This inspection took place on 3 February 2017 and was unannounced. At our last inspection in July 2015 we found that the service required improvement in relation to providing a responsive and well led service. At this inspection we found improvements had been made.

Oulton Abbey Residential & Nursing Home provides support and care for up to 30 people. At the time of this inspection 28 people used the service.

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.

Systems were in place to ensure that people who used the service were protected from the risk of abuse.

People's individual risks were assessed, monitored and reviewed; remedial action was taken quickly to protect people from the risk of harm.

There were enough suitably qualified staff available to maintain people's safety and meet their individual needs. Staff had been recruited using safe recruitment procedures. Staff had their training and development needs met.

People's medicines were managed safely; staff were well trained and supported people with their medication as required.

People were supported to access external healthcare professionals and other agencies in order to ensure their healthcare needs were fully met.

People consented to their care and the provider followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) where people lacked the capacity to make certain decisions about their care.

People were supported with their nutritional requirements and preferences.

People were supported by staff who were caring and compassionate. People were involved in the planning and review of their care.

The provider had a complaints policy available and people knew how to complain and who they needed to complain to.

People told us the registered manager and the staff team were approachable, friendly and supportive.

The provider had systems in place to monitor the quality and safety of the service.

This was a planned unannounced inspection. The service did not know that we would be visiting.

At the time of our inspection 22 people were living in the home. We spoke with staff and the majority of the people who used the service. One person told us: "It's really lovely here, of course I would like to be in my own home, but realise I can't be. This is the second best thing I am happy and comfortable". Another person told us: "I can do what I want to do, sometimes I join in the activities sometimes I don't. I like to go to Mass each week and staff help me to do that. Throughout my life I have always been to church so my faith is important to me".

We spoke with staff about the care and support they provided. They told us about the specific individual needs of people. We saw that staff treated people compassionately; offering discreet assistance to those who required it. We did hear anyone that had to wait for support when it was needed.

We saw that systems were in place to ensure that medication was administered in a safe way. This meant people had their medication at times they need them and in their preferred way.

We saw systems were in place for recruitment of staff to ensure suitable people were employed to work with vulnerable adults.

The service has a complaints procedure in the event of people wishing to make complaint. One person told us they would speak with the matron if they had any concerns but at the moment they had nothing to complain about.

During this inspection we saw that people were supported to make decisions and choices about their everyday lives. We saw staff being polite and considerate when they were supporting people. One person told us they liked to attend a dally activity, we saw staff supported the person with this.

We spoke with staff about the care and support they provided each day, they offered an explanation of people's individual needs. We looked at a selection of care records to check the care being given to people and saw the information recorded in the plans corresponded with the information given to us by staff.

We spoke with staff about their understanding of safeguarding vulnerable adults; they told us what they would do if they had any suspicions of abuse. People who used the service told us they would speak with staff or a family member if they had any concerns about the care they received.

We saw that staff were present in all areas of the home, they were quick to offer help and support to people when it was needed. People who used the service told us that the staff were very good and helpful. One person told us, "The carers smile and seem happy in their work, it makes all the difference when we see someone smile, it is very reassuring”.

We saw the service had an effective system for monitoring the quality of the service.

We inspected this service on 14 and 16 July 2015. This was an unannounced inspection. Our last inspection took place on 25 July 2013 where we found that the provider was meeting the Regulations that we inspected them against.

Oulton Abbey Nursing and Residential Home, is registered to provide accommodation for up to 30 people who require nursing care or residential care, have mobility problems, may be over 65 years of age and may be living with dementia. At the time we inspected there were 20 people using the service.

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.

We had not been notified of important events in the home, such as notifications of the death of people who used the service.

It was not always clear from the record how people were actively involved in the reviews of their care.

We found that people who used the service felt they were safe living at Oulton Abbey. They told us they liked living there and they were treated well. Staff knew how to recognise abuse and the action they should take to report it.

Staffing levels were sufficient to meet people’s needs and checks were carried out on staff to ensure they were suitable to work at the home.

Risk assessments had been carried out for each person to ensure that any identified risks were reduced. These assessments were regularly reviewed to ensure they were up to date.

Staff told us they received support and had access to the training they needed. Staff knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) varied, but staff told us and we saw that training sessions were planned. The MCA and the (DoLS) set out requirements to ensure that decisions are made in people’s best interests when they lack sufficient capacity to be able to do this for themselves.

People who were at risk of malnutrition and dehydration were closely monitored. Records were maintained of their food and drink intake to ensure they received sufficient amounts to maintain their health.

People had access to health services and the health professionals we spoke with were positive about the care and treatment provided at Oulton Abbey.

Everyone we spoke with during the inspection including people who used the service, their relatives and friends told us that they were well cared for. They gave positive accounts of the treatment they received and how their privacy and dignity was respected.

Assessments of people’s care needs were carried out and plans put in place to ensure staff had the information they needed to meet people’s needs. Personal histories were recorded to ensure that people’s interests could be considered when social and recreational activities were arranged and to support personalised care.

People who used the service told us they didn’t have any complaints about the care and support they received. We saw that a complaints procedure was on display in the main entrance of the home to inform visitors how they could complain if they needed to.

The registered manager audited the quality of the service, including complaints, accidents and incidents and risks. Action plans were developed from these audits to support continual improvements in the service.

Staff and people who used the service told us it was well led and the manager was visible and approachable.