Ashmore Nursing Home has been extended and is now a nursing home for up to 36 people. Some people may be living with dementia and have physical health conditions such as diabetes. At the time of our inspection there were 30 people living at the service. Each person had their own room and had access to lounges, a dining room and secluded gardens. An activity room was being developed for people to enjoy.

At the last inspection of 02 April 2015 the service was rated ‘Good’. At this inspection the service remained ‘Good’ and met all relevant fundamental standards.

There were arrangements in place to protect people from risks to their safety. Staffing levels of nursing and care staff were appropriate to support people meet their assessed needs. There was a robust recruitment process for employing staff appropriately to care for vulnerable people. Processes and procedures were in place to receive, record, store and administer medicines safely.

People were cared for by staff who received supervision and on-going training to develop their skills to support people with their assessed 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 support this practice. Staff encouraged people to eat sufficiently and have drinks of their choice. People were supported promptly as required to see a range of healthcare professionals in order to maintain good health.

Care was delivered in an understanding and empathic way to meet people’s needs. People were supported by staff to make day to day decisions about their care. The staff respected people’s dignity and privacy.

Each person had a care plan which was based on an individual needs assessments and took into account people’s preferences. The care plans were reviewed regularly to remain up to date. People were encouraged to engage with a variety of activities which had been developed from listening to the views of the people. People were aware of how to make a complaint and spoke positively about the staff and registered manager’s practice of acting quickly to deal with any concerns raised.

Systems were in place to ensure the service was managed effectively and to monitor the quality of the service provided. People and relatives reported the service was run by knowledgeable and responsive staff with an open culture to listen to their views.

Further information is in the detailed findings below.

We carried out this inspection on 02 April 2015. The inspection was unannounced.

Ashmore nursing home provides accommodation for up to 23 people who require nursing care. There were 21 people using the service at the time of the inspection.

There was a registered manager at the service. 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 systems in place to support staff in providing safe care for people who used the service. People’s needs were assessed and risk assessments when required were put in place to tell staff how they should provide care to people in a safe manner. Staff received training to help them fulfil their role including how to recognise and report concerns if they suspected a person to be at risk of harm or actual abuse. This helped to keep people safe and people told us they felt safe. There were sufficient skilled staff on duty to meet people’s assessed needs.

There were suitable arrangements for the safe storage, management and disposal of medicines which meant people received their medicines safely and according to their needs.

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

The CQC is required by law to monitor the operation of the MCA 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in pace 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. At the time of our inspection no applications had been made to the local authority in relation to people who lived at Ashmore nursing home.

The manager ensured staff were supported to develop their skills and knowledge to provide effective care and support for the people who used the service. People told us that the staff were caring and were complimentary about the care and support they received.

People were supported to maintain good health and there was a varied menu so people could choose what to eat and drink and have enough for their needs. . People’s privacy was respected and people were able to express their views and these were taking into account when providing them a service. This meant the service was responsive to people’s needs.

The care provided was needs led and individually focussed. There was a complaints policy which enabled people and others to raise concerns and they knew what to expect once a concern was raised.

The home was led by an effective management team who were committed to providing a good service which was responsive to people’s individual needs and had quality assurance systems in place.

During our inspection we used different methods to help us understand the experiences of people who used the service. Where people were unable to tell us about their experiences, we used observation and noted people’s responses to staff. We saw that people appeared calm and relaxed in the presence of staff. One person told us” It is nice here everything is good.”

We saw that care plans and risk assessments were regularly reviewed with people who used the service or relatives if they were unable to fully participate. We saw that staff were knowledgeable about people’s needs and promoted their independence.

We saw that the service was clean and tidy and free from offensive odours and the staff adhered to their infection control policies and procedures.

We saw that the provider had an effective recruitment and selection processes in place.

We saw that there was a complaints policy and procedure in place. People who used the service told us they were aware of how and who to complain to. A relative told us “The staff are very helpful if you let them know if you have any concerns.”

We spoke with five people living at the service and two relatives. Everyone we spoke with was very positive about their experiences at this service. All said there were sufficient staff to look after them and meet their needs. One person described their care as being “Beautifully looked after”. Everyone spoke very highly of the staff working at this service.

The people we spoke with had care plans in their room. Four people were aware of the content and what they were used for. Everyone we spoke with were confident that they could raise concerns to the manager and they would be resolved promptly.

The people living in Ashmore Nursing Home and their family members were complimentary about this service, people told us that they liked living there, that the care staff showed them respect and worked hard to look after them. They also told us that they were comfortable in the home.

The visit was just before Christmas and one person said, “You should see the Christmas menu, you wouldn't get better in a four star restaurant.” Another person told us that their room was comfortable and, “Just as I like it.”