This unannounced comprehensive inspection took place on the 7 February 2018. This was the first inspection since registration with the commission on 12 January 2017.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Nyton House is a large historic house in its own grounds situated on the outskirt of Chichester. The service provides single or double room accommodation for up to twenty five predominantly elderly people who need assistance with personal care, including those with a dementia related illness. There are also two houses in the grounds which provide accommodation to support people who are more independent. At the time of the inspection there were twenty-three people using the service.

The service is situated over three floors which are served by a passenger lift. A stair lift is located in one of the external buildings used for people with more independence. Fifteen rooms have en-suite toilets. Seven of those have baths or showers as well.

There were enough bathrooms including assisted baths on all floors. There is a large lounge on the ground floor with a conservatory also used as a dining area and general seating area overlooking the large gardens. There are a range of aids and adaptations to support people with limited mobility.

The atmosphere in the service on the day of the inspection was relaxing, friendly and calm. Staff responded promptly when people asked for help and support was provided at a relaxed pace. Throughout our inspection we observed staff providing support with respect and kindness. People told us they felt safe and comfortable living at Nyton House. Comments included, “It’s the best move I have made. Everything about living here makes me feel safe”; “All the staff have time for you. They are there whenever I need their help" and "Living here has certainly improved my quality of life and I do feel very safe living here."

People had access to an extremely diverse range of activities which were very meaningful to them. On the day of this inspection there was a choir practice which was well attended by people using the service. One person told us, “This is a wonderful idea. It is always well attended because everyone enjoys it so much. It brings back many happy memories of singing in a choir when I was younger.” People were supported to use a range of community activities either independently or with families and staff. This was to attend external events, have a coffee or visit local attractions. The service had also forged strong links with local schools who regularly visited the service to entertain people or just have a discussion with them. People also visited school events.

The service had recently introduced a new medicines system and was working through some of the changes which were designed to improve the safety and management of medicines. Medicines administration records had been completed and there were appropriate procedures in place for the ordering, storage and disposal of medicines.

Staff were sufficiently skilled to meet people’s needs. Necessary pre-employment checks had been completed and there were systems in place to provide new staff with appropriate induction training. Existing staff received regular training, supervision and annual performance appraisals.

People’s risks were being managed effectively to ensure they were safe. Records showed where changes in people’s level of risk were. Care plans had been updated so staff knew how to manage those risks.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse.

The manager used effective systems to record and report on, accidents and incidents and take action when required.

The service was suitably maintained. It was clean and hygienic and a safe place for peop