There was a registered manager in post. 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.

People told us that they were happy with the support they received with their medicines. One person told us, “The nurses here give me my tablets. Everything runs just as it should.” Systems in place ensured that medicines were managed and recorded appropriately. However, not all nurses had completed an annual competency assessment. We have identified this as an area that needs improvement.

Risks associated with the fire safety of the environment were not always identified or managed appropriately. Staff had not received appropriate fire drill training. We have identified this as an area of practice that needs improvement.

There were sufficient numbers of staff to ensure that people’s needs were met and that they received care and treatment promptly. People commented they felt safe living at Highbury House Nursing Home. One person told us, “Staff are quick to respond to the call bell and we can always find staff around.” Staff were aware of what actions they needed to take to raise a safeguarding concern. A staff member said, “By being a friendly home, I think people have trust in you as staff and raising any concerns becomes so much easier. I have done the safeguarding training and we have talked it over in meetings and I can assure you that I would report anything straight away, but it’s never come up.” Policies and procedures were in place to safeguard people. Essential training, as well as additional training to meet people’s specific needs, had been undertaken. Staff were encouraged to take further qualifications to develop their careers.

Care and treatment focused on the needs of the person and acknowledged their individuality and identity. There was a focus on meaningful activities to ensure people’s social and emotional well-being was fully promoted. There was an activity coordinator in post who led on the provision of meaningful activities. The importance of sharing this responsibility was understood by staff. One member of staff said, “We all have a role in the activities. So for example, I know that people like to get out and about so we go to Rudyard Kipling garden in the village or down to the seafront, anywhere they want to go.”

People spoke highly of the food. One relative said, “The food is absolutely delicious. Mum enjoys a lovely tart made with goats cheese. She let me taste it and it was good.” Any dietary requirements were catered for and people were given regular choice on what they wished to eat and drink. A relative told us, “[My relative] wasn’t eating very well when she first arrived. The cook made a point of coming over and introducing themselves and said, ‘If there’s anything you like I will make it.’ They send out an extra jug of gravy or cream out with the meals, as my relative doesn’t like their food too dry.” Risk of malnourishment was assessed and where people had lost weight or were at risk of losing weight, guidance was in place for staff to follow.

People told us they were happy living at Highbury House Nursing Home. One person told us, “It’s nice and homely here. It suits me very well.” People’s privacy and dignity was respected. Staff had a good understanding of people’s needs. They treated people with respect and protected their dignity when supporting them with personal care. One person said, “Staff here have love, care and compassion in abundance.” Relatives told us they could visit at any time and they were always made to feel welcome and involved in the care provided.

Care plans and risk assessments for people were in place and reflected people’s individual health and social care needs. Staff knew people well a

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

We spoke with five people who used the service, two relatives and one visitor. We also spoke with the provider and five members of staff, including the registered manager, two nurses and two care workers.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found

Is the service safe?

People were treated with respect and dignity by the staff. People who used the service told us they felt safe. A relative told us "It’s reassuring to know that (name) is safe and so well cared for here."

Systems were in place to make sure that the manager and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The registered manager compiled the staff rotas, they took people's care needs into account when they made decisions about the numbers, qualifications, skills and experience required. This helped ensure that people's needs were always met.

Policies and procedures were in place to make sure that unsafe practices were identified and people were protected.

The home had updated policies and procedures in relation to safeguarding adults at risk, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We were shown documentary evidence of a recent application that had been submitted, including details of the subsequent assessment and authorisation. Staff had received relevant training to understand and recognise abuse and knew the process for reporting any incidence of such abuse. This meant that people were safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them, and, as far as practicable, they were involved in developing and reviewing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People and their relatives said that they had the opportunity to be involved in reviewing care plans and they reflected current needs.

People's needs were taken into account with the accessible layout of the service, enabling people to move around freely and safely.

Visitors confirmed that they were able to see people in private and that visiting times were flexible. One relative told us “We were always made to feel so welcome when we came to visit mum, nothing was too much trouble. It was very comforting for us to know she was safe here and the care she received was just wonderful.”

The home had systems in place to assess and manage risks and to provide safe and effective care. Staff were appropriately trained and training was refreshed and updated regularly. Staff could also take the opportunities provided to study for additional qualifications and to develop their understanding of caring for people with complex needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A person using the service told us "The care is excellent. I’m very happy here and I tell people it’s the best care home in East Sussex.” One relative told us “Although she was obviously very ill, she always looked clean, comfortable and so well cared for.”

We saw that the staff took time interacting patiently and sensitively with people throughout the home. We observed that people were treated with consideration, dignity and respect.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People had the opportunity to take part in a range of social and recreational activities, reflecting their interests and preferences, both in and outside the service. An activities coordinator was employed and we saw an information board in the dining area which provided people with details of ‘What’s on for the month of July’.

People’s needs were assessed before they moved into the service and detailed and comprehensive care plans and risk assessments were maintained and reviewed regularly. This ensured that the care and support provided reflected any identified changes in people’s individual needs.

We were told by the manager that the service had good systems in place to monitor its own standards of service delivery and to gain feedback from people using the service, their relatives and other stakeholders. As well as satisfaction questionnaires, the manager told us they frequently carried out a range of internal audits, including care planning, medication and staff training. The manger also told us that they operated an 'open door policy' so people who used the service and visitors to the home could discuss any issues they may have.

People told us they were asked for their feedback on the service and their feedback was heard and changes were made as a result. People and their relatives, who we spoke with, also knew how to make a complaint or raise any issue or concern that they might have. They were also confident that their concerns would be listened to and acted upon.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care and support in a joined up and consistent way.

The service had established quality assurance systems in place and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service provision continued to improve.

Staff told us they were clear about their roles and responsibilities. Staff showed a good awareness of the ethos of the service and a sound understanding of the care and support needs of people who used the service. They told us that they felt valued and supported by the manager and were happy and confident in their individual roles.

During our inspection we spoke with five people who used the service. We also spoke with six staff members; these were the registered manager, a senior care worker, two care workers, a nurse and the cook.

We also took information from other sources to help us understand the views of people who used the service, which included resident meeting minutes and a residents’ survey.

The people we spoke with told us they were happy with the care they received and with the staff team. One person who used the service told us, “Excellent staff and excellent food. Everything is excellent.” Another person commented, “The staff are lovely. They look after me all the time.”

The people who used the service were supported to have adequate nutrition and hydration. People were given choices of food and drink that met their diverse needs. One person who used the service told us, “I’m really happy with the food. I always get a choice and there is plenty of it.”

The people who used the service were in safe and secure premises that promoted their wellbeing.

The provider had also ensured that sufficient numbers of staff with the right skills and abilities were employed to meet the needs of the people who used the service.

We also saw that care plans, staff records and other records relevant to the management of the home were accurate, fit for purpose and held securely.

There were 30 people who used the service at the time of our inspection. We used a number of different methods to help us understand their views and experiences. We talked to four people who used the service and two relatives. We observed the care provided and looked at supporting documentation. We spoke with five members of care staff, one nurse and the manager.

We saw that people had been involved in making decisions about their care and treatment. They had the opportunity to voice their opinions and they were listened to. Records showed that people's care needs had been assessed, planned, reviewed and delivered in line with their individual care plan. People told us they were happy living at the service. They told us they could be independent and that staff respected their choices. One person commented, “They (the staff) don’t stop you from doing anything. They give you help if you want them to and you can be independent”.

Medication was managed safely and people received their medication at the correct time. People who use the service were protected from the risk of abuse and told us that they felt safe at the service. People were protected by the service’s recruitment procedures. There were systems in place to identify, assess and manage risks to people who used the service.

We talked to one person about their medicines who told us that they were satisfied with the way their medicines were managed.