This inspection took place on 26 and 28 November 2018. The first day of the inspection was unannounced. This meant that the provider and staff did not know we were coming.

This is the first time Marigold Nursing Home been inspected.

Marigold Nursing Home is a 'care home.' People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Marigold Nursing Home cares for up to 34 some of whom have nursing needs and/or may be living with dementia. At the time of our inspection 29 people were living at the home.

A registered manager was in place. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

People and relatives told us the service was exceptional and many told us how dedicated staff had been a positive influence on their family member. External health care professionals also expressed how they were impressed by the caring nature of the staff. One health care professional stated, “The level of care that [staff member] gave to [person] was phenomenal and worthy of recognition.”

The excellent management of the home had been recognised in a Healthwatch visit with the award of a star award. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The registered manager was motivated and passionate about making sure people received the best care possible. They demonstrated strong leadership skills, empowering staff through education, reflection, encouragement and praise. The registered manager was fully supported by the provider.

The registered manager conducted extensive research into dementia and participated in projects with the Department of Health and the Alzheimer’s Society. They used this information in the design of the dementia friendly environment and creation of stimulating activities. People were encouraged to take part in a range of activities to support both their physical and emotional wellbeing.

The service had a warm friendly atmosphere. Staff were kind, considerate and displayed genuine affection to people. We observed many warm and friendly interactions between staff and people living at the service. Staff clear knew people well and showed genuine warmth and affection when supporting people. Staff were motivated to follow the provider’s values and ensured people had ‘an enhanced, meaningful and purposeful lifestyle.’

The provider had an extensive range of quality assurance systems to monitor the quality of the service, with a strong focus on driving improvement. The service actively sought feedback from people, relatives, staff and external healthcare professionals.

The provider had systems in place to safeguard people from the risk of abuse and discrimination. Safeguarding referrals were fully investigated. The provider recorded, collated and analysed safeguarding concerns and accidents and incidents to identify any patterns or trends for lessons learnt.

A rigorous recruitment process was in place. The registered manager was keen to ensure only suitable, capable and caring staff were appointed into the posts. Relatives and people using the service took part in the recruitment process.

Staff managed medicines safely. The service maintained a high standard of cleanliness and hygiene. People were supported to access health professionals when required.

The registered manager ensured there were enough competent, skilled staff on duty to meet people’s need. The service regularly reviewed staffing levels and adapted them to people’s changing needs.

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