Priory Paddocks Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Priory Paddocks Nursing Home is registered to provide personal and nursing care to a maximum of 40 older people. At the time of the inspection there were 38 people using the service.

At our last inspection 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.

Since the previous inspection the providers had employed a manager to assist them in the running of the service. However, at the time of the inspection one of the providers remained the 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.

The service continued to protect people from the risks of abuse or avoidable harm and risks to people were identified and planned for. Where incidents occurred or poor staff practice was identified, action was taken to protect people from harm. Medicines were managed and administered safely and the premises remained clean. There were processes in place to reduce the risk of the spread of infection.

The service continued to ensure that there were enough staff to meet people’s physical, social and emotional needs in a timely way and that recruitment procedures were safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service continued to support this practice.

The service provided people with a choice of appropriate food and drink. Support people required to maintain good nutrition and hydration was reflected in care planning and staff were aware of the support people required. Some improvements could be made to how the meal service is organised and coordinated by staff.

People received care from staff who had the training, skills and experience for their role. The service continued to reward staff for completing mandatory training and to encourage the development of the staff team.

People told us staff were kind to them and the service continued to promote a culture of kindness, with the providers and all staff leading this practice.

The service continued to offer people personalised care based on their individual preferences and to involve people and their representatives in the planning of care. People were supported to have contact with other health professionals where appropriate.

People were provided with adequate sources of meaningful engagement and were supported to feedback their views and experiences through meetings and surveys. Changes were made to the service according to the feedback received. People were made aware of how they could complain and the service had an appropriate complaints policy and procedure in place.

The providers and staff had an understanding of the Gold Standards Framework for end of life care and had a process in place for supporting people coming to the end of their life. The provider and manager told us they were in the process of developing more detailed end of life care planning.

The provider and manager continued to operate an effective system to monitor the quality of the service provided to people. Areas for improvement were identified and acted upon. The service continued to work

This inspection took place on 25 November 2015 and was unannounced.

The service is registered to provide nursing care and support to up to 40 people. On the day of our inspection there were 39 people living in the service.

The service had a registered manager in place. The registered manager was also one of two providers. The second provider also worked in the service.

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.

Risks to people had been identified, assessed and managed safely. Care plans contained sufficient guidance for staff to meet people’s care needs. Staff understood the signs of potential abuse and what action they needed to take if it was suspected. Premises and equipment were managed safely.

There were sufficient numbers of staff employed to meet people’s needs and the service followed safe recruitment procedures. People’s medicines were managed safely.

Staff were trained in all essential areas and participated in an induction programme. They were supported by the management team and received regular supervision.

The service was meeting the requirements of the Mental Capacity Act 2005. Applications under the Deprivation of Liberty Safeguards had been made to the appropriate authority to ensure that any restrictions placed on people were lawful and in their best interests.

People had access to healthcare professionals. A choice of food and drink was available that reflected their nutritional needs and took into account their personal preferences.

People and staff had developed positive, caring relationships. People told us they were well looked after by kind, friendly staff who understood and knew them well. People’s preferences and choices were known and respected by staff. However, care plans did not always reflect people’s involvement in their care planning. The provider has been in touch with us since our inspection visit and told us how they plan to address this.

People had opportunities to participate in a variety of activities and we observed staff actively interacting with people during our inspection. The service employed staff who were not involved in providing personal care to ensure people did not become socially isolated and to support people in carrying out activities of their choice.

All people, their relatives and staff spoken with had confidence in the registered manager and felt the service had clear leadership. There were effective systems to assess and monitor the quality of the service.

During our visit we spoke with six people, some in the privacy of their bedrooms to gain their views about the quality of care they received. One person told us, “Everyone here is so kind.” Another person said, “The care here is excellent.”

People told us they were provided with a varied choice of nutritious meals and access to regular drinks. One person told us the food was, “Good homely cooked food.”

We spent time observing the lunch time routines. We saw that the majority of staff were attentive and supported people to eat their meal in a dignified and respectful manner.

People told us if they had concerns that they felt confident to discuss their concerns with the manager. One person told us, “I do not have any complaints but if I did have I know the manager would sort things out for me.”

We spoke with three people who used the service. They all told us that they were very happy living at the service. One person told us "The staff look after me very well." Another person told us "I want for nothing, I am well looked after."

During our visit to the service we spoke with seven people who used the service, they all confirmed that the staff were very helpful and looked after their needs for them. One person said,"The staff are young and remarkably helpful".