This inspection took place on 26 January 2017 and was unannounced. The previous inspection of Churchill House was in December 2014. At that time there were no breaches of the Regulations.

The service had a registered manager. 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.

Churchill House is a care home with nursing care for up to 62 older people. People have general nursing care needs or are living with dementia.

The registered manager provided good leadership and management for the staff team. The service and staff demonstrated their commitment to care for people with dignity. They followed best practice for the care of people living at the home. They linked with care provider forums and ensured people had access to the local community. The service had a good reputation within the local community and also with health and social care professionals.

The service had a robust programme of audits in place to monitor the quality and safety of the service. Action plans were developed where shortfalls were identified so that improvements could be made. The provider reviewed the care provided so that people benefitted from a continually improving service. Any planned improvement actions were followed up to ensure they were implemented.

People were looked after with a person centred approach to care and where possible had been involved in developing their care plans. Knowledge of the person's history and personality assisted the staff team to provide the right support and maintain the person's dignity and choices. Care plans were well written. They provided detailed information about how the person wanted to be looked after and how their care was to be delivered.

People were encouraged to have a say about things that mattered to them and to raise any concerns they may have. People were looked after by staff who were kind and caring. Staff went the extra mile to ensure that people who had reached the last phase of their life could do so with dignity and comfort. The staff met not only their specific care and support needs but also their emotional, spiritual and social needs.

The staff formed good working relationships with the people they looked after but also genuinely cared about them. People felt they were well looked after. People were able to participate in a range of different meaningful activities, both in Churchill House and outside of the service.

People were provided with an exceptional and distinctive service that met their individual needs. They were encouraged where possible to make their own choices and decisions about aspects of their daily life. Staff knew what to do to ensure that any decision made on behalf of people were made in their best interests. We found the service met the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were provided with the food and drink they liked to eat. They were provided with choice and given sensitive assistance if they needed help to eat their meal. Where people were at risk of malnutrition or dehydration there were plans in place to reduce that risk. Arrangements were made for people to see their GP and other healthcare professionals as and when they needed to do so.

People were kept safe. This was because any risks to their health and welfare was well managed. The premises were well maintained and staff were trained in how to move people requiring assistance from one place to another safely. Staff received safeguarding adults training and were knowledgeable about safeguarding issues. They knew what to do if concerns were raised and who to report the concerns to.

Pre-employment checks were robust and ensured that, as far as possible, unsuita

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. It was last inspected in April 2013 and no areas of concern were identified.

Churchill House provides accommodation, nursing and personal care in four houses for up to 62 people who have nursing or dementia care needs. There were 62 people living at Churchill House when we visited.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were policies and procedures in relation to the MCA and DoLS to ensure that people who could make decisions for themselves were protected. We saw from the records we looked at that where people lacked the capacity to make decisions about something, that best interest meetings were held.

We looked at care plans for five of the people that lived there. They covered a range of needs and had been reviewed regularly to ensure that staff had up to date information. There were also detailed assessments about the person's health that included specific care plans.  We observed that staff were able to support people with dignity and respect in a safe and caring manner. We saw that when required other health professionals had been involved to help improve the care that people received.

Care records we looked and what we observed demonstrated to us that people had a choice of varied activities. People who chose to do something themselves were supported by staff to enable them to do so.

Systems were in place to monitor and review people’s experiences and complaints to ensure improvements were made where necessary. Regular resident and family meetings meant that people were given the opportunity to make any comments on the care they received.

All of the professionals, relatives and staff felt that the service was well led. There were systems in place to ensure that the provider was able to monitor the quality and safety of the service that was provided.

People we spoke with who lived in the home were very happy with the service they received. They told us that the atmosphere was, “Very nice and friendly”. One person said, “It’s lovely here”. We also spoke with a relative of someone who lived in the home and a visiting doctor. Both were very complimentary about the home.

People told us that they helped develop their own support plans and took part in regular reviews to ensure that they continued to reflect their needs.

People were supported to meet their individual needs in ways that promoted their health and wellbeing. People told us how they lived their lives as independently as they were able with support from staff when they needed it. Staff were very knowledgeable about people’s individual needs.

We found that medicines were safely stored, handled and administered. Medicine records were accurate and doctors’ instructions were properly acted upon.

Staff told us they had attended a range of training courses to equip them with the knowledge and skills to carry out their duties effectively. The staff also had the opportunity to regularly meet with their manager to review their performance and address any training and development needs.

We found that the provider had a suitable system in place to monitor the quality of the service it was providing.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience that is a person who has experience of using services and who can provide that perspective.

Fifty four people were living in the home when we visited and we were able to talk with seven people about their experiences of living there. We also talked with three staff including the manager who worked an afternoon shift during our inspection visit and looked at the care plans for three people who lived in the home to see how their needs should be met.

Some of the people who lived in the home were not able to talk directly with us because of their health conditions so we used different methods to see whether they received the care and support they needed. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

During our observations we saw that there were good relationships between the staff and the people that lived in the home. Staff were friendly and respectful when speaking with people. We saw that staff offered people assistance with their personal care discreetly. Staff offered people choices during the day these included, how they wanted to spend their time.

People who lived in the home that we were able to speak with told us that they were happy with the standards of care and support from staff to meet their needs. Comments received included:-

''Very happy here.''

''I like the staff and they help me if I need them to.''

''No concerns about the care I receive.''

We observed lunch being served to people during our visit. Staff were seen to offer people choices of where they would like to eat their meal. Some of the people who lived in the home who we spoke with told us that they were happy with the meals provided at Churchill House Nursing and Residential Home. One person told us, ''I can have other meals if I don't like what is on the menu.''