This inspection took place on 9 and10 November 2016 and was unannounced. At our last inspection in December 2015 we found that the provider ‘required improvement’ in three domains, namely effective, caring and well led and was found to be ‘good’ in safe and responsive.

Newday Nursing Home provides accommodation, nursing and personal care for up to 37 people. There were 35 people living at the home at the time of our inspection. Care and support was provided to people with nursing needs including dementia. The home is a converted property and bedrooms were located on both ground and first floor level.

There was a registered manager. 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.

People were supported by staff who had been trained in how to recognise signs of abuse and were aware of what actions they should take should they suspect someone was at risk of harm. Staff were aware of the risks to people on a daily basis and how to manage those risks.

People were supported by sufficient numbers of skilled staff who had been recruited safely. People were supported to receive their medicines as prescribed.

Staff benefitted from an induction that prepared them for their role and received mandatory and specialist training in order to meet the needs of the people they cared for.

People’s humans rights were respected by staff because staff applied the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards in their work practice.

People were supported to have sufficient amounts to eat and drink. People’s dietary needs and preferences were adhered to.

People’s healthcare needs were met and they were supported to access a variety of healthcare professionals to ensure their health and wellbeing.

People were supported by staff who were kind and caring and treated them with dignity and respect. Staff understood people’s preferences with regards to their care and what was of importance to them.

People were supported to participate in a variety of activities that were of interest to them on a daily basis.

People were aware of how to make complaints and were confident that if they did raise a concern it would be dealt with to their satisfaction

The registered manager had a number of quality audits in place to identify any areas of improvement that were required within the service. Where areas where identified, action plans were put in place to address any issues.

On the day of our inspection 34 people lived at the home. We spoke with the general manager, acting care manager, five members of staff, five people who lived there, four of their relatives. We also spoke with the activities coordinator and two external health care professionals who work closely with the home.

We saw good interactions between people who lived there and staff. We observed that the atmosphere was pleasant and relaxed. One person told us, "I'm very happy with the care and staff."

We found that people were asked to give their consent before support was given. This meant that staff acted in accordance with people's wishes to ensure that people received care and support the way they like.

We found that care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. One person told us, "I really feel safe, staff look after us very well." One relative said, “You can see that everyone is well looked after.”

We found that people were given their medicines as they had been prescribed by their doctor to ensure their health and wellbeing.

We saw that the provider had robust recruitment systems in place so that only staff suitable to work with vulnerable people were employed.

We found that appropriate records were in place that had accurate information which fully reflected people's care needs and was accessible to staff when needed.

There were 33 people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with seven people who lived at the home, six relatives, six staff and the manager.

We saw good interactions between people lining there and the staff team. The atmosphere was friendly and relaxed. We saw relatives visiting people and different activities taking place for people to join in with, if they wished to.

People we spoke with told us positive things about the home and the care and support they received. One person said "The staff are friendly and helpful" and a relative told us, "We are really pleased with the care and the staff are marvellous".

Staff received the support they needed so they could meet people's needs.

Systems were in place to ensure that people were safeguarded from the risk of harm.

The home was clean and hygenic and a comfortable place for people to live in.

There were systems in place to monitor how the home was run so it was safe for people.

We found that the people living in the home looked happy. The majority of people have high dependency needs and limited communication due to confusion and dementia. We were able to speak with some of the people living in the home. One person told us after we explained why we were visiting the home “Leave my home alone, you’re not going to close us.” This person expressed their love for the home. People said they were happy with the home “The staff are good, they tell me if something is wrong.” “They (Care Staff) look after X (Relative) very well.”

We saw that care staff treated each person as an individual. There was a good atmosphere in the home. People who had good mobility were seen to move around the home freely. We saw one person walking around the home with a cloth cleaning surfaces. Care staff told us that the person liked to clean and care staff did not restrict them from doing this. We observed that some people sat quietly in the lounge and did not get involved with what was going on around them. The television was on in the lounge and a radio was playing music at the same time. This could be confusing for people living in the home, particularly due to their state of confusion and level of dementia. Care staff told us that some family members maintain contact with their relative and contribute to their care.

The inspection took place over two days on 17 and 18 December 2015 and was an unannounced inspection. At our last inspection on 15 January 2014 we found the provider was meeting all the regulations we assessed.

Newday Nursing Home provides accommodation, nursing and personal care for up to 37 people. There were 32 people living at the home at the time of our inspection. Care and support was provided to people with nursing needs including dementia. The home is a converted property and bedrooms were located on both ground and first floor level.

The registered manager had recently resigned. The provider had appointed another manager who was due to commence in February 2016. 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.

People and their relatives told us they felt safe. Staff had been trained in safeguarding people. Staff understood their responsibility to take action to protect people from the risk of abuse and how to escalate any concerns they had.

The provider had systems and arrangements in place to recruit staff safely and to assess staffing levels.

People were supported to receive their medicines as prescribed.

Staff had some understanding of the Mental Capacity Act 2005 and we saw that people’s consent was usually sought before they undertook any care tasks. We saw that where people lacked capacity and their decisions affected their safety arrangements were in place to restrict their liberty, although these had not always been robustly applied.

Staff received training and support to carry out their role and the provider had plans in place to ensure that training updates needed were provided.

People’s health care needs were met and they were supported to access both social care and healthcare professionals to ensure their needs were met.

We observed that not all interactions were caring. Arrangements in place did not always ensure that people’s privacy and dignity was always respected.

People’s health care needs were met and they were supported to access both social care and healthcare professionals to ensure their needs were met.

The service had experienced an unsettled period with changes in the management arrangements for the home. Systems were in place to monitor the quality of the service. However, these had not always been effective in identifying where improvements were needed.