Kilfillan House is care Home’. People in care homes receive accommodation and nursing or personal care as single package under one CQC contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kilfillan House Nursing Home provides accommodation and nursing and personal care for up to 32 people. There were 27 people living at the home on the day of our inspection.

At the last inspection in April 2016, the service was rated 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 ongoing 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.

The service has 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.

The environment was well cared for and was clean in all areas. Providing a welcoming and homely environment for people in which to live.

People were safe being supported at the service. Staff were knowledgeable about how to protect people from harm. They had received effective safeguarding training. There were effective systems in place for the safe storage and management of medicine and regular audits were completed. People received their medicines as prescribed.

There were sufficient numbers of staff deployed to meet people's needs when required. Safe recruitment processes were in place to help ensure that staff were suitable to work in this type of service. Staff had received training and an ongoing support to help with their development.

People continued to be consulted about their care and they had detailed care plans in place which documented their individual needs, preferences and choices. Risks to people’s health, safety and wellbeing had been assessed and there were effective risk management plans in place which helped mitigate risks.

Care plans and risk assessments had been regularly reviewed to ensure that they were reflective of people's current needs.

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 supported this practice.

People continued to be supported to access a range of health care professionals to help maintain their health and wellbeing.

Staff were supportive and respectful. People's privacy and dignity continued to be maintained and respected. Staff knew people's needs and preferences and provided personalised support. People were generally supported to participate in meaningful activities and hobbies but further improvements to the current programme should be reviewed in order to ensure each person’s individual needs and interests are incorporated.

People and staff found the registered manager and deputy to be supportive and approachable and were very positive about how they managed the service. People felt listened to and staff were responsive to any concerns they raised. Quality monitoring systems and processes were used to make improvements when required.

This inspection was carried out on 6 April 2016 and was unannounced. At their last inspection on 10 June 2014, they were found to be meeting the standards we inspected.

Kilfillan House Nursing Home provides accommodation and nursing and personal care for up to 32 people. There were 26 people living at the home on the day of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 received care that met their needs. Staff had access to information within care plans that enabled them to provide care appropriately and safely. People were protected from the risk of abuse because staff knew how to recognise potential abuse and report concerns.

There were sufficient numbers of staff by the provider to meet people’s needs at all times and staff who were employed had undergone pre-employment checks to assess their suitability for employment in a care setting. Staff employed received regular training and felt supported by the management team to deliver care and support that was effective.

Staff were kind and caring towards the people they supported and each other and worked well as a team. They were clear about their roles and responsibilities and felt valued by the registered manager.

People were encouraged and supported to eat and drink enough to maintain their health and wellbeing, and had access to health and social care professionals, including the GP when required.

People were supported to participate in a range of activities and pursue hobbies that were of interest to them. We observed several activities in progress at the time of our inspection. People’s views on how the service was run and operated were sough through meetings and surveys.

There was a complaints policy and procedure in place and complaints were investigated and responded to appropriately. Comments and compliments were also recorded and we saw many positive messages from people who used the service and their families.

People, relatives and staff were all positive and complimentary about the way the home was managed. There were systems in place to monitor the quality of the service and where issues were identified, immediate actions were put in place to address the. The management were committed to achieving ongoing improvement.

As the home is medium size, the inspection team was made up of one inspector. We set out to answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

We found that the home was meeting all the standards we had inspected.

If you wish to see the evidence supporting our summary please read the full report.

You can see our judgements on the front page of this report.

Is the service caring?

We spoke with ten people and had sight of all the people who lived in the home. We saw that they appeared well cared for and that staff had taken care with the people’s appearance. We found that the people were cared for in a relaxed, comfortable environment by caring staff. We observed care and saw that there were sufficient numbers of staff on duty to meet the needs of people and to spend one to one time with the them. We saw affection between the staff and the people. There was a homely atmosphere, with the people at the centre of all the activities carried out on the day of our inspection.

Is the service responsive?

We were told by the people who lived in the home that ‘the manager and staff will do anything for you as soon as you ask’. We saw that staff were vigilant at all times and were ready to respond to the wishes and needs of the people. People who were confined to bed told us that they had regular staff visits. One person said that they did not get lonely as there were always staff popping in. We were told that call bells were answered promptly and that included during the night.

Is the service safe?

We saw that staff were aware of risk management and the balance between promoting independence and keeping people safe. We saw that equipment had been serviced appropriately, and that the premises were secure. Staff had been trained to recognise and respond to signs and allegations of abuse. The people told us that they felt safe at all times.

Is the service effective?

We looked at the care plans of four people and found that the people or their families had been involved in establishing what care they needed and how they wanted it delivered. We saw that care plans gave detailed instructions to staff to ensure the care they gave was effective. We saw that people who had long periods of inaction were protected from the risk of pressure areas. People had access to the local community and we were told that family members were always made welcome.

Is the service well led?

The home was managed in the best interests of the people who lived there. Staff told us that the manager was available to them should they need assistance. The manager or the deputy manager supervised the staff while they were delivering care and if there were issues they were addressed. Staff were well trained in all aspects of care delivery. The people told us that the manager was always there should they need anything they “only have to ask and it’s done”. One person said “Their relative was well cared for and that if they did not have good care they would find a different home”.

Staff were supported in their roles and had time to spend with the managers so that they could raise issues that may impact on how they cared for people.

The people who live at Kilfillan House told us that they were happy living there. They said that the staff were very kind and that they were well looked after. All the people we spoke with told us that they felt safe or very safe living there. We were told that the manager and the deputy manager were a ‘God send’ to this place. They said that they were helped to turn their life around. Another person said that the home had a “big heart” and that made a difference to the quality of life at the home.

Most of the people we spoke with said that the food could be better, the manager was aware of this and was addressing the problem.

We found that the home was meeting the standards we inspected. We looked at how people were cared for, how they were kept safe, how medicines were administered and how the home was managed.

People we spoke with told us that they were happy living at the home and that staff were able to meet their needs. Comments from people included “Staff are always respectful, I wouldn’t have it any other way” and “Staff are extremely helpful”.

During our observation we noted that interactions between staff and people using the service were positive and people were generally involved in tasks. People were generally happy and were relaxed in the presence of staff.

The relatives we had contact with were very positive about the service provided at Kilfillan House. People said it ‘exceeded their expectations’ and told us people’s complex needs were well managed with consideration for their individuality and dignity.

People told us their relatives were able to take part in the activities that take place and arrangements are also made for them to go out.

The majority of people were very positive about the approach of staff and said they always feel welcome when they visit.

The majority of people told us that Kilfillan House is well managed and they are able to speak openly with the manager and staff if they have any concerns.

Comments have also been received from a single source that on occasions there appear to have been shortages of staff as people have had to wait to get ready and at times people have experienced inconsistent levels of personal care.