Bolters Corner Nursing Home provides accommodation for up to 35 older people with dementia and a variety of other physical disabilities.

At the last inspection on 29 October 2015 the service was rated ‘Good.’ At this inspection we found the service remained ‘Good.’

People were continued to be safe at Bolters Corner Nursing Home because staff were aware of their responsibilities to keep people safe. Staff were knowledgeable about the processes to follow when they suspected abuse. The provider followed safe recruitment practices that ensured only suitable staff worked at the home. Risks to people had been identified and risk assessments were in place to enable people to remain safe. These provided guidance to staff about the risks and how to maintain people’s safety.

Records of accidents and incidents were maintained and actions to help to prevent the re-occurrence of these had been implemented. There were sufficient numbers of staff to attend to the assessed needs of people. Medicines were managed and stored safely and people received their medicines on time and as prescribed by their GP.

People continued to receive effective care from staff who had received training that enabled them to carry out their roles. Staff were supported by the registered manager through regular supervision and appraisals of their work. 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. People were provided with sufficient food and drink. People were complimentary about the food and how it was cooked. People’s healthcare needs continued to be met and they were able to access all healthcare professionals as and when required.

People’s privacy and dignity was respected and they were involved in making decisions about their care and treatment. People were treated with kindness and compassion in their day-to-day care. People received care that was personalised to their individual needs. Care plans included information about how people preferred their needs to be attended to by staff. People and their family members were involved in the writing and review of their care plans. People had a range of activities they could choose to be involved in. A complaints system was in place that enabled people, relatives and visitors to raise any concerns. No complaints had been received since our last inspection.

The registered manager and provider were visible at the home and all staff stated that they felt supported by the registered manager. The management team in place were aware of their roles and responsibilities within the home. There was a system in place to monitor the quality of care and treatment provided at the home.

Further information is in the detailed findings below.

Bolters Corner Nursing Home provides accommodation and nursing care for up to 35 older people living with dementia and several other physical disabilities. The home is locates on the outskirts of Banstead Village within access to local amenities. A lift provides access to the first floor. The home is owned by Mrs Eleni Panayi and managed by her son who is the registered manager.

The home had a registered manager in post on the day 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 and associated Regulations about how the service is run.

We looked at the medicine policy and found all staff gave medicine to people in accordance with this policy. However we found issues regarding creams and lotions not being dated when opened and found medicines stored in the fridge were either out of date or no longer in use.

People told us they were treated well by staff who were kind and caring. People’s privacy and dignity was respected. We saw staff knocked on people’s doors before they entered, and personal care was undertaken in private.

People told us they felt safe. Staff had undertaken training regarding safeguarding adults and were aware of what procedures to follow if they suspected abuse was taking place. There was a copy of Surrey County Council’s multi-agency safeguarding procedures available in the home for information and staff told us this was located in the office for reference.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. The manager and staff explained their understanding of their responsibilities of the Mental Capacity Act (MCA) 2005 and DoLS and what they needed to do should someone lack capacity or needed to be kept safe. We saw people who required a DoLS authorisation had these in place.

Staff had a good understanding of the Mental Capacity Act 2005 and had undertaken training in this. We observed mental capacity assessments had been completed and best interest meetings undertaken where appropriate.

Risk assessments were in place where people had an identified risk. For example a person was required to have a soft diet because they were at risk of choking, and people who were at risk of falling had manual handling risk assessments in place to protect them from being hurt due to falls.

Care plans were well maintained, easy to follow and information was reviewed monthly or more frequently if needs changed. For example someone was having frequent falls and guidance from the falls clinic was clearly documented.

People’s health care needs were being met. People were registered with a local GP who visited the home weekly. Visits from other health care professionals for example care managers, chiropodist, dentist, and optician also took place.

People had sufficient food and drink to keep them healthy. We saw lunch was well organised and people had the choice of meals. There was sufficient staff support available for people who required help to eat. Where people had an identified risk in relation to nutrition this was managed well by staff.

There were enough staff working in the home to meet people’s needs. People said the staff were very good and they did not have to wait too long when they required assistance. We saw several examples of staff responding to call bells in a timely way throughout the day.

Staff recruitment procedures were safe and the employment files contained all the relevant documentation and safety checks to help ensure only the appropriate people were employed to work in the home.

The activity coordinator showed us the activity arrangements in place. People were engaged in activities in the lounge during our visit.

People had been provided with a complaints procedure and knew how to make a complaint should they need to. Relatives told us they knew who to talk to if they had issues or concerns.

There were effective quality assurance systems in place to monitor the service being provided, for example reviews of care plans, risk assessments, and health and safety audits.

The home was being well managed. People, relatives and staff said they found the registered manager approachable and available. Staff told us they felt valued and feedback from people about the quality of the service was positive.

Records relating to the care and treatment of people were stored securely and maintained accurately.

Due to the complex needs of the people who lived at Bolters Corner Nursing Home, they were unable to tell us about their experiences of living at the home. To address this issue, we spoke with visitors, observed care and examined relevant documentation. One visitor told us, "This is a lovely home. I'm very lucky to have my family member here". We noted that the home employed an activities co-ordinator and saw that a wide variety of social events and activities were on offer.

We noted that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

This inspection was undertaken to look at 3 outcome areas. This was to support the previous inspection that was published in November 2012, where less than 5 outcomes (2) were looked at.

People told us that there were enough staff and they liked the home and their rooms.

We found the home to be well maintained hygienic, fresh and clean.

We found that the provider did notify the Care Quality Commission (CQC) of any incidents involving people who use the service that involved abuse or allegations of abuse.

This was a follow up visit to check whether the provider had completed the action plan submitted to CQC following their last inspection in March 2012. The action plan related to staff training, staff supervision and record keeping. We did not speak to people who used the service on this occasion.

We spoke to two people who use the service who told us they were happy living in the home. A number of people were not able to tell us their views but we saw that they were at ease with staff and appeared relaxed in their company. The atmosphere in the service was calm and relaxed.

We spoke to three representatives of people who use the service who told us they were very happy with the care and support that was provided. Comments included the staff “are very, very good”, the staff do a “fantastic job” and that they get “peace of mind”.