This inspection took place on 27 September 2017 and was unannounced.

Quinton House is a three storey nursing and residential home which provides nursing care to older people including people who are living with dementia. Quinton House is registered to provide care for 27 people and at the time of our inspection, there were 18 people living at Quinton House.

At the last inspection on 1 September 2015 the service was rated Good. At this inspection, the service continues to be rated Good. Since the last inspection the provider had made a lot of improvements to the service and was working towards a possible ‘outstanding’ rating in the future.

There was no registered manager in post. The registered manager left the service on 15 September 2017. 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. The provider told us they were in the process registering with us to become the registered manager themselves.

We received some extremely positive feedback from people who lived at Quinton House, and their relatives, about the staff who cared for them and the support from the provider. People told us they were very happy with the care they received. They said staff were, excellent, extremely caring and had made a positive difference to how they lived their lives.

Care and nursing staff were highly motivated to provide a good service to the people they supported. Staff sought people’s consent, regardless of their capacity and provided additional support to some people who had health conditions that had deteriorated over time. People's right to make their own decisions about their care, were supported by staff who understood the principles of the Mental Capacity Act 2005.

People received care which protected them from avoidable harm and abuse. Staff had completed training in safeguarding people and knew how to recognise and respond to abuse. Risks to people’s safety were identified and assessments were in place to manage identified risks. Staff received training to support people to take their medicines as prescribed.

The provider took appropriate steps to recruit staff of good character and recruited staff who shared their same passions and philosophy of providing good standards of care.

People were involved in the planning of their care, and care plans focused on the individual’s preferences and how they would like their care delivered. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed. People’s care and support needs were kept under review and staff responded when there were changes in these needs.

The service remained responsive to people’s needs and wishes. People were provided with care and support that was individual to them. Staff respected people's privacy, dignity and continued to promote their independence, which people valued.

People received meals and drinks that met their individual dietary requirements. Anyone identified at risk of malnutrition or dehydration, were monitored over a period of time so if concerns were identified, advice and treatment could be requested.

People were encouraged to raise concerns and make complaints and they were confident these would be listened to and responded to promptly. The management team used feedback from people to assist them in making improvements to the service.

Staff told us they were very happy in their work and they received excellent support from an experienced management team, who were always available to give advice. Staff were clear about their roles and responsibilities and had regular supervision and observations of their practice to make sure they carried these out safely.

Feedback from people and their repres

This inspection took place on 1 September 2015 and was unannounced.

Quinton House is a three storey residential home which provides care to older people including people who are living with dementia. Quinton House is registered to provide care for 27 people and at the time of our inspection, there were 19 people living at Quinton House.

At the time of our inspection a registered manager was not in post although the provider had arranged for two deputy managers to manage the home in the interim. The provider had appointed a manager who planned to start the end of September 2015. 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 and associated Regulations about how the service is run.

All the people we spoke with told us they felt well cared for and safe living at Quinton House. People told us staff were respectful and kind towards them and staff were caring and empathetic to people throughout our visit. Staff protected people’s privacy and dignity when they provided care and staff asked people for their consent before any care or support was provided.

Care plans contained accurate and relevant information for staff to help them provide the individual care and treatment people required. Care records reflected people’s wishes and how they preferred their care to be delivered. Risk assessments provided information for staff to keep people safe and these were reviewed to ensure they continued to protect people from risk. People received support from staff who had the knowledge to care for them and people’s personal and confidential information was kept safe and secure.

People told us they received their medicines when required. Staff were trained to administer medicines and had been assessed as competent, which meant people received their medicines from suitably trained and experienced staff.

The provider had effective recruitment procedures that helped protect people. All the necessary checks had been completed on potential staff before a decision was made to employ them at the home.

Staff understood the need to respect people’s choices and decisions. Assessments had been made and reviewed to determine people’s individual capacity to make certain decisions. Where people did not have capacity, decisions had been taken in ‘their best interests’ with the involvement of family members and appropriate health care professionals.

The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS). The registered manager had contacted the local authority and submitted applications to make sure people’s freedoms and liberties were not restricted unnecessarily. At the time of this inspection, three applications had been authorised under DoLS

Staff were caring and compassionate in their approach to people. People were given choices about how they wanted to spend their day so they were able to retain some independence in making day to day decisions about their everyday life. Staff encouraged relatives to maintain an active role in providing support to their family member.

A variety of activities were provided for people living in the home that promoted their health and wellbeing. Staff involved in providing activities were enthusiastic and encouraged the wider community to be involved.

There was an audit system that identified and improved the quality of service people received. These checks and audits helped ensure actions had been taken that led to improvements. People told us they were pleased with the service they received and if they suggested improvements, these were acted upon. People’s concerns were listened to and supported by the provider and staff who responded in a timely way.

We spoke with five people who lived at the home and a relative of a person who lived at the home. We also spoke with a visiting healthcare professional who provided care to people during our inspection. We spoke with the director, the registered manager, a registered general nurse and three staff.

We looked at the care records for three people who lived at the home and other supporting documents. People that we spoke with were very satisfied with the care they had received. One person said: “You couldn’t come to a better home”.

We found consent had been obtained from people before care and treatment had been provided. Staff we spoke with told us they respected people’s individual choices. One staff member said: “I always offer a choice and respect what people want”.

We found people received care and support as planned inaccordance with their needs. Staff understood people’s individual needs and how to give the support that they required.

People were cared for in a safe and clean environment. The premises were suitable for people who had limited mobility.

We found that the provider supported their staff and made sure staff were trained to an appropriate standard to meet people’s needs. The provider held regular supervisions with staff.

People received information on how to make a complaint if they were not happy with the service. We found that the provider had received complaints and had dealt with them to people’s satisfaction.

During the inspection we spoke with five people using the service, one relative and four staff including the registered manager.

All the people we spoke with said they liked living at the home. Four people said ‘the home had been and was going through a lot of changes which had been unsettling’. People spoke about the building work and some carers leaving.

Staff said the home was a ‘very nice place to work with lots of opportunities to improve and gain skills’. People said they ‘liked the staff and felt safe at the home’. People said they ‘liked the food, were offered a good variety of foods at meal times plus a choice of small or large meals’.

Staff at the home and people using the service said they was a choice of activities including trips into the local community. One relative said 'since the new manager had been at the home his wife had been coming out of her room'. He said this had helped her as she was more stimulated; 'her memory had improved and she was not so confused'.

People said they felt able to approach the staff or manager with any concerns. They said they were aware of the complaints system and comments or concerns had been responded to appropriately. People said they had been able to express their views in forums such as the residents meeting and through individual discussions with the staff.