About the service: St Martin’s Nursing Home is registered to provide nursing care and was supporting 23 people on the day of our inspection.

People’s experience of using this service:

People were relaxed and comfortable at St Martin’s Nursing Home and were complimentary of the care provided. There were enough attentive staff on duty to meet people’s needs and they responded promptly to people’s requests for support.

Staff understood their role in protecting people from all forms of abuse or discrimination. Risks were managed appropriately and care records included sufficient guidance for staff to enable them to ensure people’s safety.

Staff were recruited safely and had the skills necessary to meet people needs. Training was regularly updated and care staff were provided with regular supervision. We have made a recommendation in relation to the supervision arrangements for nursing staff.

Care plans were informative and included information about people’s backgrounds to help staff understand their individual needs. Although there was a detailed activities programme and the service employed three, part time, activities coordinators there was a lack of things for people to do during our inspection. We discussed this issue with the registered manager who told us that in future arrangements would be made to provide alternate activities when activity coordinators were on leave.

The service was well-led. The well-established staff team were motivated and told us the service managers were supportive and approachable. There were appropriate systems in place to monitor the service performance and people feedback was valued and acted upon.

At our previous inspection the service was rated Good. (Report published 2 November 2016)

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we may bring our inspection forward.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 23 August 2016 and was an unannounced comprehensive rating inspection. The location was last inspected in November 2014 and met all the standards inspected.

St Martins Nursing Home is a registered care home providing accommodation for up to 24 people who require nursing and personal care. At the time of our inspection there were 24 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 2008 and associated Regulations about how the service is run.

People were safe and secure. Relatives believed their family members were kept safe. Risks to people had been assessed and managed appropriately.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual needs.

People safely received their medicines as prescribed to them.

Staff sought people’s consent before providing care and support. Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there was positive communications and interactions between staff and the people living at the location.

People’s rights to privacy were upheld by staff that treated them with dignity and respect. People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs.

People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed.

The provider had management systems in place to audit, assess and monitor the quality of the service provided, to ensure that people were benefitting from a service that was continually developing.

At our last inspection in August 2013, we found that improvements were required in the way that care was planned and delivered. We identified that there were gaps and inconsistencies in staff training. The system in place to identify, assess and manage risks to the health, safety and welfare of people who lived at the home and others was not effective. We set compliance actions and told the provider to improve. During this inspection we found that necessary improvements were made.

On the day of our inspection 22 people lived at the home. We spoke with four people and three relatives. Some people were unable to verbally share with us their views about their care. We used different ways to evidence their experiences, such speaking with their relatives, looking at their care records and observing care.

We spoke with three members of staff, this included a registered nurse. We also spoke with the registered manager and the registered provider of the home.

Care was planned and delivered to ensure people’s safety and welfare. A relative told us, “The staff work in conjunction with the GP to manage their health needs”.

Safeguarding procedures were in place to identify the possibility of abuse and prevent abuse from happening. One person told us, “I have no concerns I am happy with things”.

Medicine management systems were in place so that people had their medicines as prescribed by their doctor to ensure their health and wellbeing.

People were cared for by staff who were supported, supervised and trained to deliver care to an appropriate standard. One person told us, “The staff are nice and helpful”.

The provider had an effective system to regularly assess and monitor the quality of service that people received and identify, assess and manage risks to the health, safety and welfare of people who lived at the home and others.

On the day of our inspection there were a total of 24 people living at the home. We spoke with four people, four relatives and a friend of one person who was using the service.

Some people were unable to verbally share with us their views about their care, we used different ways to evidence their experiences such speaking with relatives and looking at their care records and observing care.

We spoke with four members of staff, this included registered nurses. We spoke with the registered manager and the registered provider of the home.

Care was not always person centred and delivered to ensure people's safety and welfare.

Safeguarding procedures were in place so that staff would recognise and report any allegations of abuse to protect people from the risk of harm. One person told us, "I have no concerns I am happy with the care".

Systems were in place to ensure that people received medication that they needed for their health. One person told us, "Staff make sure I take my medicines".

Inconsistencies and gaps in training meant that not all staff had the knowledge and skills to provide care that was safe and effective.

The system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others was not robust to be fully effective.

We visited St Martin’s Nursing Home on 22 March 2012, on the day of our visit we spoke with three people who lived at St Martins Nursing Home and two relatives. We also spoke with three members of staff, the registered manager and the care home manager who was also the nominated individual for the service.

A number of people were unable to communicate the care they received at St Martin’s Nursing Home due to health conditions. We were able to look at other areas for evidence to support their experience such as sampling a set of care records, speaking to relatives and staff.

We observed how people were engaged in their environment and how staff interacted with them. We used a short observational framework for inspection (SOFI).This is a specific way of observing care to help us understand the experience of people who could not talk to us. We observed SOFI on five people living at St Martin's Nursing Home.

We observed people were relaxed and appeared overall happy with their care. People reported staff were caring and approachable. One person commented “staff look after me very well”.

People told us there were activities they could participate in like games and walks when the weather was good. People commented they did not have to take participate in activities that they did not enjoy.

People said they enjoyed their meals and they were offered choice, one person told us the food was “very nice". We saw there was some choice on the menu. Staff ensured people were comfortable and had an adequate meal.

The relatives we spoke with were overall happy with the care received by their family members.

We saw staff attended to people in a caring, considerate manner and responded

appropriately to their needs. Staff knew the people they were caring for well. Staff were able to identify people who needed extra support as reflected in their care records.

Staff we spoke with showed understanding in areas of safeguarding, equality and diversity. Staff were aware of the management of falls and pressure sores.

Staff told us they were happy working at St Martin’s Nursing Home. One staff we spoke with said “we are a very good team”. Staff felt trained and supported to provide good care. Staff understood what constituted abuse and said that they would be able to recognise and report poor practice.This demonstrated people were cared for by appropriately trained staff.

We found the service was improving as a result of findings. For example as a result of feedback improvements had been made in the types of activities available to people.