Staplehurst Manor Care Home provides residential accommodation with nursing and personal care for up to 30 older people. At the time of our inspection, there were 28 people accommodated in the service, four of whom living with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

There was a sufficient number of staff deployed to meet people’s needs. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect. People were supported to have choice and their independence was promoted by staff who understood the needs of older people and of those living with dementia. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People told us they enjoyed the food. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records help staff deliver care that met people’s individual needs. The activities provided were suitable for people living with dementia.

The provider and the management team were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. The management team acted on the results of these checks to improve the quality of the service and care.

Further information is in the detailed findings below.

Staplehurst Manor Nursing Home provides nursing and personal care for up to 30 older people, some of whom were unable to move independently. Some people were living with dementia and others required support because of illness or other age related conditions. End of life care is also provided. Staplehurst Manor is a large detached property set in extensive, well maintained grounds. There were 23 people receiving nursing care at the time of our inspection.

We inspected the service on 13 October 2014. At our last inspection on 18 October 2013 we found that the service met the essential standards of quality and safety we looked at.

A new manager had been employed at the service since May 2014. Their application to become the registered manager was being processed by the Care Quality Commission (CQC) at the time of this 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 and associated Regulations about how the service is run.

The provider had taken steps to make sure that people were safeguarded from abuse and protected from risk of harm. People told us they felt safe. People were protected from harm; risks to their safety were assessed and managed appropriately. People were involved as far as possible in their assessments and action to minimise risk was agreed with them.

The provider operated safe recruitment procedures which included carrying out legally required checks on every applicant to make sure they were suitable to work with the people who lived at this service. Staff told us there was a good atmosphere and staff worked as a team. They told us there were enough of them to care for people and keep them safe. People told us they did not have to wait long when they needed help or support.

Staff were provided with suitable training to enable them to carry out their roles. People told us, “Staff have been very good.” “All the nurses and carers are good” and, “They look after me well”.

Staff understood their roles and responsibilities. They told us they felt well supported and were provided with essential training, including induction to make sure they had the knowledge and understanding to provide effective care and support for people. Nursing staff were supported to continue their professional development. All staff received regular supervision and appraisal to make sure they were competent to deliver appropriate care and treatment. Care staff received regular supervision with their line manager where they were able to discuss their work. Nursing staff told us that they received regular clinical supervision regarding their nursing practice.

Staff received Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) training to make sure they knew how to protect people’s rights. There was no one living in the home for whom it had been necessary to make an application under DoLS to restrict their liberty. Staff understood the importance of obtaining consent from people before care or treatment was provided.

People told us they enjoyed the food. They said, “They (staff) go to no end of trouble to please you where food is concerned”. People were offered choices about what they wanted to eat and drink. People who needed support to eat were helped discreetly. Meal times were managed well to make sure that people received the support and attention they needed.

People were supported to manage their health care needs. Nursing staff carried out regular health checks on people who lived in the home and these were recorded. People told us they were able to see a GP whenever they wanted to. Records showed that people saw other health professionals such as physiotherapists, chiropodists, dentists and opticians when they needed to.

People were treated with respect, kindness and compassion. People told us they were happy and felt cared for. They said, “The care here is excellent” “The carers are good and kind” and “Everyone is treated with respect”. All agreed that they felt listened to.

Each person had an individual care plan. These were continually reviewed and updated to make sure all their needs were understood by staff who provided their care and treatment. People told us they had been consulted about how they wanted their care to be delivered.

Information about people was treated confidentially and records were stored securely. Staff were discreet in their conversations with one another and with people who were in communal areas of the home. Staff were careful to protect people’s privacy and dignity.

People received personalised care or treatment when they needed it. People told us they did not have to wait long if they needed any help. They said, “I use the buzzer if I need them and they respond pretty quickly.” and, “I have no complaints at all; they can’t do enough for you”. Staff knew people well. They were calm and patient with people, they communicated effectively, responded quickly and appropriately to people’s requests. Staff offered people choices. For example, about what they wanted to eat and where and how they wanted to spend their time.

People’s needs were assessed with them before they moved to the home to make sure the home was suitable for them. Care plans were regularly reviewed with the person concerned to make sure they were up to date and reflected their individual preferences, interests and aspirations. People were provided with a range of suitable activities they could choose from. Everyone we spoke with told us there were activities on offer.

The manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. All the people we spoke with felt able to raise any concerns with staff or the management.

People spoke positively about the way the home was run. They told us the manager and staff were approachable. One person said, “I’ve been in a lot of places in the world and this is the best place I’ve been in”. Relatives told us they felt that the home was well run and could speak to the manager at any time if they had any questions or concerns. The organisation had clear vision and values. These values put people at the centre of the service and had been successfully cascaded to staff. People were comfortable with the management team and staff in the home. Staff understood their roles and responsibilities and the staff and management structure ensured clear lines of accountability.

There were systems in place to review the quality of all aspects of the service regularly. Improvement plans were developed where any shortfalls were identified. Annual ‘customer satisfaction surveys’ and quarterly ‘resident’ and relatives’ meetings gave people the opportunity to comment on the quality of the service. People were listened to and their views were taken into account in the way the service was run.

Any accidents and incidents were monitored to make sure that causes were identified and action was taken to minimise any risk of reoccurrence.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Staff described the training they had completed to enable them to care for people who used the service. Staff were clear about their responsibilities and showed an understanding about how to meet people's needs. We found that staff had undertaken a significant number of training updates since the last inspection and that most on-going basic training had been completed by most staff. People told us “Staff are very good, they are very kind and very helpful” and “Staff are experienced and know what they’re doing.”

Staff received support, which enabled them to provide appropriate care for people who used the service through supervision and appraisal. Staff told us they could talk to the manager or senior staff about any issues regarding the care they provided and felt well supported.

People made decisions and choices in their daily life. People told us “You can decide what time you want to get up and go to bed”. People told us that they were always treated with kindness and said, “Staff always respect my privacy.”

Each person had a care plan, which gave staff guidance about how people preferred to receive support. People’s health care needs were met, although there was a slight odour in one person’s room. People’s welfare was promoted by social activities. People told us “There are always things to do; I can go to anything I want to”.

There were enough staff to meet people’s needs. People told us “Staff always stop and have a chat.” People said they had to sometimes wait an inappropriate length of time for staff to answer the call bell. People were cared for by staff who were supported to deliver care and treatment. Records did not fully evidence that all staff had received all of the training they needed to deliver care effectively and support people safely and to an appropriate standard. Staff knew how to protect people if they suspected abuse.

Staff were patient and encouraged people to do what they could for themselves and allowed people time to voice their own opinions and views. One person told us “I have no complaints at all; I can’t praise the home enough.” Not all the records needed to fully evidence the effectiveness of the quality monitoring system were available on the day of our inspection.

The people we spoke with and their relatives felt very positive about Staplehurst Manor. Overall, they spoke highly of the care given by staff.

One relative told us “I visited many different care homes before deciding on this one. They’ve delivered more than expected. I am totally happy with the staff; they’re devoted and caring people”.