The inspection took place on the 4 December 2017 and was unannounced.

Truscott Manor Care Home is a nursing home. People in nursing 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.

Truscott Manor Care Home is a large detached property set within extensive grounds and is registered to provide care, nursing and respite for up to 39 older people. Accommodation is provided over two floors, with a passenger lift providing access between floors. On the day of our inspection 34 people were using the service.

At the last inspection on 9 November 2015, the service was rated Good. At this inspection we found the service remained Good

People and relatives told us they felt the service was safe. One person told us "I feel safe they come if I need anything, they all know what I need help with". People remained protected from the risk of abuse because staff understood how to identify and report it.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People and their relatives felt staff were skilled to meet the needs of people and provide effective care. One person told us “Staff seem to know what they are doing, they all do a very good job. No complaints at all really”. Another person said “They are great and skilled in what they do. Very helpful”.

Staff supported people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs were met and people reported that they had a good choice of food and drink. One relative told us “My relative loves the food, there is always drinks coming round and they handle her very kindly”.

Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. Staff spoke positively about training and supervisions they received from the management and provider and commented on how they found they could ask questions freely. One member of staff told us “I had an induction, shadowed staff and did lots of learning. I’m also doing the care certificate and a diploma in health and social care has been discussed for me”.

Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People and relatives also said they felt listened to and any concerns or issues they raised were addressed and were told any minor issue was dealt with straight away.

People’s individual needs continued to be assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

Quality assurance audits completed by the registered manager and provider were embedded to ensure a good level of quality was maintained. We saw audit activity for areas such as infection control, care planning and training.

People, staff and relatives found the management team approachable and professional. On person told us “The nurse managers are very good and make sure it all runs well. I see them daily and always make sure I am ok”. A member of staff said “The manager and deputy manager have

Truscott Manor is a large detached property set within extensive grounds. Truscott Manor Care Home is registered to provide care, nursing and respite for up to 39 older people. Accommodation is provided over two floors, with a passenger lift providing access between floors. On the day of our inspection 32 people were using the service.

The home had a registered manager. 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 experiences of people were positive. People told us they felt safe living at the service, staff were kind and compassionate and the care they received was good. One person told us “This is a safe place to live”. We observed people at lunchtime and through the day and found people to be in a positive mood with warm and supportive staff interactions.

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate the risks. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff on duty at all times to meet people’s individual care needs. When new staff were employed at the home the registered manager followed safe recruitment practices.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

The home considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get the medicine they needed when they needed it. People were supported to maintain good health and had access to health care services when needed.

Staff supported people to eat and they were given time to eat at their own pace. The home met people’s nutritional needs and people reported that they had a good choice of food and drink. Staff were patient and polite, supported people to maintain their dignity and were respectful of their right to privacy. People had access to and could choose suitable social activities in line with their individual interests and hobbies. One person told us “I enjoy a sing song when an entertainer visits and someone brought some little dogs in which was nice”.

Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of the needs of people. One staff member told us “We get the opportunity to do lots of training, it is always displayed on the staff notice board what is available”.

Resident and staff meetings took place which provided an opportunity to feedback on the quality of the service. Feedback was sought by the registered manager via surveys. Surveys results were positive and any issues identified acted upon. People and relatives we spoke with were aware how to make a complaint and all felt they would have no problem raising any issues. The registered manager responded to complaints in a timely manner with details of any action taken.

People and relatives spoke highly of the registered manager. One person told us “The manager always comes and talks to me with a smile”. Staff we spoke with told us they found the management and staff at the home to be approachable and very supportive. One person told us, “The registered manager is always available and approachable, she’s a very good listener, and she runs the home well”.

When we visited there were 36 people in Truscott Manor, six of whom occupied the interim care beds. We spoke with seven people living there, relatives, staff, visiting health professionals, the manager, their deputy and the owner.

People said they were happy in the home and satisfied with their care and treatment. One person said “The care has been wonderful and I can’t praise them enough”. A relative told us “The atmosphere is warm and friendly and they really do care. They’ve taken away my worries totally”.

We saw that staff were friendly and courteous and people told us they were listened to and made choices about their care. One person said “The staff are polite, treat me with respect and I was properly involved in decisions about my care”.

People said they were well cared for and felt safe. We saw they had individualised care records and risk assessments in place which were reviewed regularly and helped staff understand and meet their needs. One relative said “If it wasn’t for their excellent care my relative wouldn’t be here today”.

The medication system was robust and medicines were administered safely and as prescribed.

The recruitment and selection process ensured that all staff had the appropriate checks before starting work and undertook relevant training.

There was an effective complaints system in place. People were supported to express their comments and complaints and all complaints were fully investigated and action taken if required.

During our visit we saw that staff treated people with dignity and respect. Staff were seen to knock on doors before entering and provided assistance in a kind and discreet manner. People that we spoke with were very positive about the home and staff team and comments included, “I'm happy here, it's nice" and "staff very good, can't fault them."

There was a relaxed and comfortable atmosphere within the home and the staff we spoke to understood how to support people, assisted them to make choices and maintain as much independence as possible. A member of staff told us "staff work as a team," another said "when I came here everyone helped me."

In order to protect the people who used the service, we saw that the home carried out a rigorous staff recruitment process. We saw that staff were knowledgeable about people's needs and preferences, were observed to treat people as individuals and delivered care in a personalised way.

There were processes in place to monitor the quality of service being provided and we saw that people were involved through questionnaires, reviews and one to one discussions.

Relatives we spoke to told us they were very happy with the standard of care. One person told us "even cleaners speak with residents, a really good team." Another told us their relative "looks 160% to when they first came in" and "no complaints about this place at all."

Another professional who was visiting told us "support and communication is very good here."