This inspection took place on 20 December 2016 and was unannounced.

Purley View Nursing Home is registered to provide residential care for up to 39 older people, some of whom are living with dementia. The home is purpose built over three floors with a passenger lift. At the time of our inspection 34 people were using the service.

The home had a registered manager who was also one of the registered providers. 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.

At our last inspection in February 2015 we made a recommendation for the provider to consult National Institute for Clinical Excellence (NICE) guidance on managing covert medicines in care homes. During this inspection we found guidance was being followed in this area.

People told us they were happy living at Purley View Nursing Home. They said they felt safe and staff were kind, caring and respected their privacy and dignity. They thought that the care they received was good and that staffing levels were adequate. There were procedures in place to recognise and respond to abuse and staff had been trained in how to follow these.

People were positive about the meals provided by the service and told us they were given a choice of something different if they asked for it.

We saw there were lots of different activities for people to be involved in and we heard about ways the service tried to involve everyone in activities to stop people from feeling lonely or isolated.

Care was planned and delivered to ensure people were protected against abuse and avoidable harm. There were sufficient numbers of suitable staff to help keep people safe and meet their needs. Staff had been recruited using a thorough recruitment process which was consistently applied. Appropriate checks were carried out before staff were allowed to work with people.

Medicines were stored, administered, recorded and disposed of safely. Staff were trained in the safe administration of medicines and kept records that were accurate. People’s medicines were suitably managed so they received them safely.

People were cared for by experienced and knowledgeable staff . Staff had received relevant training and were supported to obtain further qualifications relevant to their roles.

The provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This provides a legal framework to help ensure people’s rights are protected. Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions.

Arrangements were in place for people and relatives to share their views or raise complaints. The provider listened and acted upon their feedback. The provider obtained the views of people using the service and their relatives or representatives. There were systems to regularly monitor the quality of the service provided at Purley View Care Home.

Purley View provides nursing care for people who may have dementia. When we visited there were 33 older people living there. Those who were able to talk with us told us they were very happy living there. They said “staff are very kind here they help me to do things I can’t do for myself anymore”. They told us they were able to choose how they spent their days and said "I can please myself no one makes me do anything that I don’t want to do”. 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 peoples 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. Food that was served in the home met people’s preferences and they were able to make choices about what they ate and drank.

We looked at medication procedures. Although we raised a concern about these it was addressed promptly. Training programmes were in place for staff. Supervision and appraisal ensured that their performance was monitored and any individual training needs were highlighted. The provider had a robust procedure in place for monitoring and resolving complaints.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service and a practising professional.

We used the Short Observational Framework for Inspections (SOFI).SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. Through the use of SOFI we were able to observe that people’s experience of the service was a positive one. We saw staff support being provided in a way that protected the dignity of people and that the service was meeting the nutritional needs of the people using the service.

One person told us "the staff are very good here, they always come when I press my buzzer. My room is lovely and clean, I chose it because I can see the world go by from the window". Another person said " I love it here, it's my home, I feel well cared for, what more could I want".

People told us that they liked the food served in the home. They said that the chef came round to tell them what they were cooking that day and offered an alternative option if it was not suitable.

Purley View Nursing Home is a purpose built residential home that provides nursing care and support for up to 39 older people, some of whom are living with dementia. At the time of our inspection 34 people were using the service.

Our inspection took place on 10 and 11 February 2015 and was unannounced. At our last inspection in May 2013 the provider met the regulations we inspected.

We met with the newly appointed manager who had started their registration process with the Care Quality Commission (CQC) to become 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 told us they felt safe. Staff knew how to identify if people were at risk of abuse and what to do to help ensure they were protected.

Staff spoke with people in a friendly and kind way. They were helpful and polite while supporting people at mealtimes to make sure people had sufficient amounts to eat and drink. People and their relatives were positive about the food at Purley View Nursing Home. Special dietary requirements were catered for and people’s nutritional risks were assessed and monitored.

We observed that staff were caring. They showed people dignity and respect and had a good understanding of individual needs.

Staff made sure any risks to people’s safety were identified and managed appropriately. The manager had identified areas where improvement was needed in the service. Improvements were on-going at the time of our inspection. This included essential maintenance needed to ensure the safety of people who used the service.

People had access to healthcare services when they needed it and received ongoing healthcare support from GPs and other healthcare professionals.

People and staff were asked for their views on how to improve the service. Staff felt listened to and supported by their manager.

Staffing numbers were managed flexibly in order to support the needs of people using the service so that they received care and support when needed. Staff received the training they needed to deliver safe and appropriate care to people.

The provider was aware of the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) that ensured people’s rights were protected.

The provider had systems in place to help them understand the quality of the care and support people received. Accidents and incidents were reported and examined. The manager and staff used this information to make improvements to the service.

People received their prescribed medicines at the right times, these were stored securely and administered by registered nurses. We found some records that related to people, who were given their medicines covertly, were not always complete.

We have recommended that the provider consults the National Institute for Clinical Excellence (NICE) Guidance on Managing Covert Medicines in Care Homes.