We carried out an unannounced inspection on 19 October 2016.

Arden House provides accommodation and nursing care for up to 18 people, some of whom live with dementia. At the time of our inspection there were 15 people living in the home.

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.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised and how to safeguard people from the risk of possible harm. People’s medicines had been managed safely.

The provider had effective recruitment processes in place and there were sufficient staff to support people safely. Staff understood their roles and responsibilities and would seek people’s consent before they provided any care or support. Staff received supervision and support, and had been trained to meet people’s individual needs.

People were supported by staff who were exceptionally caring and respectful, and who knew them well. People enjoyed living in a person centred home which catered for their requirements.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. The service supported people with health care visits, such as GP appointments, optician appointments, chiropodists and hospital visits.

There was a formal process for handling complaints and concerns. The registered manager encouraged feedback from people and acted on the comments received to continually improve the quality of the service. There were effective quality monitoring processes in place to ensure that the home was meeting the required standards of care.

We found that consent to care and treatment was documented in people's care plans and that care plans were comprehensive.

We talked with four people who used the service and four sets of relatives who all told us that the care provided was very good and one relative commented that "nothing was too much trouble" for staff.

We saw that people's nutrition and hydration needs were assessed and that they were provided with appropriate and nutritious food.

The environment was clean and processes were in place to prevent and control the spread of infection.

There were adequate numbers of staff with the appropriate skills to meet people's needs.

We found that systems were in place to enable complaints to be identified and addressed.

The people we spoke with said that the care and treatment they received as excellent. One person said that, “It’s like a home from home. The food is good and the staff are caring, understanding and supportive. I could not ask for anything more.” Another person said, “I am happy with the care I receive. The staff are pleasant and I do not have any complaints.”

We found that the home was meeting the standards we had inspected. People said that their privacy and dignity were respected and that they and their relatives had been involved in the decisions about their care and treatment. We noted from the care plans reviewed that people had an assessment of needs carried out. The care plans and the risk assessments had been reviewed regularly to reflect any changes in people needs. There were systems in place for the safe administration and management of medicines. Staff had been provided with relevant training and support for the work they did. There were systems in place to assess and monitor the quality of service.

People using the service and their relatives told us in telephone conversations, letters and during our visit on the 13 January 2011 about the good standards of care and support provided at Arden House. They commented on the good relationships they have with staff and appreciate the support that is provided by a consistent team of staff they know. One relative described the staff as 'efficient and dedicated individuals'.

People told us that Arden House ‘is a small, friendly and caring home with a ‘homely’ feel and family atmosphere. They said people’s dignity was respected and ‘sensitive’ support was provided by staff. People said that the staff are ‘knowledgeable and attentive’ and their nursing skills are ‘excellent’

People are positive about the approach of the manager and directors in making themselves available to listen to any concerns they may have and asking for people's opinions on how the service is being run.

People who use the service enjoy the meals they are served and are provided with choices of food and drink from the daily menu that meets their personal needs and preferences.

This inspection took place on 10 December 2014 and was unannounced. This visit was carried out by two Inspectors.

Arden House Nursing Home is registered to provide accommodation and nursing care for up to 18 older people. At the time of our inspection 15 people lived at the home.

The service was found to be meeting the required standards at their last inspection on 5 December 2013.

There was a registered manager in post at this home. 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 CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. The registered manager and staff were aware of their responsibilities under the MCA 2005 and DoLS. The manager was in the process of submitting DoLS applications to the local authority for people who needed these safeguards.

We found that, where people lacked capacity to make their own decisions, consent had been obtained in line with the MCA 2005.

People were protected from abuse and felt safe at the home. Staff were knowledgeable about the risks of abuse and reporting procedures. There were sufficient staff available to meet people’s individual care and support needs. Safe and effective recruitment practices were followed which included appropriate background and employment checks.

There were suitable arrangements for the safe storage, management and disposal of medicines.

Incidents and risks were managed well and reported appropriately and people were supported to ensure they received a well balanced diet to their liking.

People were supported by staff who knew them well and were involved with decisions about the home, and their own care. Their independence and dignity was promoted by staff that had access to appropriate training and who were knowledgeable about their care needs. The manager regularly reviewed peoples needs and the service responded appropriately when care needs changed.

People felt well cared for and supported by the manager and the provider, they felt listened to and that their views were taken into account. There were regular resident forums and staff meetings for people to express their views and any concerns were acted upon and responded to. The service had a complaints procedure in place. Issues and concerns identified were improved upon quickly and to benefit the people that used the service.

The service was well led by a manager that supported the staff and provided visible leadership. The provider supported the manager and staff well. There was a quality management system in place which included a system of audits to identify where improvements could be made.