About the service: Shottendane Nursing Home supports up to 38 people who have nursing needs and require end of life care. At the time of the inspection there were 34 people at the service. Shottendane Nursing Home is a large building with care being provided over three floors and sitting in large grounds. Each floor has its own lounge and dining area.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

People and their loved ones told us they were supported by committed and compassionate staff. One person said, “I have loved every minute of being here, the staff are so lovely.”

The visions and values of the service put people at the centre of their care and this was shared by all staff.

People were supported by staff who understood how to keep them safe and how to report any concerns. People and their loved ones were involved in planning their care.

End of life care was individualised and based on people’s preferences. People were encouraged and supported to stay well and independent for as long as possible. Staff worked closely with health professionals to manage people’s health conditions.

People told us the food was good and that they had plenty of choice. All staff knew people well including those who worked in the kitchen or laundry. There were affectionate and humorous interactions throughout the inspection.

The registered manager was approachable and open. People, relatives and loved ones told us they could go to them at any time and that concerns would be resolved. There was a culture of learning from concerns or issues which involved all staff.

Rating at last inspection: The service was rated Good at the last inspection, published in October 2016. At this inspection the service remained Good.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service.

This inspection took place on 20 September 2016 and was unannounced.

Shottendane Nursing Home is a Grade II listed manor house with extensive grounds in Margate. The service provides accommodation, support and nursing care for up to 38 people with a range of nursing and palliative care needs. At the time of the inspection there were 31 people living at the service.

A registered manager was 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. Shottendane Nursing Home is owned by a provider who regularly visited the service. The day to day running of the service was manged and overseen by a chief executive and the registered manager.

People and their relatives told us they felt safe living at the service. Risks to people were identified and assessed and guidance was provided for staff to follow to reduce risks to people. People received their medicines safely and on time.

Staff knew about abuse and knew what to do if they suspected any incidents of abuse. Staff were aware of the whistle blowing policy and the ability to take concerns to agencies outside of the service. Staff were confident that any concerns they raised would be investigated to ensure people were kept safe.

The provider had a recruitment policy and processes in place to make sure that staff were of good character. Staff completed regular training, had one to one meetings and annual appraisals to discuss their personal development. There were consistent numbers of staff deployed, day and night, to meet people’s needs.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. Staff knew the importance of giving people choices and gaining their consent.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. Some people had an authorised DoLS in place and these were regularly reviewed.

People enjoyed a choice of healthy, home-cooked, food and told us they had enough to eat and drink. Relatives often had meals with their loved ones. People’s health was assessed and monitored and staff took prompt action when they noticed any changes or a decline in health. Staff worked closely with health professionals and followed and guidance given to them to ensure people received safe and effective care.

People said they were happy living at the service and that their privacy and dignity were respected. Staff spoke with and engaged with people in a kind, caring and compassionate way. People were involved in the planning or their care and support and told us care was provided in the way they chose. Each person had a descriptive care plan which had been written with them. People’s religious and cultural needs were recorded and respected.

The provider had a complaints policy and procedure. People knew how to complain and told us they had no complaints about the service received from the staff team.

Staff supported people to maintain friendships and relationships. People’s friends and family could visit when they wanted and there were no restrictions on the time of day. Staff, including an activities co-ordinator, spent time with people on a one to one basis. People were encouraged to maintain as much independence and choice as possible.

People, staff and health professionals felt the service was well-led. There was effective and

People who used the service told us that they were happy with the care they received. One person told us, “They care for me very well here, the staff are so nice”. A relative we spoke to told us, “I visit my relative every day. It’s a very nice place, they provide a first class service and the food is excellent. My relative is very happy here and I know they are safe when I go home”.

We observed staff interacting with the people who used the service in a sensitive manner and saw that they explained the care they delivered at a level each person could understand. We observed People eating their meals at lunch time and found that people had a choice of dishes from the menu and that drinks were readily available throughout the day. We saw that there were enough staff to meet people’s needs and that call bells were answered swiftly.

We found that the home was clean and free from infection. Staff were able to demonstrate their understanding of infection control processes and we saw that policies and procedures were followed.

During our visit we saw that staff treated people with dignity and respect. Staff were seen to knock on doors before entering people's rooms and provided assistance in a kind and discreet manner. People that we spoke with were very positive about the home and staff team and comments included, “I get every attention, staff very good," another said "staff come in and chat and know what I need, if I need anything else I only need to ask."

There was a relaxed and comfortable atmosphere within the home and the staff we spoke to understood how to support people, assisted them to make choices and to remain as independent as possible. A member of staff told us "we encourage people to do as much as possible for themself even if it's only to wash and dry their face."

In order to protect people who used the service, we saw that the home carried out a rigorous staff recruitment process. Staff were knowledgeable about people's needs and preferences and were observed to treat people as individuals and delivered care in a personalised way.

There were processes in place to monitor the quality of service being provided and we saw that people were involved through questionnaires, regular reviews of their care and one to one discussions.

Relatives we spoke to told us they were very happy with the standard of care. One person told us "staff do anything you ask them to, very respectful." Another told us "staff always talk to them about their care needs and explained the treatment."