This inspection took place on 28 February and 1 March 2017 and was unannounced. This was the second rating inspection at Mowbray Nursing Home. We previously rated the service provided as good in four areas with a rating of requires improvement in one area. Overall the provider was rated as good.

The provider is registered to provide accommodation with nursing or personal care for up to 39 people with a range of needs including dementia care.

There was a registered manager in post at the time of our inspection. 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 2008 and associated Regulations about how the home is run.

People told us they liked the staff and were treated well making them feel staff. Staff we spoke with knew of their responsibility to protect people from the risk of abuse and knew the signs people may display. The registered manager had reported concerns regarding the care people had received prior to their admission to the nursing home. People told us staff were kind and caring and encouraged independence where possible. People were aware of the registered manager and of their right to complain about their care if needed.

The registered manager had systems in place to ensure sufficient staff were available to meet the assessed needs of people. People told us they felt their needs were met and the majority believed staff responded in a timely way when they needed assistance. People told us they were able to participate in organised events at the home or spend time in their own bedrooms.

The provider had recruitment arrangements in place to ensure staff were suitable to work with people and were of good character. Staff received induction training before they started working at the home including time with experienced staff members. Staff received on-going training and were able to identify training which they believed would be beneficial to their learning and development. Staff were able to attend staff meetings and felt supported by the management.

People confirmed staff sought permission prior to providing care and support and felt they were able to make choices about their care. The registered manager was able to assure us that people were provided with care and support in line with their individual choice. Staff were aware of the need to support people in the least restrictive way and to ensure people were not unlawfully restricted.

People were supported to maintain their health and welfare. Visiting professionals were confident in the care people received at the home. Professional were complimentary about the nutritional support people received as well as the choice of diet provided and medicines management. People had access to healthcare professionals as needed to maintain their welfare.

The registered manager had systems in place to monitor the quality of the care provided and to monitor events which took place in the home to assist keeping people safe. Risks to people’s care and support were assessed and reviewed as needed. The registered manager had visions for the future development of the care and support provided for people to further enhance the quality of life people experienced.

The inspection at Mowbray Nursing Home was unannounced inspected and took place on the 20 April 2015. The provider of Mowbray Nursing Home is registered to provide accommodation for people who require nursing or personal care for up to 39 people. At the time of the inspection 35 people lived at the home.

There was a registered manager in post. 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.

Some people felt that at times staff did not always respond effectively and in a timely manner when they needed care and support having rung their call bell. We found with the exception of delays answering the call bell that people felt safe. People who lived at the home told us that they felt safe. These comments were shared by relatives that we spoke with. Staff were knowledgeable regarding their responsibility to keep people safe and were aware of the actions they would need to take if abuse took place. We found that people were cared for in a supportive way which did not restrict their freedom.

We found that some improvement was needed with the management of medicines to ensure that people always received the correct dose and that any changes to their regime were acted upon.

People were cared for by staff who had received training and support to enable them to meet people’s care needs. People had access to healthcare professionals who were complimentary about the level of care and support provided.

People we spoke with were complimentary about the food provided and received regular drinks throughout the day. Staff were aware of people’s dietary needs as well as their individual likes and dislikes. We found that these were reflected in the care provided.

We saw that staff were caring and respectful to people who lived at the home and ensured that their privacy and dignity was maintained. People told us that they were listened to and that they were involved in the planning of the care. People’s personal history and past experiences were known. People were able to participate in hobbies that interested them.

People we spoke with were confident that any concerns they raised would be listened to and that the registered manager would take the necessary action to improve things. People who used the service as well as relatives and staff told us that they had found the registered manager to be supportive and approachable.

The provider had systems in place to ensure the quality of care provided was monitored. Audits and surveys were in place and showed what actions had been taken.

At the time we inspected this service, there were 24 people who lived at the home, all of whom had varying levels of needs. We talked with three people. They told us they were happy with the home and the staff. One person told us: “The staff are excellent, I can’t fault them.” Another said: “It is marvellous here.” We also spoke with five relatives of people who lived at the home. They were very complimentary about the care their relatives received. One relative said: “They cater for X’s needs very well.” We also spoke with the manager, the provider’s area manager and two members of staff.

We watched staff as they cared for people. They provided care and support that met people’s needs. We found that staff knew about the needs of the people they cared for. We looked at care records for two people and found that these contained guidance for staff on how to meet their needs. We saw that people’s needs had been reviewed regularly.

We found that medicines were prescribed and given to people appropriately. We also found that medicines had been secured stored and managed safely.

People were protected from the risk of harm and abuse because staff had received training and had a clear understanding of their roles and responsibilities with regard to safeguarding. Staff told us that they had been supported by the manager and had received training that they needed to do their jobs. Records had been maintained appropriately and stored securely.

During our inspection we spoke with four people who used the service, three visitors and five members of staff. People who used the service were complimentary of the service and told us that they were cared for well. One person who had recently moved into the service told us, “It is excellent. I couldn’t have wished for anything nicer”.

Two people who were regular visitors to the home told us that they were always made welcome and never had any concerns about peoples care when they visited.

We saw that staff cared for people well and that they had a good understanding of people's individual needs and personal preferences. Care plans had been recorded for each person which detailed the care needed to be given by staff. The information staff gave us about the people they cared for matched the information we saw in people's care plans.

There had been a number of improvements to the environment since our last inspection. These had included a programme of redecoration, improvements to bathing and shower facilities and the purchase of some new equipment. All of the equipment and areas of the environment we looked at on the day of our inspection were clean.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

Many of the people who live at the home were unable to speak to us because of their condition. However, we spoke with four people living there, and a relative who was visiting a person living at Mowbray. We saw that staff were kind and caring, and spoke to people respectfully. One person said that they were “very kindly taken care of”.

Most of the people who live at the home were resting after lunch, so we were unable to speak to them.