This inspection was carried out on 19 and 25 January 2017 and was unannounced.

Park House Nursing Home provides accommodation, nursing and personal care for up to 40 people. At the time of our inspection there were 40 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.

People had care that was person centred that maintained their health and wellbeing.

People were treated with dignity and respect. People had positive relationships with staff.

Staff were motivated and well supported with training to enable them to meet the individual needs of people living at the home. There were sufficient numbers of staff to ensure people were supported safely and people’s health needs responded to quickly. Medicines were managed safely and people received their medicines in line with their prescription.

People and relatives knew the registered manager and the provider. People felt that if they had any concerns they were able to speak with the registered manager or provider. People felt safe and knew how to raise concerns. The provider welcomed people's views and opinions and acted upon them.

Staff felt comfortable to raise any concerns about people’s safety and understood about how to keep people safe. Risk assessments were in place and action taken to reduce any risks. Staff supported people to take positive risks. Where risks had been identified risk assessments were in place and action had been taken to reduce the risk of harm.

People enjoyed the food and had the support they needed to enjoy their food and drinks safely. People were able to make choices about the food and drink they wanted. There was a choice of freshly prepared nutritious food and where additional monitoring and support was needed this was provided.

People's health needs were monitored and changes made to people's care in response to any changes in their needs. People had access to other health professionals and were referred to them by the registered manager if there were any concerns about their health needs.

There were a range of audits and checks to make sure that good standards of care and support were maintained. Feedback from people and relatives were gathered on a regular basis and where any actions were identified these were actioned quickly.

We carried out this inspection on 15 January 2015. The inspection was unannounced.

The provider is registered for accommodation and personal and nursing care for up to 40 people who may have a diagnosis of dementia. At the time of our inspection 36 people lived at the home.

A registered manager was 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.

People who lived at the home and relatives told us they felt safe with the staff. Staff we spoke with understood how to protect people from harm and knew who to contact if they had any concerns about people’s safety. We found there were sufficient staff available to meet people’s needs and that safe recruitment practices were followed.

We found improvements were needed in the way people received their medicines to make sure they were administered safely and as prescribed.

Staff told us their training was up to date and we saw this was reflected in their practice and the environment. All of the staff felt their training and supervision supported and enabled them to deliver care safely and to an appropriate standard.

People’s capacity to make decisions had been assessed and, for those people who lacked capacity, decisions were made in their best interests. People received care and support to meet their needs in the least restrictive way. Where restrictions were in place to ensure people were safe and their needs were met this had been assessed by the local authority in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff monitored people’s health and shared information effectively to make sure people received advice from doctors, dieticians and the community mental health team, according to their needs. People had meals they liked with support from staff to meet their nutritional needs.

People told us the staff were kind and caring. People’s privacy and dignity was respected and they were supported to maintain their independence.

All the people we spoke with were satisfied staff cared for and supported them in the way they wanted. People’s care plans described their needs and abilities and were relevant to the risks identified in their individual risk assessments. This included enabling people to have fun and interesting things to do.

People’s complaints were responded to appropriately and action taken to drive through any improvements to the services people received as a result of complaints.

The provider had effective arrangements in place to support, guide and lead staff that enabled the quality of care and support people received was continually improved and consistent.

Not all the people we met were able to speak with us about the care they received and their experience of living at Park House Nursing Home. Therefore we observed how staff interacted and supported people. This helped us to make a judgement on how their needs were being met.

Those people who found it difficult to communicate with us, because of their dementia, all showed signs of positive wellbeing. We saw that staff had time to stop and chat with them and help them with their activities. We saw that people were treated respectfully and kindly. Staff took time to encourage them and explain what was happening. We saw that people’s care had been planned with them or with their families if they were not able to contribute to the process. Written records provided information for staff so that people's safety was maintained. Relatives we spoke with gave very positive feedback about the care their loved ones received.

We found the home to be clean, and regular checks had been carried out to ensure the required standards of cleanliness and infection control.

Staff were aware of how to respond to any allegation of abuse in a way that safeguarded vulnerable adults.

The provider had effective recruitment procedures in place.

We used a number of methods to help us understand the experience of people who used the service, because people were not all able to tell us their views.

We spoke with one person living at the home and four visitors. We observed staff interaction with seven people using a tool designed for the Care Quality Commission. We spoke with four nursing and care staff and the owner. We looked at care records for three people, and medication records for five people. We saw records about staff, the running of the home and the provider’s analysis of quality surveys, which were positive.

During our visit people were well cared for and had privacy. People were treated as individuals with sensitivity. Choice was offered and consent was sought before care or activities were provided. People and visitors said the food was very good, and people had support when they needed it to eat and drink.

Families were involved in care planning. Visitors told us: “They really look after people well here”; “The staff and manager answer any questions we have and sort out anything we ask for”; They offer visitors hospitality.”

Staff understood people’s needs, felt well supported and had professional development for their roles. Equipment was kept in good working order, and staff had guidance and training to use equipment safely. There were systems in place to act on and learn from any incidents, comments or complaints.