This inspection took place on 11 September 2018.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Neville House Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

Neville House is located in Chadderton, Oldham. The home provides care and accommodation for up to 22 older people. Bedrooms are situated on the ground floor and first floor of the home. Access between floors is via a passenger lift and staircase. The building is situated in its own grounds with gardens and off-road parking. At the time of our inspection 20 people were living at Neville House Residential Care Home.

There was a registered manager in place. 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.

We made an recommendation that the service refer to the latest best practice in supporting people with their sensory needs.

We made a recommendation that the service refer to the latest best practice in relation to activities in order to provide more stimulation for people.

Staff knew people's care needs, preferences, personal histories and backgrounds. People said staff protected their privacy and their dignity was respected. People were supported to be independent.

People said staff treated them with kindness and compassion. Comments included, “I am happy and like living here. Everyone is kind. It is a friendly, homely place," and "[Registered manager] is very approachable, good and caring.”

People received care from staff who were appropriately trained to effectively carry out their job roles. People were supported to have maximum choice and control of their lives. The service acted in accordance with the Mental Capacity Act (2005).

People's nutritional needs were met and they were supported to maintain good health and receive ongoing healthcare support.

Staff were aware of their responsibilities to safeguard people from abuse. Safe recruitment practices were in place and the service followed national and local safeguarding guidance.

There were sufficient staff to care for people. Risks to people's safety were assessed and medicines were administered safely.

We found records were written in a positive and respectful way and provided appropriate guidance on how to support people safely.

Neville House had arrangements in place to receive feedback from people that used the service, their relatives, external stakeholders and staff members about the services provided. This information was used to support continuous improvement.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there and their relatives. Staff had regular supervisions and were invited to team meetings.

The inspection took place on 1 March 2016 and was unannounced, which meant the provider did not know we were coming. At the last inspection, in September 2014, the service was judged compliant with the regulations inspected.

The service has a registered manager who has been registered with the Care Quality Commission since December 2010. 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.

Neville House Residential Home provides support with personal care needs for up to 18 older people. There was 17 people receiving a service at the time of this inspection. The home provides accommodation on both the ground and first floors in eight single and five shared rooms. A passenger lift is available. On the ground floor there is a large lounge and a conservatory which is used for dining.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The registered manager had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, however the applications were still awaiting authorisation.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. For example we saw evidence that the home regularly made contact with district nurses, community nurses for mental health issues, and peoples own doctors. Other health professionals such as dieticians, dentists, occupational therapists and opticians were also requested as needed.

People told us that they received their medicines on time. Our observation of part of two medication rounds together with our review of records provided evidence that medicines were safely administered.

There were robust recruitment procedures in place, and there were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff told us they felt supported by the manager and provider. However, formal supervisions and appraisals were still being brought up to date. The registered manager has agreed a timescale for these to be in place.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked. We observed people being offered a second helping during breakfast and lunch. Snacks of fruit and biscuits and drinks were also available for people throughout the day.

People were able to access activities. We observed a quiz and we saw people enjoying being pampered in the morning. The registered manager told us that dedicated time is allocated during the morning and afternoon to facilitate activities.

Staff were positive about the registered manager and the way in which she led the service. They told us that the registered manager was always around and was approachable and proactive in trying to make the service as good as possible. The registered manager had clear goals for the service and spoke about future developments for the home which included an extension to the building.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints proce

Neville House is a care home offering accommodation and support for up to 18 people. Five rooms were shared and eight were single. At the time of our visit there were 17 people living at the home.

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

This summary is based on a visit to the home where we spoke to the manager and observed staff interactions with people using the service. We looked at records and talked in private with four visiting relatives, three people using the service two health or social care professionals and three members of staff.

The full report contains the evidence to support this summary.

Is the service safe?

The people we spoke with at the inspection visit were positive about the care provided by the home. Visitors told us they thought their relatives were safe.

Staff who we spoke with told us they believed people using the service were protected from abuse or exploitation. Comments from staff included: “I couldn’t work with poor care being delivered”; “[the best thing is] the way people are treated”; and “[safe?] very much so”.

There was documentary evidence that staff had received training in the safeguarding of vulnerable adults. This was confirmed by staff who we asked. Staff also told us they understood the need to be vigilant and, to whistle blow if necessary.

We had a quick tour of the building. This included communal areas and a small selection of people’s bedrooms. No obvious hazards to people’s health and safety were seen. Staff were provided with disposable gloves and aprons to help minimise the risk of cross infection.

Is the service effective?

Each individual’s care needs were assessed and reviewed. A care plan was developed on the basis of the assessment. People who used the service and their relatives where appropriate could contribute to decisions about the best way to meet their needs. People who used the service and visitors who we asked, all told us they were listened to by the staff at the home.

Staff were made aware of the up to date needs of each individual. Staff told us that communication within the home was good.

Staff followed advice from health care professionals

Is the service caring?

Observations of interactions between staff and people using the service indicated a warm and caring atmosphere.

All people who used the service and their relatives spoke positively about the caring attitude and approach of the staff. Comments included: “[staff are] pleasant and interested in people”; “I feel comfortable with them [staff]. I don’t feel embarrassed or shy because they put your mind at ease” and “Brilliant. Carers can’t do enough for them [people who used the service]”.

Is the service responsive?

We did not look specifically at the service’s complaints procedure at this visit. However, people using the service and visitors who we asked during our visits said they believed they would be listened to if they had a complaint. Staff were confident that the registered manager would respond positively to any issues which were raised.

People who used the service and their relatives said that they were comfortable talking to staff and believed that their views were listened to. One person told us that amongst the best things about the home was “you can always go to anyone you need to and they will listen to you.”

There were quality monitoring and quality assurance systems in place.

Is the service well led?

The registered manager provided strong leadership and gave staff a clear understanding of what good practice was. Staff told us that the registered manager was approachable, supportive and encouraged staff to further improve their practice by attending training.

Staff also confirmed that the registered manager provided good leadership. One staff member said “Rachel is clear and we know what we are meant to do”.

Several visitors and people who used the service commented on how approachable the registered manager was. Comments included “”you can talk to Rachel [the registered manager]. She is very good and makes you feel happier” and “Rachel is absolutely fantastic – can’t praise her enough”.

We spoke with three people who lived at the home and one visiting relative. One person said “It’s excellent here” and “They [the staff] help me when I need it”. Another person said the staff were not “pushy”, “always asked permission” before providing assistance and “respected” their wishes. The visitor we spoke with said their relative was “happy” living in the home.

People were consulted about their day to day care needs and we saw that they received respectful and supportive care from staff. The three care staff we spoke with demonstrated a good understanding of providing individual support to people.

People said the manager was approachable and they could voice a concern or complaint and be confident that it would be addressed.

The management of medication and staff recruitment practices were appropriate. Records were kept up to date and maintained securely.

At the time of our visit 18 people were living at the home. We spoke with three people and asked them for their views and experiences of staying at the home. We also spoke with two visitors at the home. We heard that people felt they received good care. People told us “Staff look after us properly”, “Staff respect you. They are smashing” and “They treat me as though I was someone special”. We heard that people felt safe.

We heard that visitors were welcomed. One visitor said that there was “Always a cosy atmosphere in the home”. Another visitor said that their relative had stayed in local authority care services previously but the service provided at Neville House Residential Home was even better. The person said staff “Give 120%”. We heard one visitor say they had “Complete faith” their relative was all right when they left the care home.

Both visitors told us that there is always something going on no matter what time of day they visited. One person said they played quizzes, games, sing-a-longs, and bingo and watched DVDs.

We heard that people’s wishes were respected. One person said “Staff listen to you and you do have choices”. People told us the food was very good and that it was “Always homemade”.

We heard that the manager and staff were “Amazing” and that they worked hard. People told us they thought the home was very clean.

We spoke with the local authority commissioners. They told us that they monitored the quality of the service provided in the home but were not aware of any concerns.