This inspection took place on the 9 and 10 August 2016. The first day of the inspection visit was unannounced, the second day was announced. At our last inspection on the 26 and 27 August 2015, we found there were two areas where the service was found to be requiring improvement. These related to staff member’s attitudes were not consistently caring and the quality assurance monitoring of the service. During this inspection we found there had been some improvements made, although some further improvements were required on how the service was monitored.

Neville Williams House is a purpose built residential care and nursing home registered to provide accommodation and nursing care for 50 people. At the time of our visit there were 46 people living 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 and associated Regulations about how the service is run.

There had been an improvement in staff member’s attitudes, they demonstrated a positive regard for the people they were supporting. People felt staff were caring and kind.

The management of the service was stable and the management team carried out regular audits. Improved systems were in place to monitor, audit and assess the quality and safety of the service but they had not been consistently effective and still required further improvement.

People felt safe living at Neville Williams House. Staff understood their responsibility to take action to protect people from the risk of harm because the provider had systems in place to minimise the risk of abuse. People’s needs were individually assessed and written in care records that minimised any identified risks so reducing the risk of harm.

There were sufficient numbers of staff available to support people. Suitable staff had been recruited and had received training to enable them to support people with their individual needs.

People received their medicines as prescribed by their doctor.

People were able to consent to the care they received where they had the mental capacity to do so. Where people did not have the mental capacity to make decisions, staff understood how to seek consent and systems were in place to ensure that their human rights were protected.

People were able to choose what they ate and drank and enjoyed their meals. Everyone spoke positively about the choice and quality of the food available. Staff supported people to eat their meals when needed.

People were supported to receive care and treatment from a variety of healthcare professionals and received treatment if they were unwell.

People were supported and encouraged to take part in hobbies and interests either in a group or on an individual basis.

Peoples’ health care and support needs were assessed and reviewed. There was a complaints process in place and people felt they could raise concerns. Feedback on the service provided at Neville Williams was sought from people living at the home and their relatives.

We spoke with six people using the service, six staff and five visitors on the day of inspection. We looked at policies and processes, reviewed seven care records and six staff records to gain further insight of the care provided.

People were involved in decisions about the care provided and details of their needs and interests were included in the care records we saw. Care plans and risk assessments were in place and updated regularly to ensure people received the care they needed.

There were a variety of activities available designed to meet people's needs. One person told us that, "Staff are so kind, nothing is too much for them." Another said "I love the farm; I wish I could go every day."

People’s safety was protected because there were systems in place to report safeguarding concerns and staff received relevant training. People told us they were satisfied with the care provided and said they felt safe.

There were appropriate recruitment systems in place. Staff were supported with training and guidance by the provider. Staff were happy with their training and felt it met the needs of the people using the service. Staff we spoke to said they liked working there. One person said, "It is a pleasure to come to work" and another said "I love it, it is so different every day."

People experienced good quality care because systems of monitoring were in place and there was evidence that people and their families knew how to complain if things weren't right.

At the inspection we spoke to four visitors who were visiting their relatives. We spoke with six staff, four of which were involved with direct care. We spoke with two people who used the service.

The service provided care and welfare that met peoples’ needs. One person told us “I’m so lucky, I love it here”. We saw that care was well planned, updated and delivered in line with care plans. The service sought and followed the advice of other healthcare professionals to ensure peoples wellbeing.

People and relatives were involved in their care and were supported to give their input into the activities of the service.

We saw that the premises were well maintained and that an ongoing program of improvement was followed. Staff were aware of the procedure to follow within the service to ensure maintenance jobs were attended to in a timely fashion.

Staff told us they felt supported, and the service was run with enough staff to meet the needs of the people they supported.

Auditing of the service was an integral part of the delivery. One relative told us that, “They ask me all time”, [if their relative needs anything more in their room].

People who use the service and their relatives were very positive about the staff and the support they provided. We received many positive comments from people who lived at the home, their relatives, staff and professionals that visit the home.

One relative said, ‘I looked around many homes before this one, and this was the top of our list, we are so fortunate to get a place here.’ And ‘Staff are so accommodating they can’t do enough’

This was an unannounced inspection which took place on 26 and 27 August 2015. We last inspected this service on 14 October 2013, where we found the provider was meeting the requirements of the regulations we inspected.

Neville Williams House is a purpose built residential care and nursing home for up to 50 people. At the time of our inspection 50 people were living 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 and associated Regulations about how the service is run.

Some people had different ways of expressing their feelings and were not able to tell us about their experiences. People who could speak with us felt safe and secure in their home. Communications between people and staff were generally friendly and polite. Relatives, social care and health professionals and staff felt people were kept safe and cared for. Staff understood their responsibilities to protect people from the risk of harm and abuse.

People received their medicine safely because procedures were in place to make sure this was done without risk of harm. We found people had received their medicine as prescribed by their doctor. People’s needs were individually assessed and written in care records that minimised any identified risks so reducing the risk of harm.

We found there were enough staff to meet people’s identified needs. The provider had a robust recruitment process that ensured suitable staff were recruited to meet the care needs of people living at the home. Staff received continuous training to support them in their role.

The provider took the appropriate action to protect people’s rights and staff were generally aware of how to protect the rights of people.

People were supported to have choices and their care and support needs were met. Everyone spoke positively about the choice and quality of the food available. Staff supported people to eat their meals when needed. However there was some inconsistency between the dining areas, when providing people with a choice and individual one to one support.

People were supported to access other health care professionals to ensure that their health care needs were met.

People and relatives told us that staff was kind, caring and friendly and treated people with dignity and respect. Staff supported people who could not communicate verbally, in a dignified way, ensuring staff remained respectful. Although there were occasions where the behaviour of staff that supported people, was presented in a discourteous way.

People’s health care and support needs were assessed and reviewed. People and their relatives told us they were confident that if they had any concerns or complaints they would be listened to and matters addressed quickly.

The management of the service was stable and the registered and care home managers carried out regular audits. The provider had systems in place to monitor and improve the quality of the service, although these were not always effective, in ensuring the home was consistently well led and some improvements were needed.