Holywell Nursing Home is registered to provide accommodation and nursing care to up to 30 people. The home specialises in the care of older people. At the time of the inspection there were 25 people living at the home.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good

The provider made sure all new staff were thoroughly checked before they began employment which helped to minimise the risks of abuse to people. People told us they felt safe at the home. One person told us, “There’s no nastiness here. Nothing to worry about.” There were adequate numbers of appropriately skilled and experienced staff to safely meet people’s needs.

People’s healthcare needs were constantly monitored by registered nurses. One person said, “No concerns on the healthcare front. Nurses come in to chat and sort things out.” People’s nutritional needs were assessed and met and people were very complimentary about the food served at the home. 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 home supported this practice.

People were supported by kind and caring staff who showed patience and understanding. Staff interacted well with people and provided on-going social stimulation. One person said, “There is always kindness and laughter.” People’s privacy and dignity was respected. The staff ensured that people were comfortable and pain free at the end of their lives.

The staff were responsive to people’s individual needs and people were able to make choices about their day to day lives. There was a variety of group activities and trips out that people could take part in if they chose to. People told us they would be able to make a complaint if they were not happy with any aspect of their care or support. One person said, “I don’t have any complaints but I’m sure they’d want to know if I did so I would certainly tell them.”

People benefitted from a management team who were passionate about providing good quality care to people and committed to on-going improvements. Staff morale was good which created a warm and happy atmosphere for people to live in. One visitor commented they felt part of “One big happy family.”

Further information is in the detailed findings below

This inspection took place on 2 February 2015 and was an unannounced inspection.

At the last inspection carried out on 25 June 2013 we did not identify any concerns with the care provided to people.

Holywell Nursing Home is a large detached property situated in the village of Brent Knoll. The home has ample parking, a pleasant garden and views of the surrounding countryside. The home can accommodate up to 30 people. It provides nursing care to older people. The home is staffed 24 hours a day and a registered nurse is on duty at all times.

The registered provider is also the manager of the home. As the registered person, there is no requirement for them to register a separate manager. 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.’

The manager described the ethos of the home as “open and honest.” They told us “The most important thing is that our residents are safe, happy and get the best care.” Staff morale was very good. Staff told us they were well supported and received appropriate training to meet the needs of people who lived at the home.

Many of the people who lived at the home were very frail and required staff assistance with all aspects of their life. Some people were nursed in bed. Staff were kind, compassionate and caring when interacting with people. People and visitors were very positive about the staff. One person said “I’ve been here for some time now. It’s just like home. They [the staff] couldn’t be better.” Another person said “Matron [the manager] and all the staff couldn’t be kinder or more caring. You are treated like a member of the family.” A visitor commented “I visit every day and all I see is kindness. You can tell that the staff really do care. It’s not just a job to them.” Another visitor said “We looked at several homes before coming here. As soon as we walked in here it felt like one big family. Everyone is so friendly and kind.”

People told us they felt safe and well cared for. They told us their needs were met by skilled staff and staff were knowledgeable and respected their wishes and preferences. One person told us “I feel very safe indeed. I sleep very well at night because I feel safe.” Another person told us “They [the staff] take time to find out what is important to you. Some things might not mean much but they are so important to me.”

Staff knew how to recognise and report abuse. They said they would not hesitate in reporting any signs or allegations of abuse to make sure people were safe. Staff sought people’s consent before assisting them and we heard staff offering and respecting people’s wishes. Improvements were needed to make sure people who lacked the mental capacity to make decisions had their legal rights protected.

The manager was not fully up to date with changes to the law about how to keep people safe when they lacked the mental capacity to make a decision for themselves. This meant that some people may have restrictions placed on them without legal protection.

People told us they could see a doctor and other health care professionals when they needed to. Examples included speech and language therapists, dieticians, opticians and chiropodists. One person told us “I lived locally so I was able to stay with the doctor I had at home. He has been to see me and the staff will call him if ever I am unwell. I am confident of that.” Another person said “I wasn’t feeling to well over Christmas. The staff were great. They told the nurse and the nurse arranged for the doctor to see me. I had some antibiotics and soon felt better.” The home ensured people received their medicines when they needed them.

The home had achieved the National Gold Standard Framework in October 2014. This is a comprehensive quality assurance system which enables care homes to provide quality care to people nearing the end of their life. A visitor told us “when my [relative] moved here we were supported to discuss my [relative’s] wishes. Not an easy thing to talk about but important. It was done is such a kind, caring and understanding way.”

People could see their visitors whenever they wished. One person told us “My family visit me several times a week. I like to see them in my room. The staff always great them with a smile and offer refreshments.” A visitor said “I visit every day and at different times. I am always made to feel welcome and the staff are so friendly and attentive.”

When we visited 23 people were living at the home. We spoke with 10 people, six members of staff and a visitor. The manager was available throughout our visit.

People told us they were consulted about the care they received. Comments included “the staff are excellent. They respect my choices and decisions” and “the staff here never make you do anything. They always check that I am happy with things.”

The people we spoke with were positive about the care and support they received. Comments included “the care and attention I get couldn’t be better. It’s more like a hotel” and “they look after me so well. I can’t think of anything they could do better. All the staff are so very kind.” One person told us “I just love it here. It is the next best thing to home and I wouldn’t want to live anywhere else.” A visitor told us “I feel such relief knowing that my X is being so well cared for. My X has improved so much since moving here.”

The home’s health and safety procedures minimised risks to the people who lived at the home. We saw that people had been provided with equipment in line with their assessed needs.

The home’s staff recruitment procedures meant that people were supported by staff that were suitable and appropriately trained.

There were systems in place which monitored and improved the quality of the service provided. The views of people who lived at the home were regularly sought and responded to.

People who lived at the home told us that they were able to make choices about all aspects of their daily lives. During our visit we observed that people moved freely around the home and they were able to access their bedrooms when ever they wished. Comments included “I am very happy here and I can go to my room when I please” and “there is always something going on but you don’t have to join in if you don’t want to”.

People told us that they had been consulted about their preferences for food, drink, activities and daily routines. Comments included “I feel the staff know me very well” and “they even know how many sugars I like in my tea”. We met with three visitors and all confirmed that they and their relative had been consulted about their likes, dislikes and preferences.

People appeared very comfortable in the presence of staff and it was evident that staff knew people well. Staff interactions were noted to be kind and respectful. The atmosphere in the home was relaxed and inclusive and people were offered assistance with personal care in a dignified and discreet manner.

People who lived at the home told us that they were treated with respect by the staff who supported them. Comments included “the staff are so kind and I never feel uncomfortable when they help me to go to the bathroom” and “the staff help me get into the bath and make sure I am safe but they let me have my privacy”.

We noted that everyone living at the home was very well presented which demonstrated that staff took time to support people with personal care and dressing.

All appointments with health and social care professionals had been recorded in care plans which demonstrated that people had access to appropriate professionals in line with their individual needs.

People who lived at the home were very positive about the care they received. Comments included “this is my home and all the staff are so very kind”, “the staff are kind and attentive and it seems that nothing is too much trouble”. We met with three visitors who said “their patience and kindness is unbelievable”, “their care and communications are excellent” and “I visit everyday and you cannot fault the care or the staff”.

Staff observed and spoken with, demonstrated a good knowledge of the needs and preferences of people living at the home. People who lived at the home confirmed that staff knew them “very well”. Visitors told us “they know my relative so well” and “they know all the things that are important to my relative”.

People were positive about the meals offered at the home. Comments included “the food is lovely” and “I get plenty to eat and it is very nice”. We observed people having lunch and this was a pleasant and relaxed experience for people. Staff offered assistance to people in an unhurried and dignified manner. People were offered a choice of meal and drinks.

People told us that they were provided with opportunities for social stimulation. Comments included “we often have trips out and I always go” and “there is always something going on here”. The home employed two activities coordinators and a varied programme of activities had been displayed in the home.

No concerns were raised with us during our visit and people told us that they would feel comfortable raising concerns if they had any. Comments included “I am very happy and would certainly tell them if I had any concerns” and “I could talk to any member of staff if I was unhappy”.

We met with three visitors and they told us that they had no concerns about the care their relatives received. They confirmed that they would not hesitate in raising concerns if they had any. All confirmed that they had received a copy of the home’s complaints procedure. They told us that their relative was “safe” and “well cared for “.