This inspection took place on 18 July 2017 and was unannounced. St Aubyns Nursing Home provides nursing care for up to 39 older people. Some people using the service may be living with dementia or may have a physical disability. At the time of our inspection the home was providing accommodation care and support to 33 people.

The home did not have a registered manager in post. 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 current manager had managed the home since November 2016. At the time of this inspection they were in the process of applying to the CQC to become the registered manager for the home.

At our last inspection of the home, 8 June 2016 we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in that people were not always supported to engage in meaningful activities that reflected their interests and supported their well-being. We also found that improvement was required because staff were not always deployed effectively at the home to meet people’s preferred support times. During this inspection we found improvements had been made and that people were being provided with a range of activities and appropriate numbers of staff were deployed throughout the home that effectively met people’s needs.

There were safeguarding adults and whistle-blowing procedures in place and staff had a clear understanding of these procedures. Procedures were in place to support people where risks to their health and care needs had been identified. There were safe staff recruitment practices in place. Medicines were managed, administered and stored safely.

The manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Staff had completed an induction when they started work and they had received training relevant to the needs of people using the service and regular supervision. People’s care files included assessments relating to their dietary support needs. People had access to health care professionals when they needed them.

People’s privacy was respected. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. People received appropriate end of life care and support when required. Care plans and risk assessments provided guidance for staff on how to support people with their needs. People and their relatives knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

There were appropriate arrangements in place for monitoring the quality and safety of the service that people received. The provider took into account the views of people using the service through a residents forum and annual satisfaction surveys. The provider carried out unannounced visits to the home to make sure people where receiving appropriate care and support. Staff said they enjoyed working at the home and they received good support from the manager, the deputy manager and the provider.

This unannounced inspection took place on 8 June 2016. This was the first inspection of this location.

St Aubyns Nursing Home provides residential and nursing care for up to 39 older people. Some people using the service may be living with dementia or may have a physical disability. On the day of our inspection, there were 36 people using the service.

A registered manager was not in place at the time of our visit. This was due to the current manager being on extended leave and as a result the registration process for becoming the registered manager was incomplete. 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 did not observe people participating in activities during our inspection. There were no individual activity plans in peoples care plans and no planned activities taking place. We found that people were not always supported to engage in meaningful activities that reflected their interests and supported their well-being.

Although we found that there were sufficient staff employed at the service and working on the day of our inspection, feedback from people and their relatives included concerns about there not being enough staff to meet people needs at certain times of the day. Management we spoke with confirmed that during morning times people may on occasions have to wait longer for support than expected. They agreed to review how staff were deployed and would match people’s preferred times for support with available staff.

Managers and staff knew what constituted abuse and the action they should take if such an incident occurred. They received regular safeguarding training and policies and procedures were in place for them to follow.

Assessments were undertaken to assess any risks to people using the service and steps were taken to minimise potential risks and to safeguard people from harm.

There were suitable arrangements for the safe management of medicines.

Safe recruitment procedures were in place that ensured staff were suitable to work with people as staff had undergone the required checks before working at the service.

Training records showed that staff had completed an induction course and mandatory training in line with the provider’s policy as well as more specialists training on dementia, challenging behaviour, death and bereavement.

Records showed that staff had received regular one to one supervision. There were also evidence of regular annual appraisals being carried out with staff.

Applications for Deprivation of Liberty Safeguards (DoLS) authorisation had been made where appropriate to legally deprive people of their liberty. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005.

Staff showed dignity and respect as well as demonstrating an understanding of people’s individual needs. They had a good understanding of equality and diversity issues, and how equality and diversity should be valued and upheld.

The complaints policy detailed how complaints would be investigated and included the nature of the complaint, whether it was a satisfactory outcome for the complainant. There were mechanisms in place to ensure learning from complaints was shared.

Audits and quality monitoring checks took place regularly and an annual service user satisfaction surveys were undertaken to ensure the service was delivering a high quality, person centred service.