Wardington House Nursing Home is a care home for up to 60 people. At the time of our inspection there were 40 people using the service. The home specialises in supporting people who are living with dementia.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service support this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People and their relatives felt involved in decisions about their care needs and the support they required to meet those needs.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.

We carried out our inspection on 16 October 2014. This was an unannounced inspection.

The service had a registered manager who was responsible for overall management of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

Wardington House is a care home providing nursing care for up to 60 people. The home specialises in caring for people living with dementia. At the time of our visit there were 46 people living at the home. The ethos at Wardington House is to support people to live as independently as possible by actively encouraging choice and promoting positive risk taking.

Medicines were administered safely. Some people were prescribed medicines that were not contained in a monitored dosage system. Records of stock balances for some of these medicines were not always correct.

The management of the home ensured that people were on minimal medication. This approach was seen positively by all health professionals we spoke with.

Nursing and care staff were skilled and knowledgeable in their roles. Health and social care professionals we spoke with prior to the inspection told us that staff always had a good knowledge of both the clinical and social needs of people.

On the day of our visit there was a calm and relaxed atmosphere in the home. Staff were kind and caring when supporting people, treating them with dignity and respect. People were engaged in a variety of activities throughout the day. We saw four people chatting and laughing with the activity coordinator as they played a board game; others in the room were joining in the conversation. Where people became anxious staff used their knowledge of the person to calm and reassure them. People were free to walk about the home and gardens and were supported by staff to do so. During our visit there was always staff available to meet people’s needs in a timely manner.

Staff, visitors and professionals told us the management of the home were extremely open and approachable. We saw the registered manager and senior staff interacting in a friendly and supportive manner with people using the service, visitors and staff throughout the day.

The provider recorded and investigated accidents and incidents. We found two incidents which should have been notified to the Care Quality Commission (CQC). However the provider had notified CQC of other reportable incidents. We recommend that the provider considers the guidance on notifications to CQC.

On the day of our visit 46 people living with dementia were using the service. 14 care staff were on duty along with administration, kitchen and support workers.

People had their health and welfare needs met, and people were very happy with the care provided. We spoke with two relatives of a person who had recently used the service. They had asked to speak to us. They told us that the service was excellent. One said "I am a healthcare professional myself so I know what I am looking for. This is a wonderful place and I have been most impressed. They are respectful and have promoted my mother in laws dignity, right to the end. Very professional and very caring". Another relative said "We had a really good relationship that allowed me to help my mother. I felt informed and involved throughout".

We spoke with seven members of care staff who told us the home had its own philosophy. One said "It is all about choices, the timing of events, meals, bedtime, bathing and activities. They get to choose". Another said "We promote a person centre approach that puts them first”.

People were safe from abuse. All care staff had been trained in protecting vulnerable adults from abuse and knew what to do if they suspected abuse was occurring. One relative we spoke with who had recently lost their mother said "Oh yes, my mother was safe here".

We saw that the provider had appropriate recruitment and selection procedures in place and that they measured the quality of service they provided.

. We conducted a Short Observational Framework for Inspection exercise and observed positive interactions between care staff and people who use the service. Staff were polite, respectful and friendly towards the people in the home and they took time to talk to them in a caring and patient way.

People using the service were able to get up when they wanted and breakfast and drinks were available throughout the morning. They were able to have meals in their rooms or in the dinning room. They were also able to choose what time they went to bed.

We spoke to six staff members, all of whom showed a good level of knowledge concerning the people they care for. All the staff we spoke to were aware of the needs of the people and they said that there was always enough staff on duty to allow them to spend time with the people they care for. All staff members we spoke to said they had been trained in Dementia care.

We looked at six care plans. The plans addressed the needs of the people using the service and supported them, demonstrating input from family and relatives.

We looked at records and found that staff were recruited correctly and had recieved the appropriate training and support to enable them to deliver an appropriate level of care at the home.

Relatives comments in the homes survey showed that they thought people received the nursing care that they needed. One person told us, ‘care was wonderful.’

Relatives told us they had regular contact with staff in the home and were able to discuss any concerns or aspects about the support provided to the people they visited.

Relatives confirmed that they participated in annual surveys carried out by the home where they commented about the quality of the services provided.