This inspection took place 14 and 15 August 2018 and was unannounced, which means they did not know we were coming. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

Herons Park Nursing Home 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.

Herons Park accommodates 82 people across three separate floors, each of which have separate adapted facilities. One of the area specialises in providing care to people living with dementia.

There was a registered manager in place at the time 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 2008 and associated Regulations about how the service is run.

People continued to tell us they felt safe living in the home. Staff showed good knowledge in how they were to protect people from harm, and recognised the signs of abuse and knew how to report this. Staff had identified potential risks to people and had put plans in place to reduce the risk of harm, without taking away people’s right to make decisions about their care. People were supported by enough staff to keep them safe and meet their needs. People’s medicines were managed in a safe way. Staff carried out safe practice to reduce the risk of infection.

People’s care continued to be assessed and reviewed with external healthcare professionals involved and listened to. People were supported to have a healthy balanced diet and where people required additional support with their eating and drinking staff knew who required this support. 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 worked with external healthcare professionals and followed their guidance and advice about how to support people.

Staff treated people as individuals and respected the choices they made. People were treated with respect and their dignity was promoted. People care was delivered in a responsive way, with any changes in care being communicated clearly to the staff team. People were supported to maintain their hobbies and interests. People had access to information about how they could complain about the service. Where the registered manager had received complaints, these had been responded to, with a satisfactory outcome and learning shared.

People told us they had the opportunity to raise their suggestions and ideas about how the service was run and these were listened to. Staff were supported by the registered manager and provider to carry out their roles and responsibilities effectively, through training and daily contact. People, relatives and staff felt the registered manager was approachable and listened to them. We found checks the registered manager and the provider completed on the service focused upon the experiences of people.

The inspection was unannounced and took place 19 January 2016.

Herons Park is registered to provide accommodation and personal and nursing care for adults who may have a dementia related illness for a maximum of 82 people. There were 71 people living at home on the day of the inspection. The home is over three floors, one of which provides nursing care to people living with a dementia related illness.

There was a register manager in place however they were not working on the day of the inspection and were due to leave the location at the end of January 2016. A 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.

People felt safe living at the home and that the care and nursing staff were friendly. All staff told us they were confident that they understood how to keep people safe from the potential risk of abuse and what the action they would take to protect a person at risk. Nursing staff provided people with their medicines when they needed them and kept records to show what medicines had been given.

People were able to tell care staff about the care and treatment they needed and day to day decisions. Where people had not been able to make decisions on their own they had been supported by the management team to have decisions made in their best interests. People were assured that all staff have been trained and understood how to look after them. All staff we spoke with felt they had the right skills and knowledge and attended regular training to ensure they kept their knowledge updated.

People were involved in choosing their meals and all staff were seen to support people to eat and drink if needed. People told us the food was nice and well prepared with lots of choice at each meal time. People were supported to access local professional healthcare outside of the home. They had regular visits from their GP, dentists and opticians. Where appointments were needed at hospital or with consultants these were supported by care staff and any changes to care needs recorded and implemented.

People told us they enjoyed the company of staff and got to spend time with them chatting and getting to know them. All staff told us that whilst they provided care they also spent time with people to ensure they were happy and relaxed in their home. Visitors to the home felt their family members were well cared for and that the care staff always stopped to chat and update them with any changes.

People enjoyed some group activities which staff provided twice a day. People also got to enjoy their own hobbies and interests. People and relatives felt that all staff were approachable and listened to their requests in the care of their family member. Complaints were recorded and responded to and people felt their ideas or concerns were acted on. People and visitors felt the management team and staff at the home were easy to talk to and they felt they were listened to.

Care staff felt the management team listened to and involved them when providing feedback on the service. The management team ensured regular checks were completed to monitor the quality of the care that people received. Areas of improvements were planned to improve one lounge for people living with dementia.

When we visited the home we met with people who lived there, the registered manager, nurses and care workers. We observed how staff talked with people to offer advice and support. We asked a person who was using the service if they could decide when to go to bed and get up in the mornings, they said:

“I can do that when I feel like it”.

People who were using the service told us they received appropriate care and that their needs had been assessed before they moved into the home. The care plans we reviewed included information and staff guidance about people’s specific needs.

We saw that people were quite relaxed, at ease with staff and comfortable within their environment. We observed that people readily asked staff to carry out tasks for them and that staff responded in a positive and timely way. We found that there were systems in place to protect people from risks of abuse.

We were shown information that confirmed enough staff had been rostered to care for the people who were living in the home. People using the service had a good relationship with staff and were complimentary about them, one person said:

“I have found them very, very kind and sociable, I can’t fault them”.

We found that the home received relatively few complaints but the ones received had been dealt with appropriately and full responses had been sent to complainants. Where improvements could be made the home had put the systems in place to achieve them. The people we spoke with during our inspection visit told us they were happy with the services they received.

We spoke with 12 people who lived at the home, eight visiting relatives and nine staff. We spent some time in communal areas and observed the interaction between staff and people who used the service. We also observed how staff interacted with people who were unable to express their views.

Consent had been obtained from people before care and treatment had been provided. Alternative arrangements had been made to support people who were unable to consent to their treatment or support. Staff told us they: “Always ask people if it’s ok or if they are happy with me providing care”. One staff member said: “It’s about individualising the care and promoting choice and independence”.

People received the care and treatment they required in line with their individual care plan. Staff told us they were aware of each person’s needs and how to give care and support to meet those needs. People told us: It’s fantastic here and I am very happy”. A relative we spoke with said: “We visit at least four times a week and the care is good”.

People told us that they felt safe living at the home and knew who to speak to if they had any concerns. Staff knew how to recognise signs of abuse and knew who to report concerns to.

We saw that although staff were supported to be trained to an appropriate standard some parts of their training had not been refreshed recently.

We looked at records which showed that the provider regularly monitored the quality of its service.