We inspected Ashwood Nursing Home – Spalding on 27 November 2018. The inspection was unannounced. Ashwood Nursing Home – Spalding is a ‘care home’. People in care 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. The home can accommodate up to 47 older people, some of whom may experience memory loss and physical health needs.

On the day of our inspection 46 people were living in the home.

At our last inspection on 5 April 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive a safe service. Systems were in place to protect them from avoidable harm and abuse. Risk assessment were regularly updated to ensure people’s changing needs were identified and planned for in a timely way. Staff knew how to protect people’s safety and welfare and received training to ensure their skills and knowledge were up to date. People received their medicines from staff who were appropriately trained. The home environment was adapted to meet people’s needs and staff understood the importance of preventing and controlling the spread of infection.

People continued to receive an effective service. The principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) were followed which meant people’s rights and freedoms were protected. There were sufficient numbers of staff who were safely recruited, appropriately trained and well supported to meet people’s individual needs.

People’s nutritional needs were met and they had access to appropriate healthcare services whenever they needed them.

People continued to receive care from staff who were kind, patient and considerate. They were provided with comfort and reassurance when they became upset or anxious. Their privacy and dignity was fully respected and they had developed positive relationships with staff members.

People continued to receive a responsive service. They were involved in determining how their care was provided and personalised for them. Staff understood people’s needs and preferences well. People were supported to enjoy a varied social life.

There was an open and inclusive culture within the home. People, their family members and staff were encouraged to express their views about how the home was run. There were systems in place to regularly monitor and improve the quality of the services provided.

The inspection took place on 5 April 2016 and was unannounced.

The home is registered to provide nursing and residential care for 47 people. There were 46 people living at the home on the day of our inspection.

There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS were 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. This is usually to protect themselves. The registered manager had made appropriate requests for people to assessed under the DoLS and all the care provided minimised the restriction on people.

People were care for staff who worked together to ensure that the care provided was personalised to people’s individual needs. Staff were able to do this as the planning completed by the registered manager ensured that there were always enough staff on duty allowing staff to spend quality time with people. The provider and registered manager were supportive of staff and ensured that the mandatory training provided them with the skills needed to provide person centred care. In addition, more specialised training was available to support people’s individual needs which improved people’s health and reduced their pain.

People received care from a staff group which were engaged, kind and caring. Staff focused on people’s needs and constantly checked to ensure people were safe, comfortable and happy. The kindness provided included ensuring the families of people living at the home were safe and supported. People and their relatives were involved in planning their care and were kept up to date with any changes in care needs. People were supported to lead active lives and to access the local community on a regular basis. In addition people were supported to be entertained by staff who provided activities on a daily basis.

The quality of information in the care plans was good and they supported staff to ensure that the care they provided was tailored to people’s individual needs. Risks to people were identified and care was planned and equipment was available to ensure people were protected. Mealtimes were a pleasant experience with plenty of staff to support people on an individual basis when needed. People’s abilities to eat safely and to maintain a healthy weight were monitored. When needed people were appropriately referred for professional advice and support. The administration of medicines was done in a methodical way which reduced the risk of errors. The nurses administering the medicines took time to speak with people and advise them what medicines they were taking which ensured people were involved in their care.

The registered manager was approachable and staff, people living at the home and visitors were all complimentary about the way they ran the home. There were audit systems in place to monitor the quality of the care people received and these were implemented effectively by the registered manager. The provider ensured the registered manager and staff were supported to provide good care by employing staff at head office who kept up to date with any changes in how care should be provided. This enabled the provider to disseminate the latest guidance around best practice and any changes in legislation effectively and consistently. In addition the provider’s culture was that of an open organisation with a no blame culture which supported learning across their care homes as well as within each home.

All of the six people with whom we spoke gave us positive feedback about the service. One of them said, “The staff are kind to us and are very helpful. They’re always polite and I don’t have any concerns.”

People had been given accurate information about the fees they would have to pay. Records showed that people had been correctly charged for the facilities and services they had received.

People said or showed us that they received all of the health and personal care they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

There were safe systems for managing medication so that people received the right medicines at the right time.

Staff had received the training and support they needed to provide care for people in the right way.

There was an effective complaints system so that people could raise concerns and have them resolved.

On the day we visited Ashwood Nursing Home there were 46 people living there. The manager of the home was on leave at the time of our visit. However, a manager who had been managing the home for three weeks was available and able to answer any questions about the home and the people who lived there.

We saw the home was maintained to a good standard and people looked comfortable and well cared for. There were good relationships between the staff and people living at the home.

People told us they liked living at the home. One person said, “The staff are ever so good, really they are. I eat what I want and it’s very nice, puddings are lovely.”

Relatives we spoke with told us they were happy with the care provided. One relative told us, “Everyone is friendly and the room is always clean. Mum always looks nice.” Another relative said, “Mum is as happy and settled as she could be. It’s an all round good home.”