This unannounced inspection took place on 21 and 27 February 2017. Peartree Care Centre provides care and accommodation to 70 older people in a purpose built four storey building. The ground and third floors are designated for people with nursing care needs. The first and second floors accommodate people with personal care needs and some of who have dementia. Each floor has a dining room and sitting areas for people to use. There were 68 people living at the service when we visited.

At the last inspection on 19 January 2015, the service was rated Good. At this inspection we found the service remained Good.

The service had a registered manager who had worked at the service for several years. 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.

People’s medicines were administered safely, as prescribed. Medicines were also managed and stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans put in place to ensure people’s health and well-being were maintained.

People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and understood their responsibilities in relation to MCA and DoLS.

People were safeguarded from the risks of abuse and improper treatment. Staff had received training on safeguarding and they were knowledgeable on the procedure to follow if they had any concerns. There were sufficient staff available to meet people’s needs safely.

People told us staff were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.

People’s nutritional needs were met. People told us they enjoyed the choice of food that was available to them. People had access to food and drinks throughout the day. People were kept occupied and encouraged to participate in activities.

Staff were trained on various areas to impact them with the relevant skills, knowledge and experience to provide good care to the people they looked after. Staff received regular support and supervision to carry out their duties effectively.

The service liaised with various healthcare professionals to meet the needs of people. People at the final stages of their lives were supported in line with their wishes and they were cared for in a dignified way. The service honoured and celebrated the lives of people who had passed on from the service and gave staff and the people’s relative’s opportunity to reflect on their lives. The home hold a ‘Beacon Status’ accreditation through the Gold Standard Framework for end of life care. This award confirmed the service had proven they delivered high quality care to people in their last stages of life.

People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People and their relatives had opportunities to share their views and give feedback about the service and these were acted upon. The registered manager responded appropriately to complaints about the service. The service was subjected to regular quality checks to ensure the service was of good quality and met people’s needs.

This unannounced inspection took place on 19 January 2015. The last inspection of Peartree Care Centre took place on 22 September 2013. The service met all the standards we inspected at that time.

The service provides care and accommodation to 75 older people in a purpose built four storey building. Each floor has a dining room and sitting areas. People’s rooms are large with an adjoining bathroom. The ground floor has 13 rooms for people with nursing needs. The first and second floors each have 19 rooms for people who have residential care needs related to dementia. The third floor has 19 rooms for people with nursing needs.

The service has a registered manager who has been in post since 2008. 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.

People in the service received safe care and support. Medicines were kept securely and people received their medicines as prescribed. The service identified risks to people and had up to date plans in place to keep them as safe as possible. People were asked for their consent to the care and support they received. The service met the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

There were sufficient staff available to meet people’s needs. People told us staff were kind and caring. We observed that people were treated with dignity and respect by the staff who cared for them. People were supported to communicate their views about how they wanted to be cared for. People told us they enjoyed the choice of food that was available to them at the service.

Staff received comprehensive training on the care of older people and received support to carry out their duties. Staff had a good understanding of how to meet the needs of people with dementia.

The service had received an award in recognition of staff skills in providing care to people in the final years of life. People told us the care and support they received kept them as comfortable as possible. They said there were effective arrangements in place for them to plan how they should be cared for in future. Health professionals told us the service communicated well with them to ensure people received appropriate care and treatment.

The service had assessed people’s individual needs and planned the delivery of their support. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People were asked for their views and their feedback was used to develop the service. The registered manager responded appropriately to complaints about the service. They made regular checks on the quality of the service to ensure that care records were up to date and people were safe. Developments were made to the service, such as the recruitment of ‘dementia friends’ to promote the understanding of the needs of people with dementia.

On the day of our visit we spoke with five people who were using the services and three relatives. We also spoke to staff and to the management team including the clinical lead. A person who used the service said that it is, "Nice everything is done for you." Another person said that the staff were, "All right." Some people said that they wanted to be able to access the garden more but were dependent upon the availability of staff to take them. People said that they felt safe and their relatives agreed that people were cared for in a safe environment. People who used services were appreciative of the activities that took place but were sometimes bored when there were no planned activities. People were observed enjoying their lunch and were supported to eat and drink in a respectful way.

The staff team felt supported by their managers and welcomed the opportunities that the company provided for training and learning. The management team had good oversight of the way that the home operated and had put in place systems to learn from what people said and responded to the views of people and their relatives to make improvements.

People told us what it was like to live at this 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 CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective) and a practising professional.

We spoke to people using the service. They told us that their views and preferences were respected and that they had choices about which activities they got involved with. They said that they were treated well at the home and had choices about what food was on the menus. They said they knew how to raise any concerns they had about the way they were treated at the home.

We also 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. At Peartree Nursing Home there are a number of people who have dementia or find it difficult to communicate verbally.