We inspected the service on 16 May 2017. The inspection was unannounced so the provider did not know we were coming. Albemarle Hall Nursing Home is owned and managed by Albemarle Hall Limited. It is situated in the Woodthorpe area of Nottingham and offers accommodation for to up to 25 people who require nursing and personal care. On the day of our inspection there were 20 people who lived at the home. We previously inspected the home in November 2015 and it was rated as ‘Requires Improvement’. We found at this inspection that improvements had been made.

The home had a registered manager in place at the time of our inspection. 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 knew how to recognise abuse and how to respond to concerns. Risks in relation to people’s daily life were assessed and planned for to protect them from harm and staff followed instructions in people’s risk assessments.

People were supported by enough staff to ensure they received care and support when they needed it. Medicines were managed safely and people received their medicines as prescribed.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. People were supported to make decisions and staff knew how to act if people did not have the capacity to make decisions.

People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions. We saw that involvement of external healthcare professionals was sought when needed.

People lived in a home where staff listened to them. People’s emotional needs were recognised and responded to by a staff team who cared about the individual they were supporting. People were supported to enjoy a social life.

People were involved in giving their views on how the home was run and there were systems in place to monitor and improve the quality of the service provided.

People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions.

People lived in a home where staff listened to them. People’s emotional needs were recognised and responded to by a staff team who cared about the individual they were supporting. People were supported to enjoy a social life.

People were involved in giving their views on how the home was run and there were systems in place to monitor and improve the quality of the service provided.

We carried out an unannounced inspection of the service on 4 November 2015.

Albemarle Hall Nursing Home provides accommodation for older people. It is registered for a maximum of 27 people. There were 23 people receiving care and support at the home at the time of our visit.

There was a manager registered with the Care Quality Commission (CQC). They were not available at the time of the inspection. 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 felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. Numbers of staff on duty were insufficient to keep people safe, but they were recruited through safe recruitment practices. Medicines were safely managed.

People we spoke with told us they were satisfied with the skills of the staff. Staff received appropriate induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink, but their meal time experience required improvement. External professionals were involved in people’s care as appropriate.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care.

People’s needs were responded to. Most care records provided sufficient information for staff to provide personalised care and care plans were reviewed on an ongoing process. Activities were available in the home. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the management, but had mixed feelings about whether they felt supported as the registered manager had been absent from the service for a lengthy period. By law the provider has to notify us and keep us updated of any changes to the service. We were aware the manager was absent long term. There were systems in place to monitor and improve the quality of the service provided.

We visited Albemarle Hall nursing home on 12th March 2014 following concerns that four of the bedrooms had inadequate ventilation and windows that did not open. People had been moved out of these bedrooms and we were concerned that they were not adequately accommodated. Due to the complex needs of these people they were unable to talk with us.

We saw each of the rooms had two skylight window panels. We checked to ensure all the skylight windows opened. The provider told us the people who currently occupy the four rooms are not nursed in bed and were not permanently in their rooms.

The provider told us that people who were required to be permanently nursed in bed would not be accommodated in any of the four bedrooms.

Since we visited the service we have seen the provider has written action plans and risk assessments for the four rooms.