We inspected St Paul’s Nursing Home on the 8 October 2018, the visit was unannounced. St Paul’s Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. St Paul’s Nursing Home is registered for 22 people in one adapted building. On the day of our inspection, 17 people were living at the service.

There was a registered manager in post who was available throughout the inspection. 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 at the service were protected from the risk of abuse, as the staff were aware of their responsibilities in relation to keeping people safe. There were established procedures and protocols in place to guide staff should they suspect abuse, and the registered manager dealt with any safeguarding incidences thoroughly. The registered manager had processes in place to ensure learning from safeguarding incidents took place to reduce the risk of reoccurrence.

The risks to people’s safety were assessed, and measures to reduce risks were in place to protect people from harm. There were enough staff to meet the needs of the people at the service and the registered manager regularly reviewed staffing levels to ensure sufficient staff were available to support people. Safe recruitment practices were in place.

Overall, the management of people’s medicines was safe. However we found some minor concerns, following our inspection, the registered manager sent us information to show how they had addressed this. People were protected from the risks of cross infection, as staff undertook safe practices in relation to infection prevention.

People’s needs were assessed using nationally recognised assessment tools and staff supporting people received adequate training to guide them in their roles.

Overall, people’s nutritional needs were well managed and people received diets appropriate to their needs. People’s health needs were supported by staff who worked with the relevant health professionals to manage this. People lived in an environment that met their needs.

Staff sought consent from people before caring for them and they understood and followed the principles of the Mental Capacity Act, 2005 (MCA). 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 supported this practice.

People were supported by a caring group of staff who listened to their views and ensured their choices and preferences were met. People received person centred individualised care. They were treated with dignity and respect, and staff supported their independence.

People were supported to join in with several social activities provided by the service. Their concerns and complaints were dealt with in line with the providers complaints policy.

People were supported at the end of their life by staff who were aware of their preferences, and their needs and wishes were respected.

The service was well led, the registered manager was visible and supportive towards people, their relatives and the staff who worked at the service. There were effective quality assurance systems in place to monitor performance and quality of care. The registered manager responded positively to changes and used information to improve the service and care people received.