This inspection took place on 12 November 2015 and was unannounced. Stanfield Nursing Home is a care home and the provider is registered to provide personal and nursing care for up to 41 people. At the time of the inspection there were 39 people living at the home.

There was a registered manager in post and was present at the time of our inspection.

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 kept safe with the help from staff who understood their needs and the risks associated with them. Staff knew how to identify signs of potential abuse and how to report it. Staff were trained to be able to meet the needs of the people who lived at the home.

People’s medicines were managed safely. Medicines were stored in locked cabinets and there was a system in place for recording and checking medicines so they could be accounted for.

People were asked for their consent for care and were provided with care that protected their freedom and promoted their human rights. Before performing any support the staff asked people’s permission and gave them a choice how they would like to be supported. Where people did not have the capacity to make decisions staff followed the principles of the Mental Capacity Act (2005) and best interest decisions were made and recorded.

People were encouraged to join in activities to help maintain their physical and mental fitness.

People enjoyed the home cooked food they received and were supported to eat and drink enough to keep them healthy. The manager had accessed a range of healthcare professionals to make sure people had their nutritional needs met, to assist them to stay healthy and well.

Staff had developed caring relationships with people and knew individual preferences and support plans. People felt staff were kind and caring and involved them in their care. Staff appreciated people’s need for maintaining dignity and respect. Personal care requirements were supported with privately and respectfully. Call Bells were responded to quickly so people didn’t have to wait very long for assistance. Emergency calls were dealt with in a calm, manner so not causing undue alarm to people living in the home.

People and their relatives knew how to complain and felt happy to raise concerns with staff, management team and the proprietor. People and relative feedback was sought and the information used to develop the future needs of the service.

Staff understood their roles and worked well as a team. The people benefitted from a low turnover from staff, so had been able to establish continuity and deliver good quality care. The manager had developed quality audits for the service to capture areas for improvement They had encouraged links with local academic research establishments to enhance the service and ensure people received high quality care.

A single inspector with an expert by experience carried out this inspection. When we visited we spoke with eight of the 33 people who lived at the home. We also spoke with three relatives, six staff, the registered manager and the owner. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that when staff administered medicines to people they provided instruction and encouragement. People were also able to have their medicines in private. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People at the home were supported with enough staff to meet their needs. Two people we spoke with told us: “I just ask if I need something” and: “I don’t wait”. We observed staff talking with people and were able to support them when needed. Additional staff were available during meal times to help serve food and drinks. Care staff were then able to focus on providing care and support to people with their meal.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no application had been submitted proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

People’s health and care needs were assessed with them, but they were not always involved in writing their care plans due to their conditions. The provider had also considered information and involvement from relatives, other health professionals and staff. One person we spoke with told us their relative: “Looked after that (paperwork)”.

Visitors confirmed that they were able to see people when they wanted to and the home were accommodating and welcoming.

Three people we spoke with said they saw their doctor and other health professionals. One person told us they were: “Receiving weekly physiotherapy”. The service worked with other agencies and services to make sure people received their care in a joined up way. We saw evidence of this in people's care records when the provision of people's care was planned and reviewed. These reviews involved social workers, district nurses and consultants.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us: “Very courteous staff” and: “Good and friendly here”. A relative told us that the home was: “By far the best” for their relative.

Staff we spoke with had a good knowledge of people's individual needs, and knew how to support people so that their needs were met. Staff spoke about people as individuals and we observed that staff listened to people’s views and opinions.

Is the service responsive?

One person told us about the entertainment at the home. They particularly enjoyed the music sessions as there was: “A good eclectic mix”. People completed a range of activities in and outside the service regularly and staff supported people to with these activities. People told us they had their own interests which they enjoyed and that other group events were arranged for them by staff. One person told us they had been able to go to the local cricket ground with support and visit a school for concerts.

We saw the home had been responsive to people’s changing needs and had responded to professional advice that had been provided. For example, we saw the home had worked with a local hospital to support one person who needed an operation. Appropriate action and advice had been taken to ensure the person received the required support until their operation.

Is the service well-led?

People, their relatives and staff that we spoke with on the day of the inspection told us they felt they were listened to and that action was taken in response to their comments. If action was not taken then an explanation had been provided.

The provider had a quality assurance system in place. We saw records that identified shortfalls and the actions that had been taken to address them. The provider listened and responded to people, staff and visitors who had left comments and suggestions.

There were a range of audits and systems put in place in by the manager and provider to monitor the quality of the service being provided.

Stanfield Nursing Home provided nursing care for older people. During this inspection we spoke with seven people who lived at the home, three relatives, seven staff, the registered manager and the provider. We looked at three care records and four staff records.

People we spoke with were complimentary about the care and support that they received. One person who lived in the home told us; “The staff are friendly, I want to write a letter to thank them”.

Staff understood people's needs and responded to them in the way the person wished.

We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were provided with a choice of nutritious meals that they enjoyed.

We found that staff were supported to meet the specific needs of the group of people they were caring for.

The provider had systems in place to regularly assess and monitor the quality of service that people received.

We inspected the service and spoke with three people who lived there, two relatives and four staff. We found people were able to express their views and had been involved in making decisions about their care and treatment.

People were complimentary about the care and support they received. One person told us, “Staff are very caring, great atmosphere”. Another person said, “The staff can’t do enough for you”, also, “I would be lost without matron”.

Staff were visible throughout our inspection. Care staff were on hand to provide care and support to people. We saw staff providing one to one care throughout the day, providing comfort and positive interaction.

We found people were supported to move around the home. There was a variety of personal interaction such as musical activities observed during the day. We found staff respected people as individuals and knew a lot about their personal lives, families and preferred choices. Staff knew people’s current care needs and provided appropriate support.

People were safeguarded as the provider had taken steps to ensure any potential instances of abuse could be identified and reported. Care staff we spoke to told us they felt supported by the manager and provider to take the appropriate action where required.

The provider had a system in place to make sure staff recruited had the required documents and checks in place to protect people. People knew how to make a complaint and felt supported in that process.

We carried out this review to check on the care and welfare of people using this service.

During this visit we spoke to ten people who were living at the home and with visiting relatives. People told us that the care they received was good and they felt looked after. Relatives were very complimentary about the care workers and management of the home, and commented on the “homely” atmosphere and how they were made to feel welcome at anytime.

People that lived in the home told us they chose how they spent their day, that they were not restricted on bedtimes or wake up times and if they needed or wanted to, could stay in their room. One person we spoke to preferred to stay in their room due to health reasons and personal choice. The rooms we saw were clean, well decorated and contained some personal items and photographs. People were able to choose from three lounges and two dining rooms.

The home employed an activities coordinator seven days a week. An electronic display in the hall showed the pictures and names of the care workers on shift, the mealtime menu, activities taking place and other information for that day. There was also a timetable of communal activities on the wall in the entrance hall. People who lived at the home were supported on trips in to the local community.