We carried out an unannounced inspection of the service on 10 November 2016. The Conifers Rest Home is registered to accommodate up to 18 people who require nursing or personal care. At the time of the inspection there were 18 people using the service.

On the day of our inspection there was a registered manager in place. 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 understood how to reduce the risks of people experiencing avoidable harm and abuse. Accidents and incidents were investigated, analysed and used to reduce the risk to people’s safety. Regular assessments were carried out of the risks to people’s safety, the environment in which they lived and the equipment used to support them. Processes were in place to support people to lead as free a life as possible with the minimum of restrictions.

People felt there were enough staff to support them safely. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People’s medicines were managed safely.

People were supported by staff who completed an induction prior to commencing their role and had the skills and training needed to support them effectively. However, a more consistent approach to the frequency of supervisions was needed.

The registered manager ensured they had recorded how the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. The appropriate processes had been followed when applications for Deprivation of Liberty Safeguards had been made.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by staff and external health and social care professionals.

Staff supported people in a very kind, caring and respectful way. Staff had an excellent understanding of people’s needs and listened to and acted upon their views. People and staff clearly liked each other’s company. People were provided with information they needed if they wished to speak with an independent advocate about their care. Innovative methods were used to encourage each person to lead their lives in the way they wanted to. There was a clear and person centred approach to care delivery, with staff often going above and beyond what would normally be expected of them. People were treated with dignity and their requests for privacy were always respected.

People were able to contribute to decisions about their care. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

People were involved with planning the care they wanted to receive from staff. People’s care records were written in a person centred way and staff knew people’s likes and dislikes and what interested them. Thoughtful activities were in place that encouraged all people to do the things that were important to them. People were provided with the information they needed if they wished to make a complaint.

The registered manager led the service well, understood their responsibilities and were well liked and respected by people, staff and relatives. People, relatives and staff felt the service was well managed. People were encouraged to provide feedback and this information was used to improve the service. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.