We carried out an unannounced inspection of this home on 29 September 2016. The home is registered to provide accommodation, nursing and personal care for up to 47 older people and people with physical disabilities. Accommodation is arranged over two floors with lift and stair access to the second floor. At the time of our inspection 47 people lived at the home.

A registered manager was 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.

People were supported by staff who had a good understanding of how to keep them safe, identify signs of abuse and report these appropriately. Robust processes to check the suitability of staff to work with people were in place. There were sufficient staff available to meet the needs of people and they received appropriate training and support to ensure people were cared for in line with their needs and preferences.

Medicines were administered, stored and ordered in a safe and effective way. We have made a recommendation about the safe disposal of small amounts of controlled medicines.

Risks associated with people’s care were identified and clear plans of care were in place to ensure staff knew how to mitigate these risks. Staff had a very good understanding of these risks and how to ensure the safety and welfare of people. Incidents and accidents were clearly documented and investigated. Actions and learning were identified from these and shared with all staff.

People were encouraged and supported to make decisions about their care and welfare. Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. Where people were legally deprived of their liberty to ensure their safety, appropriate guidance had been followed.

People received nutritious meals in line with their needs and preferences. Those who required specific dietary requirements for a health need were supported to manage these.

People’s privacy and dignity was maintained and staff were caring and considerate as they supported people. Whilst people did not attend formal meetings about the service, the registered manager and all staff involved people and their relatives in the planning of their care and in developments in the service.

Care plans in place reflected people’s identified needs and the associated risks. Whilst care plans were updated and reviewed regularly, the registered manager had identified not all care plans were updated in a timely way. This was being addressed.

Staff were caring and compassionate and knew people in the home very well. External health and social care professionals spoke highly of the care and support people received at the home. They were involved in the care of people and care plans reflected this.

Effective systems were in place to monitor and evaluate any concerns or complaints received and to ensure learning outcomes or improvements were identified from these. Staff encouraged people and their relatives to share their concerns and experiences with them.

The service had a good staffing structure which provided support, guidance and stability for people, staff and their relatives. The registered manager was very visible in the service and provided strong and effective leadership whilst promoting an ethos of high standards of person centred care in all that they did.

A robust system of audits was in place at the home to ensure the safety and welfare of people. Any actions required from these audits were completed although these were not always clearly documented. This was being addressed.

There were processes in place to support people to make informed choices about the care and support they received.

Each person living in the home had a detailed plan of care that included their individual needs and wishes and also recorded people’s physical and emotional needs.

A person living in the home told us. “It was an enormous decision for me to move here but I am really happy. The atmosphere is cheerful and friendly but always efficient. The administration is good from the top to the bottom and they take all the worry out of everything”.

We spoke with staff and reviewed records which showed us that people were protected from risk of abuse and their care was planned and delivered in a safe manner.

People were protected by their being a robust staff selection and recruitment process and staff had the skills they needed to safely support people.

Complaints and concerns were recorded and responded to in a timely manner.

Comments from families that spoke with us included. “The manager and staff are great, I can’t fault them. We have had some difficult issues to deal with and they have been very supportive. If I ever have to go to live in a care home I hope it is here.”

We spoke with six people who used the service and two relatives of people who lived at the home. They told us they were happy living at the home. They told us it was “one of the best”. They told us that their wishes about how they received their care and support were considered by staff at the home. People commented that the home arranged for them to see health care professionals such as GPs when they needed to.

We were told about how people chose whether to join in with group activities and those people that did join in with these activities spoke about how much they enjoyed them. Other people chose to occupy themselves in their private rooms doing activities such a listening to music, watching their television or reading books. People told us that staff respected their individual religious and spiritual needs, providing assistance and support so that they could attend church services of their own choice.

We were told that they had opportunities to give feedback to the manager about the running of the service and their views would be listened to and acted on.

They told us they had confidence that staff had the necessary skills to provide the care and support they needed.