Parkhill Nursing Home is a nursing and residential care home providing care and support for up to 38 people close to Millbrook village near Stalybridge. The home is an extended Victorian property with bedrooms on three floors.

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

Residents felt safe and the home had policies and procedures in place to guide staff on how to protect residents from harm. There were sufficient suitable staff on duty at the time of the inspection. People’s medicines were managed safely.

Residents’ care was given in a way that took account of and respected their choices. Care workers were well trained and felt well supported. Residents’ were involved in planning the food menus and told us the food was good. People were supported to access other health services for example opticians and dentists. The home was well decorated and clean. People’s rights under the Mental Capacity Act were protected.

The home had a friendly and welcoming atmosphere. Residents and their relatives spoke highly of the care workers and management. Care workers were observed interacting with residents in a caring and respectful way, treating them with dignity. Relatives told us they felt welcome when they visited the home.

Residents received care that was tailored for them and were encouraged to be as independent as possible. A range of activities were made available in the home which were popular with residents. Relatives and residents told us they knew how to make a complaint and felt confident their concerns would be addressed if they did complain. The home has Gold Standard Framework Platinum status for end of life care indicating they adhered to nationally recognised standards of good practice when supporting people at the end stage of their life.

The home had a registered manager in line with CQC registration requirements. 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.

Residents and relatives said they felt the home had an open and welcoming culture and we observed this during our inspection. Care workers were professional and friendly to both residents and each other. The home works well with other agencies and seeks to continually improve.

This inspection was carried out on 26 November 2015 and our visit was unannounced.

We last inspected Parkhill Nursing Home on 7, 8 and 9 January 2015. During that inspection it was found that the domain Is the service effective? Required improvements to be made. Following that inspection, the provider sent us an action planning telling us what they were going to do to achieve compliance in this area. This focused inspection took place to check if the provider had now achieved compliance.

During this inspection we reviewed the information and records held at the service in relation to staff supervision and annual appraisals and spoke with the registered manager. We found that the action taken by the provider since our last inspection of the service meant the provider was now compliant in the domain Is the service effective?

Parkhill Nursing Home is registered to provide both residential and nursing care for up to 38 older people.

There was a registered manager in post. 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 saw evidence that staff were receiving formal supervision on a consistent basis and were able to attend ‘group’ supervision sessions. Plans were in place for all staff to receive an annual appraisal of their work.

Many of the people using the service lived with varying levels of dementia and were unable to fully express their views due to their limited abilities to communicate verbally. Some people were able to talk with us and they told us: “The girls (staff) look after us very well, they are all very kind”. “I am very happy living here, I have friends and people to talk with” and “I wouldn’t want to live anywhere else.”

We found that people living in Parkhill were enabled to make choices about the support and treatment they received. People we spoke with during our visit told us that they could make their own decisions about their daily lifestyle and about things that are important to them. Comments included:

“They (staff) never do anything without asking you first”. “I am always asked if I’m happy with things and the way I’m being looked after” and “If I don’t want to do something, then I won’t.”

Visiting relatives told us: “They pull out all the stops to make sure your relative receives love, care and gentleness”. “The staff are absolutely brilliant and they all work extremely hard” and “I recommend this place to everyone.”

We saw that care plans and associated risk assessments were in place, up to date and had been regularly reviewed.

We found the home to be clean, tidy and free from any unpleasant smells.

People were receiving their medication as prescribed by their doctor.

People told us what it was like to live at his home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission inspector joined by a practising professional and an expert by experience; a person who has experience of using this type of service and who can provide that perspective.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The people who used the service said that their wishes were respected in terms of personal care. One person said, “You can request somebody, you only have to ask.....” People we spoke with said they enjoyed the meals. One person said, “On Sundays we have a roast dinner, turkey, beef, lamb or pork, with all the trimmings. It's nice.”

We spoke to relatives of the people who used the service. They said they were very happy with the care provided. One person said, “The staff are fabulous. They are very respectful and know about my relative’s care needs. I am always kept informed about what’s going on.”

Health care professionals spoke highly of the home and said staff were aware of people’s care needs and followed their guidance correctly. They said staff made appropriate referrals to ensure people received the right level of care. They said the staff were receptive to training and sought advice when unsure of matters.

People living in Parkhill Nursing home told us that they felt supported and well cared for and that care workers understood their needs and how to meet them. We were told that things important to people such as their rights to privacy, dignity and respect were maintained by the staff working in the home and any concerns or worries would be listened to and addressed quickly and appropriately. People appeared happy and comfortable in their surroundings and told us that they could influence their daily lifestyles.

The service was last inspected on 03 September 2013 and at the time was meeting all regulations assessed during the inspection. This inspection was carried out over three days on 7, 8 and 9 January 2015. Our visit on 7 January was unannounced.

Parkhill Nursing Home is registered to provide both residential and nursing care for up to 38 older people. There were 31 people living at the service when we visited.

There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

The building was well maintained, clean, tidy and free of any unpleasant odours.

There was a calm and relaxed atmosphere in the home and we saw that staff interacted with people in a friendly and respectful manner.

People who used the service and the visitors we spoke with were positive and complimentary about the attitude, skills and competency of the staff team. Individual care was assessed and planned and was subject to review. However, some timescale for reviews had ‘slipped’ due to staffing difficulties and the manager was aware of this and taking action to address it.

There was appropriate communication between all levels of staff at the home.

We found staff recruitment to be thorough and all relevant pre-employment checks had been completed before a member of staff started to work in the home.

The registered manager led by example and spent time working with staff, supporting them whilst carrying out their care duties.

The provision of food was good and regular activities were available for those people who wished to participate.

Information which we received from a range of health and social care professionals who had regular contact with the home were very positive and complimentary about the care and support provided by the whole staff team.

Staff did not receive enough appropriate formal supervision or appraisals. We have made a recommendation about this.