The inspection took place on 2 and 8 June 2016 and was unannounced.

Rustington Convalescent Home is a Grade II listed building located on the Sussex coast. It is registered to provide accommodation, nursing care and support for up to 30 people. The home primarily provides short term convalescence following an operation, accident or illness, although short term respite care is also provided. In the Provider Information Return (PIR), the registered manager stated that, ‘The homes vision is to support people who stay with us so they are able to regain their independence and this is achieved with their involvement so we are all working towards the same goal.’ The home has 26 single rooms and two twin rooms, which are usually reserved for married couples. Many of the bedrooms have sea views. At the time of our visit there were 23 people staying at the home.

We found that Rustington Convalescent home had some elements of outstanding that could be expanded upon to give a rating of outstanding. We recommend that the provider refers to the guidance and characteristics of outstanding on our website.

Rustington Convalescent Home has well-furnished lounges, a large conservatory, dining room, television room and activity room. The home has extensive landscaped grounds, with a summerhouse and terrace, which are accessible to people staying at the home. The home offers a combination of nineteenth century Grade II listed building with modern facilities, including Wi-Fi.

The home had a registered manager in place. 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 were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence.

People said they felt safe at the service and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.

People were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. The focus of the home was rehabilitation and to provide people with the skills they needed to return home. Staff completed a comprehensive discharge summary, a copy of which was sent to people’s GPs or hospital consultants. This included specific details of any community follow up that may be required, for example a referral to a district nurse to monitor any surgical wounds.

People were encouraged to safely self-administer their medicines. People had enough to eat and drink throughout the day and night. The mealtime was an inclusive experience. After people had finished their meal many remained in the dining room chatting and drinking tea and coffee.

There was an open and friendly culture combined with a dedication to providing the best possible care to people. Staff at all levels were approachable, knowledgeable, professional, keen to talk about their work and committed to the on-going development of the home. The atmosphere in the home was happy and calm. People were engaged and occupied; they were interacting with each other and chatting. Every person we spoke to, without exception was extremely complimentary about the caring nature of the management and staff.

Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.

There were enough staff on duty to support people with their assessed needs. The regis

The home provided short term respite and convalescence for people recovering from illness or surgery. At the time of the inspection 21 people were staying at the home. We spoke with twelve people using the service, five visiting relatives, two care staff, two nurses on duty, the chef and the registered manager. The summary describes what they told us, what we observed and the documents and records we looked at.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found:

Is the service safe?

The purpose of the home was to support people to regain their independence. People we spoke with told us the home was a safe environment in which to recover and become fitter to return home.

The registered manager and care staff had attended training in safeguarding people, the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS become important when a person is found to lack the capacity to make an informed decision related to aspects of their care and treatment. All people staying at the home had chosen to be there and had capacity to make decisions for themselves. The manager had not had to make an application under DoLS.

Risks to people’s health and safety had been assessed and plans were in place to minimise the risks. People were encouraged and supported to take risks with regard to their mobility as part of their rehabilitation.

Is the service effective?

People had their needs assessed and a care plan was completed on admission. There were separate wound care plans where this was required. A care plan was completed at each stay, to reflect the person’s current needs. We saw examples of admission and discharge reviews on the three care files we looked at. These would inform care and treatment provided subsequently by other medical professionals.

People told us they received the care and support they needed, and everyone we spoke with was positive about the service they received. One person told us, “Wonderful place. They can’t do enough for you. Words can’t express.” Another said, “I can’t praise it highly enough. I’m hoping to be here longer.”

Staff had received training to enable them to meet the specific needs of people staying at the home.

Is the service caring?

Everyone we spoke who was staying at the home and their relatives praised the care they received. One person told us, “The staff are excellent – very caring. They fall over backwards to help you.” Another said, “You get care, attention and kindness.” A third person said, “It’s an old-fashioned charm. You are cared about as a person. It soothes you mentally.”

People identified the admission process in a positive way, particularly when they came from hospital and felt anxious about their condition. Two people told us about how their bags were dealt with and they were settled with tea before going to their room. One said, “It’s comfort and care. The manager said ‘you are not here to worry, we’ll do the worrying, you get better’ and that is how it is”.

Is the service responsive?

Individual needs were continually assessed with the aim of supporting people to regain their independence.

We saw how changes were made to practice as a result of suggestions for improvement by staff.

Is the service well-led?

Staff demonstrated a good understanding of the values that underpinned the care and treatment provided at the home.

People were cared for by care staff and nurses who were trained and well supported. We spoke with the registered manager the two care staff on duty and two nurses, all of whom said they felt supported by their managers. However, supervision sessions were not planned in advance and we saw few records.

We spoke with five people who use the service, three staff and the manager, the local general practitioner (GP) who visited the service twice weekly and one of the physiotherapists. The GP and physiotherapist told us they were very happy with the way the service was run and the care and treatment that people received.

We were told by people in the service that they were very happy with the care they received, their choices in daily living and in care and treatment. Some of the comments made to us were; "It is very agreeable and comfortable here","Having email access is wonderful, I can keep in touch with friends","Staff are very kind and caring" and "They are very amenable to you wishes".

People told us they felt safe in the service and never heard raised voices.

People said they could look after and manage their own medicines, however we found the medicines were not always locked up in their rooms.

People told us they knew how to make a complaint and would feel able to do so. We were told things were corrected when raised with the manager.

We spoke with five people during our visit who were all extremely complimentary about the care that they had received at the service.

People told us that they were well cared for by friendly and competent staff. One person said, "I was booked here for a weeks respite last year but liked it so much that I stayed for three weeks, and here I am again, I love it here". Another person said that their care during their stay at the home had been, "Outstandingly good, I am terribly impressed, an all round amazing place".

People told us that the food was good and that they had a choice of menu. One person told us, "There are so many breakfast choices, continental, cooked, fruit and yoghurt. Its like staying in a top class hotel".

Another person told us, "They (staff) are here if you want them but they don't intrude. The whole atmosphere is very friendly. The food is excellent and appetising".

We found evidence that supported what people had told us during our visit.

We spoke with people staying in the home; people told us that they were very happy with the care provided in the home, that the staff were polite and respectful and that they were very happy with the food.

Comments made included the following “The care is excellent and the food is excellent”, “ They are brilliant at remembering everyone’s name” , “They come quickly if you ring the bell, it is like a hotel” and “I have seen the complaints procedure but I have no need to complain”