Pengover is a nursing home providing care and accommodation for up to 40 older people, some of whom are living with dementia and mental health needs. On the day of the inspection there were 35 people living at the home. Pengover is part of Cornwall Care Limited.

We carried out this inspection on 1 August 2017. At the last inspection, in May and June 2015, the service was rated Good. At this inspection we found the service remained Good.

People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. Comments from people and visitors included, “It’s good here”, “No complaints” and “Very satisfied with the service.”

Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had meaningful relationships with staff and staff interacted with people in a caring and compassionate manner. Comments from people and visitors included, “I can’t find fault with the staff”, “The staff are as good as gold, I have no complaints whatsoever”, “Staff treat the residents extremely well” and “Staff put their arms around people, they show love and compassion.”

Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

Safe arrangements were in place for the storing and administration of medicines. People were supported to take their medicines at the right time by staff who had been appropriately trained.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Pengover. Staff supported people to access healthcare services such as occupational therapists, GPs, chiropodists and specialist professionals such as dementia liaison and stoma care nurses. A visiting healthcare professional told us, “The care is good and well organised. This works well in partnership with the general practice.” Relatives told us the service always kept them informed of any changes to people’s health and when healthcare appointments had been made.

Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted.

People were able to take part in a range of group and individual activities. These included armchair exercises, baking, craft work, reminiscence sessions as well as external entertainers and religious services. Where people stayed in their rooms, either through their choice or because they were cared for in bed, staff spent one-to-one time with them. This helped to prevent them from becoming socially isolated and promoted their emotional well-being.

Staff supported people to maintain a balanced diet in line with their dietary needs and preferences. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs. People were given plates and cutlery suitable for their needs and to enable them to eat independently wherever possible. People and their relatives told us, “The meals are excellent”, “The food is good” and “Very happy with the food.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Staff demonstrated the principles of the MCA in the way they cared for people. Where people did not have the capaci

We met with the senior health care assistant in charge, staff and people who used the service. We spoke with five people who told us they were happy at Pengover and their care needs were met.

We saw people who used the service were spoken with in an adult, attentive, respectful, and caring way. People talked with staff during personal care and when being assisted. We observed the lunch time meal and saw staff respected peoples' dignity when assisting them to eat.

During our inspection, we found people’s privacy, dignity and independence were respected. Where people were able to express their views and experiences, these were taken into account in the way the service was provided and delivered in relation to their care.

People were protected from abuse and staff were trained and supported to carry out their roles.

Staff told us training was provided, and also confirmed they had received supervision.

Care plans and associated documentation provided sufficient detail to direct and guide staff as to the actions necessary to take in order to meet people’s assessed care needs. People's records were personalised and provided clear information about the person’s wishes and abilities.

Some of the people we spoke with were not able to express an opinion about the service, those

that could told us the staff were kind and always did their best.

Staff told us they liked working at the home, and they confirmed the availability of training

courses and staff supervision.

We spoke with two visitors who told us they were pleased their relative lived at Pengover. We spoke to people and spent time observing people and staff over a meal period. We saw people’s privacy and dignity was respected and staff were helpful. We saw people chatted with each other and with staff. One person said, “Its lovely here, the staff are good and polite”. Another person said, ”The staff ask us what we want and give us choices, I have no complaints”.

We were told that people could go to bed and get up in the morning when they wish to do so. People told us the staff answer call bells quickly. Two people said they were aware of their care plans and were involved in reviews of their care.

During our observations we saw staff helped people to move around the home. We saw staff assisting people to the bathroom. We saw people talking to each other in the lounges.

We witnessed staff interaction with people which was positive.

We heard care workers ask people what they would like to do and gave they them ideas if they could not make a choice.

We reviewed all the information we hold about this provider, carried out a visit on 23 January 2012, observed how people were being cared for, talked with people who use services, talked with staff, and checked records.

Some people we spoke with were not able to express an opinion about the service, those that could told us that the staff were kind and always did their best.

Staff told us they liked working at the home, and they confirmed the availability of training courses and staff supervision.

The inspection took place on 26 May and 3 June 2015 and was unannounced. Pengover is a nursing home providing care and accommodation for up to 40 older people, some of whom are living with dementia and mental health needs. On the day of the inspection there were 35 people living at the home. Pengover is part of Cornwall Care Limited.

The service had a registered manager in post. 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.

We observed a calm and relaxed atmosphere within the service. People and staff were busy and enjoying each other’s company. Comments included; “Staff have helped me settle in.” People told us they were happy living there.

People and their relatives were happy with the care staff provided. Professionals and relatives said the service knew people well and the staff were knowledgeable and competent to meet people’s needs.

People were encouraged and supported to make decisions and choices whenever possible in their day to day lives. People had their privacy and dignity maintained. Staff were observed supporting people with kindness.

People were protected by safe recruitment procedures. Staff were supported with an induction and ongoing training programme to develop their skills and staff competency was assessed. Everyone we spoke with felt there were sufficient staff on duty. Staff told us they had enough time to support people and didn’t need to rush them. A relative said; “Plenty of staff around and nothing too much trouble.”

People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs such as GPs and DLN (Dementia Liaison Nurses). Staff followed the guidance provided by professionals. This ensured people received the care they needed to remain safe and well, for example people had one to one staff support when needed.

People’s medicines were managed safely. Medicines were managed, stored and disposed of safely. Senior staff and nurses administered medicines and had been appropriately trained and confirmed they understood the importance of safe administration and management of medicines.

The registered manager and staff had sought and acted on advice where they thought people’s freedom was being restricted. This helped to ensure people’s rights were protected. Applications were made and advice sought to help safeguard people and respect their human rights. Staff had undertaken safeguarding training, they displayed a good knowledge on how to report concerns and were able to describe the action they would take to protect people against harm. Staff were confident any incidents or allegations would be fully investigated. People who were able to told us they felt safe.

People were supported to maintain a healthy, balanced diet. People told us they enjoyed their meals and an observed lunchtime did not feel rushed.

People’s care records were comprehensive and detailed people’s preferences. People’s methods of communication and preferences were taken into account and respected by staff.

People’s risks were considered, well-managed and regularly reviewed to keep people safe. Where possible, people had choice and control over their lives and were supported to engage in activities within the home and outside where possible. Records were updated to reflect people’s changing needs. People and their families were involved in the planning of their care.

People and staff described the management as very supportive and approachable. Staff talked positively about their jobs and took pride in their work. Visiting professionals and staff confirmed the management of the service made themselves available and were very good.

People’s opinions were sought formally and informally. Audits were conducted to ensure the quality of care and environmental issues were identified promptly. Accidents and safeguarding concerns were investigated and, where there were areas for improvement, these were shared for learning.