Priory Court provides nursing, personal care and accommodation for up to 28 people. Accommodation is provided across three floors with access by passenger lift to the upper floors. Most rooms are of single status and some rooms have en-suite facilities. There are two double rooms. There are several communal areas and accessible gardens for people to make use of.

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

People who lived at the home told us they were happy with their care and liked the staff who looked after them. We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards people in their care.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

The service had sufficient staffing levels in place to provide support people required. We saw staff members could undertake supporting people without feeling rushed. People who lived at the home told us staff were responsive to their needs.

We found staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storage in place.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and relative surveys to seek their views about the service provided.

On the day of our visit we spoke with the director of nursing for the organisation, manager, staff, relatives and residents, who were at home. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Priory Court Nursing Home.

During the inspection we looked at care, maintenance and staff records. We also looked at how the home deployed staff members during the day and night.

Staff members we spoke with had an awareness of residents care needs. We discussed with staff how the needs of residents were being met. Comments included, “We know the residents well and can easy pick up if someone is not themselves.”

We found the home had a mix of qualified nurses, carers and domestic staff on duty. This meant residents were cared for by people with a range of skills suitable to meet people’s needs. Staff we spoke with were satisfied with the amount of people on duty. One resident we spoke with said, “The staff are wonderful they don’t rush you and always have time to spend with you on your own.”

There were a range of audits and systems in place to monitor the quality of the service being provided.

Prior to our visit we contacted Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

People had a good assessment of their needs and they had consented to their care and support. Where people could not give their consent they were fairly represented. People told us they were treated with kindness and respect. We observed staff’s approach to people was professional. They spoke to people respectfully and attended to personal care needs as required.

People commented “The staff are lovely caring and sensitive to my needs. They make sure I’m kept covered up when they are giving me a bed bath. If they have to get something they never leave me in a state of undress”. And “When that nice male nurse came to help me with my usual carer he asked my permission before he helped me just to make sure I was all right with a male nurse. “You can ask for anything. If you’re not well they get the doctor and will keep checking that you are all right”. “I know I am improving. My husband has noticed too. It’s taking a long time but I have all the support I need and who knows, I live in hope thanks to the staff here”. We found people were given a nutritionally balanced and varied diet. Nutritional needs were being monitored. People said they felt safe in the home. “I do feel safe here. Staff come immediately if I ring for them”. “Even the staff that clean our rooms have time to chat and give the impression they are interested in our well being”. “They are really nice people working here, everyone is so caring. I think the matron is wonderful and staff follow her example”.

People we talked to told us they feel staff working in the home treat them with dignity and respect.

They told us they have time to spend with them and help them with personal tasks. Comments included, “they always take their time with me and I never feel rushed by them", " Staff are very patient; they have a lot to do but they always seem to have time for us".

Staff told us they thought it was important to make time for people so they feel valued. They told us they always try and act in people’s best interest. Comments included, “I think it’s very important that people feel listened to”,” I always make time for people even though it can be difficult sometimes, because we are always busy".

We spoke to some people who told us they are involved in their care planning process. Comments included, “The staff tell me about things I need to know", " I always know when I have appointments because the staff tell me".

Staff told us they keep all files up to date, and they have delegated responsibilities for completing and updating care planning records, which is overseen by the manager, so that information is accurate and up to date.

Records we looked at and people we spoke to told us their needs were being met by the service, and people had access to a range of services which met their individual needs.

"They take care of everything so I don’t have to worry about anything”.

People told us they loved the choice of activities and that the activity co-ordinator was "very good at his job".

"There's always something going on, and if you don’t want to join in you don't have to".

Some people told us they don’t like to join in things. "I'm not a person who likes to join in group things, but I don’t feel I have to".

The activity coordinator told us they like their job and feel they take into account everybody’s needs including those who are not always able to join in group activities. "I think it’s important to listen to the needs of everybody. There is always something for people to do even if they are bedfast".

We spoke to the cook who told us they enjoyed preparing meals for people in residential care and they have a good understanding of the nutritional needs of older people.

“We get to know what people like and don’t like, and what their favourites are".

People we spoke to about meals told us they liked the meals but didn’t really know what choices there were.

Comments included, "I like the meals on the whole, but sometimes wish there was more choice".

Staff we spoke to told us they have a good relationship with the local doctors and district nurses, and social workers. “We have a good working relationship with all the practices we are involved with".

Staff we spoke to told us they have received training in safeguarding people. "I have had training in safeguarding people, and they also go through it during the induction period".

"They are always working hard to keep the place spick- and- span", "They make sure it’s clean and work hard to ensure all the rooms are cleaned and tidied every day".

The infection control practitioner told us they have no ongoing issues or concerns with the home.

We saw people being given their medication. Staff were seen to be following safe practices in the way they administer and record medication.

Staff told us they feel they have the necessary knowledge and skills to safely administer medication. They told us only qualified nurses administer medication in the home.

People we spoke to told us they like the way the homes environment, and felt the standards of the home were very high.

“I think it’s a lovely home, with a lot of the old features still in here".

"You can move around and there is a lift upstairs if you need it".

Staff we spoke to said they think it’s a nice environment in which to work.

"It’s got a lot of clinical things with it being a nursing home, but it still has that homely feeling about it".

Staff we spoke to told us they had all the necessary checks before they started to work in the home. “I know I had checks before I started to work here".

Staff told us they felt they had a good opportunity to train in different areas of care. “The manager encourages us to go on courses when they come up".

"I'm here for training today".

People we spoke to told us they think the staff are very supportive. They told us they like the fact there are not many changes to the staff team so that they can get to know them.

Staff we spoke to said they felt there is a good staff team. They said each shift has a good skills mix, and that the communication between them is good. "We have daily updates at handover and it is expected we share information so that we know if there are any changes in peoples needs".

By speaking to people using the service we were told they are asked about their care and treatment.

Comments included, "they do ask how things are and are we happy with everything".

"I think I can say when I don’t agree with something or when I am very satisfied with something, I tell them".

People we spoke to told us they felt confident they could raise an issue of concern or complaint to the staff or managers if they felt they needed to.

Comments included, "I've never had to complain about anything whilst living here, but they tell you what to do if you need to complain".

"I'm a regular visitor and I would know who to go to if I am not satisfied about something and I have the confidence it will get sorted out satisfactorily".

People we spoke to were aware they had care plans and written information about them.

Comments from staff included, " We are made aware of how to keep records about people and to make sure they are confidential"

This unannounced inspection took place on 28 November and 01 December 2014. The home was large with ample space and all parts of the home looked well maintained and the furniture and fittings were of good quality. Bedrooms were generally spacious and comfortable with personal possessions in evidence. The home must only accommodate a maximum of 33 service users, and can provide accommodation for persons who require nursing or personal care.

People were supported to understand what keeping safe meant and were encouraged to raise any concerns they may have about this. Staff at the service understood that people's safety had to be balanced with people’s right to make choices and to take risks. Staff recognised the important role that safeguarding people from abuse had in enabling people to live a positive life. People who used the service felt that the risks associated with their care were managed appropriately and that they were involved in making decisions about any risks they wanted to take. The systems and procedures operated at the home were designed to enable people to live their lives in the way they chose, so they could be as independent as possible. The care and support offered to people at the home was personalised and put the person at the centre in identifying their needs and choices.

People received their medicines as prescribed, because they were stored, administered and disposed of safely, in line with current and relevant regulations and guidance. Staff were provided with effective support, induction, supervision, appraisal and training. People told us they had enough to eat and drink throughout the day, and at night if required. The management team and staff had a clear vision and set of values based on involvement, compassion, dignity, independence, respect, equality and safety.

The service had a system to manage and report accidents and incidents and where required, action plans were developed and monitored to ensure people's safety was promoted and protected. Quality was seen to be integral to the service’s approach and staff were aware of potential risks to the quality of the service. Robust quality assurance and, where appropriate, governance systems were in place and these were used to drive continuous improvement. The service had appropriate data management systems in place. There was a registered manager in place at the time of our inspection. 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 last inspected this service on 28 May 2014 and the home was compliant with the regulations we checked during the inspection.