The inspection took place on 19 and 20 November 2018 and was unannounced.

Torpoint Nursing Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The service provides care and accommodation for up to 54 people. On the days of the inspection 37 people were staying at the service. Some people were living with dementia, or had physical and mental health needs.

The service is owned and operated by Torcare Limited. They also own two other care homes in East Cornwall, providing residential and nursing care to older people, as well as a domiciliary care agency.

The service had 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

Why the service is rated good.

People told us they felt safe living at the service. The provider’s systems and processes protected people from abuse. Risks associated with people’s care were managed safely. People were supported by sufficient numbers of staff.

People’s medicines were managed safely. People were protected by infection control practices, and lessons were learnt when things went wrong, and the learning was used to help improve the service.

People’s needs were assessed prior to them moving into the service to help ensure they were cared and supported effectively and safely. Staff received training to be able to meet people’s needs.

People received enough to eat and drink. However, people living dementia did not always receive a dining experience which promoted their independence and ensured they were treated with respect and dignity. However, the provider had already recognised that improvements were needed, and had started to take action.

The service worked well with external organisations to the benefit of people. External professionals were complimentary of the staff, care and leadership of the service.

People were encouraged to live healthy lives, and their overall wellbeing was promoted. The design and decoration of the service was suitable, and the Accessible Information Standard (AIS) was known and had been considered. The AIS aims to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand. People’s individual communication needs were known by staff, and the provider had researched and used assistive technology to help support people’s communication needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their families told us staff were kind, and we observed compassionate interactions between staff and people. People were involved in their care, as far as possible and, overall their privacy, dignity and independence was promoted. People were supported compassionately at the end of t

The inspection took place on 15 March 2016 and was unannounced.

Torpoint Nursing Centre is owned and operated by Torcare Limited. They also own two other care homes in East Cornwall, providing residential and nursing care to older people as well as a domiciliary care agency. Torpoint Nursing Centre provides residential and nursing care for up to 54 older people. Some people may be living with dementia, or have physical and mental health needs. On the days of our inspection 38 people were living at the care home. Torpoint Nursing Centre is separated into four different areas, each specialising in different levels of care and support for people. These included residential, nursing, and dementia care. The home has two floors, with access to the upper floor via stairs or a passenger lift. Some bedrooms have en-suite facilities. There are shared bathrooms, shower facilities and toilets. Communal areas included one lounge, two lounge/dining rooms, and three dining rooms. There is a garden patio and seating area.

The service had 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.

People told us they felt safe living at the service. Staff, knew how to recognise abuse and were confident about what action to take to protect people. People told us there were enough staff to meet their needs. Some staff told us, more staff were required to help ensure quality time could be spent with people, for example to participate in social activities. The provider was aware of how staff were feeling and the recruitment of additional staff was currently taking place. Staff had been recruited safely to help ensure they were suitable to work with vulnerable people.

People told us staff were kind and caring. Staff knew people well, which meant they could meet their needs in an individualised way, whilst engaging in meaningful conversations. People’s independence, privacy and dignity was promoted. People were respectfully cared for at the end of their life. Nursing staff had good links with GP’s to help ensure a co-ordinated and sensitive approach.

People were encouraged to balance the risks associated with their care, so as not to restrict their life. People had risk assessments in place to help provide guidance and direction to staff about how to minimise any risks. People lived in a clean environment which was free from odour. Staff followed infection control practices to help protect people from the spread of infections.

People told us the meals were nice, however, the provider was in the process of taking action in response to the outcome of a recent survey which had shown meals were not always liked by people.

People’s consent was obtained when required, and people's mental capacity had been assessed. When a person did not have capacity, documentation showed legislation had been followed to ensure people’s human rights were protected. Not all staff understood how people’s human rights should be protected so the provider told us further training would be arranged.

People told us their needs were met, and people had care plans in place which were individualised and provided guidance to staff about how to meet people’s individual needs. People could participate in social activities, were encouraged to be part of the local community and had their religious and spiritual beliefs respected.

People were cared for by staff who were experienced and attended training. Nursing staff kept their clinical practice up to date to maintain their professional registration with the Nursing and Midwifery Council (NMC). People received their medicine safely, and people had there changing health care needs referred to relevant health

We (the Care Quality Commission) carried out this inspection as part of our scheduled inspection programme.

We talked with ten people who lived at the home. People using the service told us, “we are looked after very well” and “the staff are all lovely”. We asked people if they felt staff treated them with dignity and respect. Everybody we spoke with, who were able, said staff were always respectful and treated them well. People told us that they felt safe at the home.

We spoke with 12 staff who all told us they enjoyed working at the home. They said “ they are great, hard working staff here” and “ we are here for those people who cannot speak for themselves”.

We pathway tracked five people who use the service. Pathway tracking means we looked in detail at the care five people received. We spoke to staff about the care given, looked at records related to them, met with them and observed staff working with them. Records relating to people’s care were detailed and personal and supported staff by providing sufficient information to meet people’s needs.

People using the service and staff told us that they felt there were sufficient staff on duty to meet people’s needs.

We looked at the systems in place to monitor the quality of the service. We found that auditing systems were in place to monitor the service, address any problems found and work towards continual service improvement.

Torcare Ltd owns and runs the Torpoint Nursing Centre but also has a domiciliary care agency registered from the same premises. This offers personal care to people in their own homes. This report includes the inspection of both.

THE NURSING CENTRE

The nursing centre’s inspection was unannounced. We spent two days reviewing the nursing centre.

We were told there were 47 people living in the home at the time of our visit. We read seven care plans, spoke with five people who used the service and met with six family members. We also spoke with five members of staff and observed how the staff interacted with people who lived in the home. We also spoke with one professional with knowledge of the service.

During our visit we met with the matron, registered manager and nominated individual who was also the general manager.

We found there were system is place where consent to care and treatment was being sought and recorded. When people were unable to make choices for themselves due to people being poorly or having advanced dementia the home acted within the law to ensure their rights were safeguarded.

We found that people’s care and welfare needs were being met and the care plans reflected the current care needs.

We found the home was ensuring the environment was clean and people were protected from cross contamination through good standards of infection control.

We found the staff were well trained and supported to ensure they were providing care safely and appropriately.

We found that the home was ensuring the quality of the care they were providing was of a good standard.

The home had reviewed its practices in respect of the sending the required notifications to the Care Quality Commission and these were now taking place.

THE DOMICILARY CARE AGENCY

The inspection for the domiciliary care agency (the agency) was announced. We spent two days reviewing the agency.

We were told that the agency currently provided personal care for 22 people. We visited five people in their home and spoke to them and two relatives. We spoke with three care staff and the manager of the agency. We also met with the nominated individual who is also the general manager.

We found the agency was ensuring people were respected and involved in planning their care. We also found that consent was being sought in relation to their care planning and day to day care choices.

We found that people’s care and welfare needs were being met and emergency situations were addressed and concerns met.

We found staff were recruited safely and the agency was ensuring people were protected as a result. People were being safeguarded by training the staff and had systems in place where concerns could be shared and addressed quickly.

The agency had a complaints procedure in place that was available to people in their home and the contact details of those to speak too were on the front of the care plans.