This inspection took place on 23 November 2016. It was an unannounced inspection.

St Luke’s Hospital is registered to provide accommodation for up to 51 older people who require nursing care. At the time of the inspection there were 45 people living at the service.

The service had a registered manager. 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 told us they were safe. People were supported by staff who could explain what constitutes abuse and what to do in the event of suspecting abuse. Staff had completed safeguarding training and understood their responsibilities.

Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

There were sufficient staff to meet people’s needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People received their medicines as prescribed. Staff administering medicines checked each person’s identity and explained what was happening before giving people their medicine. Nurses were supported to maintain their registrations with the nursing and midwifery council (NMC).

Staff understood the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves.

People told us they enjoyed the food provided by the home. Where people required special diets these were provided by a chef who clearly understood the dietary needs of the people they were catering for.

People received person centred care. People were cared for by a service that understood the importance of getting to know the people they supported. There was a clear focus on the importance of knowing people’s histories.

The service employed three recreational therapists and supported 15 volunteers to provide people with meaningful activities as well as supporting people to attend exercise classes and physiotherapy appointments.

People were confident they would be listened to and action would be taken if they raised a concern. People told us the service was responsive and well managed. The service sought people’s views and opinions and acted upon them.

The service had systems to assess the quality of the service provided. Learning from audits took place which promoted people’s safety and quality of life.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staff and the registered manager shared the visions and values of the service and these were embedded within service delivery.

We spoke with eight people who used the service, four people’s relatives and nine members of staff. We looked at five care plans and spoke with visiting professionals. At the time of our inspection there were 40 people living at the service. 25 people were long stay residents and 15 people were short stay residents.

People we spoke with felt respected and involved in their care. One person told us, “I have a choice to be involved in activities being run, but I prefer to read, or watch TV in my room. Someone does come to check whether I want to be involved in activities that are taking place”. One person’s relative told us they felt involved in decisions relating to the care and support of their relative and their views are listened to.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care files we reviewed all contained preadmission assessments which informed care and treatment plans and these were regularly reviewed. Where needed risk assessments were completed and regularly updated.

We saw that the provider had procedures in place to respond appropriately when they suspected that abuse had occurred or was at risk of occurring. We saw that there was an up to date safeguarding policy and procedure in place.

We saw that the provider carried out monthly satisfaction surveys for people in the short stay department and annual surveys for long term patients. We saw the results of a patient satisfaction survey for the short stay beds which showed the majority of people were “Very Satisfied” with their care and would recommend St Luke’s to friends and family.

People told us that the staff treated and respected them when supporting them with their care.

We talked to people who were living at the service for a number of years on a long term basis and those who came for respite or short term rehabilitation. One person said "I think it's great, the food is lovely". Another person said "its the best place I've ever been, I can't imagine how they could improve on it".

People who use the service told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, matron or nurse if they needed to.

Assessment and care plans were in place that people using the service were involved in developing and reviewing.This demonstrated that people experienced care, treatment and support that met their needs and protected their rights.

We were told by people that they were supported to live their lives as they wished and that they liked living in the home. They told us that they received the support they needed and were able to continue with the social activities that they had participated in before they came to live in the home.

We were told that people liked the staff who were ‘friendly and had a great sense of humour.’ We were told that staff were approachable and there always appeared to be enough staff on duty at all times.