Little Manor Nursing Home provides nursing care for up to 26 older people, some of whom may be living with dementia. At the time of the inspection there were 22 people resident at the home, of which eight people were in intermediate care beds. Intermediate care is a short term reablement service for people discharged from hospital and waiting to return to their own home. The home was last inspected in December 2013 and was found to be meeting all of the standards assessed.

The inspection took place on the 1 and 2 March 2016 and was unannounced.

There was a registered manager in post at the service. 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 told us they felt safe living at the home. Staff understood their responsibilities and the actions they needed to take to keep people safe from harm and abuse. Risks to people’s health and safety were identified and plans were in place to minimise these risks.

People’s medicines were managed safely and they had access to health care services when required.

Staff knew people well and supported them with maintaining their independence. People and their relatives told us staff treated them or their relative with kindness and respected their privacy and dignity.

People were supported to have sufficient to eat and drink to maintain good health. People told us they enjoyed the food and that there was always plenty available.

The registered manager investigated complaints and concerns. People, their relatives and staff were supported and encouraged to share their views on the running of the home. Their views were taken into account in the planning of the service.

Health and social care professionals spoke positively about the care and support people received and praised the management team. They said they found the staff and management team approachable and told us they sought advice and guidance where appropriate regarding changes to people’s care and support.

The provider had quality monitoring systems in place. Accidents and incidents were investigated and discussed with staff and at team meetings to minimise the risks of reoccurrence.

Arrangements were in place for keeping the home clean and hygienic and to ensure people were protected from the risk of infections.

Staff acted in accordance with the requirements of the Mental Capacity Act 2005. Where people did not have the capacity to make the decisions themselves, mental capacity assessments were in place and records showed that decisions had been made in line with best interests. Where required Deprivation of Liberty Safeguarding applications had been submitted by the registered

manager.

One person living at the home said ‘I get a choice of meals, I prefer to eat the same thing, but they ask me every day and I can change any time that I like’.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We saw that the home and the garden were accessible and well maintained.

Staff received appropriate professional development. One person said ‘I can ask if I want to go on training and go if I want to’. Another staff member said ‘supervision is adequate’.

The provider had some effective systems to assess and monitor the quality of service that people receive.

People told us the home met their needs and staff respected them. One person described how staff “always shut the door if they’re doing anything personal.” A person who had been admitted to the home with pressure ulcers told us they were “improving” with the care the home was giving them.

People said they liked the meals and they could choose what they ate. A person who had been admitted to the home recently told us “I was very surprised at the choice of food – I didn’t think it’d be like this.” We saw people received the support they needed to eat and drink.

The home was clean throughout, including areas such as sluice rooms and the laundry. All staff told us they were regularly trained in infection control.

People living in the home and staff said there were enough staff, with the right skills to meet people’s needs. A person who remained in their bed all the time told us they weren’t left on their own for long.

People said they could bring up issues of concern. A relative told us “you can tell the person in charge and it’ll all be taken care of. “

At the last review people told us that they were happy living at Little Manor. They told us that staff treated them well and that their care needs were met. People were satisfied with the environment and the food provided to them. People told us that their views were sought about the service and that they were able to confidently raise any concerns or worries with the manager.

People told us that they were happy living at Little Manor. They told us that staff treated them well and that their care needs were met. People were satisfied with the environment and the food provided to them. People told us that their views were sought about the service and that they were able to confidently raise any concerns or worries with the manager.

We saw that care plans were not always being followed. Accurate records were not always maintained. Confidential records were not always stored securely.