationship with the people they supported. Those people who were able to talk with us spoke very positively about the service and told us they felt safe and well cared for. One person told us, “The staff here are lovely, I am really well looked after.”

Suitable arrangements were in place to protect people from the risk of abuse. People told us they felt safe and secure. Safeguards were in place for people who may have been unable to make decisions about their care and support.

People were involved and consulted with about their needs and wishes. Care records provided good information to direct staff in the safe delivery of people’s care and support. Records were kept under review so information reflected the current and changing needs of people. Information was stored securely ensuring confidentiality was maintained.

Staff worked closely with healthcare agencies so that people received the care and treatment they needed. Information was shared with other services so that people continued to receive safe and effective care.

Staff spoken with were positive about their work and confirmed they were supported by the manager. Staff received on-going training and development in the areas of care and support people required. This helped to ensure staff had the knowledge and skills needed to meet the specific needs of people.

At the last inspection the care plan records lacked evidence to show how people and their relatives had been involved in developing an individualised plan of care based on people’s wishes and preferences. We noted that in three of the care plan records they had been recently signed by relatives. One relative who told us,” The care is very good. The care is much better in lots of respects; there is a lot more nursing care.” The care plans were detailed and contained information regarding people’s health care needs and risk assessments.

Discussions with the senior staff confirmed that they had received training on the Mental Capacity Act and Deprivation of Liberty Safeguards and understood what actions to take to safeguard people.

One relative we spoke with told us,” the food is always nicely cooked and made on the premises.” New staff were supported through an induction process which included mandatory training and shadowing opportunities. There were a range of audits and systems in place to monitor the quality of the service being provided.

From our observations we saw that people living at North Shore Nursing Home had some degree of confusion, forgetfulness or a dementia type illness. This meant it was difficult for them to tell us about their experiences of living at the care home.

Therefore we spent sometime observing people and how staff interacted and supported them. Staff were seen to be helpful and polite when offering assistance and support to people.

We did have an opportunity to speak with one person and their visitor. The visitor said “There always seems to be enough staff around if you needed them”, “They make you very welcome” and “They [the staff] keep in contact with family if there’s anything they need to know”.

Care records were in place to guide staff in the delivery of care. These would be enhanced with more personal information about people’s wishes and preferences.

Accommodation provided for people was well maintained and the décor was of a good standard.

Sufficient staffing levels were provided to meet the needs of people living at North Shore. We also spoke with staff during our visit. One carer told us that the team was; “A happy and loyal team”. Staff spoken with confirmed they received regular training and supervision to guide them in their work.