Llysfield is a care home which provides residential and nursing care for up to 30 people. People living in the home have a mixture of needs, from requiring support with personal care to requiring nursing intervention for a particular medical condition. At the time of the inspection there were 24 people living at the home.

This was an unannounced inspection that took place on 8 November 2016. The home 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 and associated Regulations about how the service is run. The registered manager was not on duty at this inspection.

We last inspected this home on 30 September 2015 where we identified one breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to people who had not been able to make a decision about their own care. The provider had not recorded why a certain decision had been made for them by staff. We asked the provider to submit to us an action plan outlining how they planned to meet this regulation. We reviewed the action plan during this inspection to see whether or not the provider had taken appropriate action. We found the provider had taken sufficient action to show they were now meeting the regulations.

Staff understood their role in keeping people safe. Staff carried out risk assessments and created plans to minimise known hazards whilst encouraging people's independence. There were sufficient staff in the home to help ensure people received the care and support they required.

Recruitment processes were in place to ensure that those staff who were providing care were suitable to be working at the home.

Staff followed the provider’s procedures in administering medicines and medicines were stored safely.

Care was provided by staff who were trained and received relevant support from their line manager. Staff told us they felt supported by the registered manager and enjoyed working in the home.

Staff provided care in line with the Mental Capacity Act 2005 (MCA). Records demonstrated that people's rights were protected as staff acted in accordance with the MCA when being supported to make specific decisions. The staff were aware of when people may be restricted and the need to submit applications to the supervisory body in relation to this.

People were provided with a choice of meals each day and those who had dietary requirements received appropriate foods. Staff followed the guidance of healthcare professionals where appropriate.

There was a caring and calm atmosphere in the home where people and staff interacted together well. People and relatives were very happy with the care provided and relatives were made to feel welcome when they visited.

Staff supported people to take part in various activities. Staff were attentive to people and knew them well.

People knew how to make a complaint if they felt the need to. Suggestions raised by people were responded to by management.

Care plans contained information to guide staff on how someone wished to be cared for. Staff had a good understanding of people's needs and backgrounds as detailed in their care plans.

Quality assurance checks were carried out to help ensure the environment was a safe place for people to live and they received a good quality of care. People and relatives were given the opportunity to provide feedback on the care they received.

The inspection took place on 30 September 2015 and was unannounced.

Llysfield nursing home is registered to provide accommodation with nursing care for up to 30 people. There were 25 people living at the home on the day of our inspection.

There was a registered manager who was present during the 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’s right to make their own decisions about their care had not been appropriately assessed. Where decisions had been made on people’s behalf there were no records to show that these decisions were in their best interests.

People’s privacy and dignity was not consistently protected. During our visit one person was examined by the doctor in the lounge where other people were present.

The provider had checks in place to assess and monitor risks associated with people’s care and treatment. People’s care plans contained information on how to reduce these risks and were followed by staff. However staff did not always complete the required records to show the daily actions they had taken.

People and their relatives felt that they and their belongings were kept safe. Staff were aware of the risks associated with people’s needs and knew how to keep people safe from harm or abuse.

People were supported by staff who had the skills to meet their needs. Staff had received training and support to enable them to fulfil their roles. Relevant checks had been made to ensure staff were suitable to work at the home.

People received their medicine when they needed it. Staff made sure medicine was given to people safely and maintained accurate records. People were able to see health care professionals as and when needed.

People’s nutritional needs had been assessed and regularly reviewed. They were given support to eat where needed and drinks and snacks were readily available.

People were treated with kindness and respect. People were supported to identify their needs and preferences for care delivery.

People were able to choose how and where they spent their time. Staff supported people to take part in activities or outings of their choosing.

People and their families were encouraged to give feedback on the quality of the service and to make suggestions for improvement. The provider had a complaints process and people felt confident and able to raise any concerns with staff or management.

All eight people spoken with were positive about the care and treatment they received. One person described the care as “very good”. Another person told us that the staff were “very good” and “marvellous”. Staff spoke to people respectfully and people were able to choose where they preferred to spend their time.

People's needs were assessed and care and treatment was planned and delivered in line with their individual needs. Care plans were detailed and regularly reviewed. This helped ensure that all the needs of people were met.

There were arrangements in place for the safe storage and administration of medication. Care records contained people’s signed consent for the home to manage their medication. A person centred medication profile had also been completed for people, highlighting how best to support people with taking their medication.

People using the service and their relatives were asked for their views about care and treatment and they were acted upon where necessary. People spoken with were happy with the service they received and told us “there is nothing to complain about” and “I have no complaints at all”.

We spoke with six of the 21 people living at the home. We also spoke with the registered manager, two visitors and five staff. People were very satisfied with the way they were looked after and the standard of the service at the home.

We saw that people were offered choices about how their care was delivered and how they spent their time. We observed staff being kind and courteous towards people.

Care records were kept securely and well organised. Staff knew how to find information about each person’s care needs in the care plans. Some people were able to remember being asked about how they wanted their care to be provided.

People were very satisfied with the standard of service provided and comments included "it's marvellous here", "the foods beautiful" and "the staff are very kind to me".

Systems were in place to make sure that people were safe and could raise any concerns or complaints. People told us that they felt safe at the home.

Recruitment procedures made sure that the people working at the home were suitable.