The inspection took place on 9 May 2017 and was unannounced.

The Heathers Nursing Home provides nursing care for up to 45 people, some of whom may be living with dementia or a physical disability. At the time of this inspection there were 36 people living in the home. Accommodation is over a single story and people benefit from a number of communal areas and gardens.

There was a registered manager 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.

The service had procedures in place that minimised the risk of employing people not suitable to work with those that used the service. Staff received an induction, ongoing training and regular support to ensure they had the appropriate skills and knowledge to perform their role.

We saw that staff worked well as a team, were supportive of each other and contributed to a positive culture within the home. This all helped to ensure that the service was warm, welcoming and effective. There were enough staff to meet people’s needs in an individual and unhurried manner.

Care and support was delivered in a kindly and respectful manner. The service understood the need to make people feel valued, in control of their care and empowered. Humour and laughter were used to build relationships and people had confidence in the staff.

People’s privacy was respected and dignity considered in all aspects of the service provided. Independence was promoted and people were supported to make choices. Staff understood people’s backgrounds and life histories and how these might impact on the support they required.

Procedures were in place to help protect people from the risk of abuse and staff had knowledge of these. Risks to individuals, staff and visitors had been identified, assessed and managed with preventative measures considered and implemented. Accidents and incidents were recorded and used to minimise future risk. People received their medicines as prescribed and good practice guidance was followed.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service had a robust knowledge of this legislation and fully adhered to its principles. It understood the importance of its implementation.

People were fully involved in the planning of the care and support they received and any changes required in order to meet their developing needs. People received care that was individual to them and that had been considered and discussed in order to provide the best holistic outcomes for them. Care plans were person centred and clearly demonstrated a service that put those who used the service at the centre of decisions.

Nutritional needs were met and people had access to healthcare provision. The service was proactive and preventative in their approach to these needs. Healthcare and community professionals had confidence in the home and told us that it delivered a good quality service.

The service provided varied activities and we saw that people engaged in these. People were supported to follow their interests. Staff knew those they supported well and had developed meaningful and trustful relationships with people and their families and friends who were welcome at any time.

The registered manager demonstrated knowledge, accountability and passion in their role. They had an ethos of open-mindedness and were proactive in order to make the service the best it could be and was motivated in doing so. They openly welcomed suggestions and sought feedback to drive improvement. Regular audits were in place to assist in assessing and monitoring the quality of the service.

People had confidence in how the service was managed and told