Mavern House Nursing Home provides accommodation to people who require nursing and personal care. Some people have dementia. The home is registered to accommodate up to 51 people. At our last inspection in November 2013, we did not identify any concerns.

The inspection took place on 25 and 26 October 2016 and was unannounced.

On the day of our inspection, there were 48 people living at the home. There were two lounges, an activities room, a separate dining room, bathrooms and toilets and a passenger lift to give easier access to both floors.

A registered manager was employed by 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. The registered manager was present on both days of the inspection.

The ordering, storage and disposal of medicines was managed effectively. We observed a medicines round during the inspection. The administration of medicines was done in accordance with current guidelines and regulations. However, there were gaps in signing of administration of some medicines which had not been identified by staff.

People told us they felt safe when receiving care. Staff were able to tell us how to recognise signs of potential abuse and what action to take if they had any concerns. People’s risk assessments had been made and recorded in people’s care files.

There were sufficient numbers of suitable staff to support people and safe recruitment practices had been followed before new staff members started working at the home. Staff responded to people’s needs in a calm and proficient way and had sufficient knowledge to provide support and keep people safe.

Arrangements were in place for keeping the home clean and help reduce the risk and spread of infection. People’s rooms and sanitary ware in bath and shower rooms were kept clean. Staff had sufficient personal protective equipment available which we saw being used throughout the inspection.

The service had a clear understanding on the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Following a recent audit which had looked at people’s care plans, the need to implement improved documentation; particularly around consent had been identified and the new processes were now in place. Some care records had been updated in response to this and the service were in the process of completing this for all people using the service.

Staff received regular training in relation to their role and the people they supported and told us this had supported them to do their job effectively. Staff received regular supervisions and an annual appraisal where they could discuss personal development plans. This meant staff received the appropriate support to enable them to provide care to people who used the service.

People were supported to maintain good health and had access to health services which included regularly seeing their GP with additional visits according to any changing healthcare requirements. We saw an example of this during the inspection when one person who had become unwell had been referred to their GP.

People and their relatives were positive about the care and support they received from staff. We saw staff support people in a kind and friendly way which also protected their privacy and dignity.

The documentation to monitor diet and fluid intake of people who were at risk of malnutrition and/or dehydration were not consistently completed. However, records to monitor risks identified in other areas such as pressure care were well recorded and this information had been well communicated between staff for example, during staff handover.

Staff understood the needs of people they were providing care for. Car

We found that people living at Mavern House were consulted about the support they received and that their consent was obtained. Where people lacked capacity, we found that their relatives or advocates were involved, in order to ensure people's best interests were taken into account.

People's health and welfare needs were being met and the support they received was appropriate to their needs. People and their relatives were very happy about the care provided. We found the management of medications to be safe and appropriate to people's needs.

We found that people were supported by well trained staff who in turn, were well supported by the home's management team. The quality of the service was being monitored and systems were in place to meet people's health, welfare and safety needs.

People told us they were happy with the care and treatment they received. They said they were able to make choices in their daily lives. They told us they decided when they got up and went to bed, what and where they ate and how they spent their day.

People said they appreciated having their own rooms, and being able to choose how they were decorated. One person told us "I have brought some of my own things into the home”.

Staff responded quickly to people when they asked for assistance. People told us

their rights to privacy and dignity were promoted.

Staff members made sure when they spoke to people who used wheelchairs they were at their eye level. People were invited to join in conversations about current affairs and people were spoken to respectfully.

People told us they would tell a member of staff or the manager if they were unhappy with their care or treatment. They said staff listened and they were confident that any issue would be satisfactorily resolved.

We saw on people’s care files that the views of relatives, social workers and health professionals were sought in the provision of care. We saw that people completed

questionnaires about the service and there were many positive comments.

People told us they were very happy with the care and treatment they received. They said they were able to make choices in their daily lives such as when to get up and go to bed, what and where they ate and how they spent their day. People said they could make suggestions for possible improvements to the home and told us they felt confident in raising a concern to staff or the manager.

People look well presented. People in bed looked comfortable with clean nightwear and fresh bedding. Call bells were within easy reach and people said they knew how to use them. Staff responded quickly to people when they asked for assistance. People told us their rights to privacy and dignity were promoted although we noted a number of areas which compromised this.

There were many social activities within the home that people could join in with. In addition, there was a resident artist, a resident story teller, a reflexologist and a community choir. People said there were regular trips out and about within the local community. There is a sensory garden for people to enjoy.