We carried out an unannounced inspection of the service on 28 and 29 November 2017.

[St Peters] is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. (The care home) accommodates 38 people in one adapted building. There were 33 people receiving care and support at the home at the time of our visit.

The service was last inspected 15 October 2015 and the rating for that inspection was Good.

Since the last inspection 15 October 2015 there has been a new registered manager recruited and the home has increased its bed numbers from 18 to 38.

There was a manager registered with the Care Quality Commission (CQC). 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 continued to feel safe. Risks were assessed and managed. There was sufficient staff to meet people’s needs. Safe recruitment was followed to ensure suitable staff were employed.

Medicines were managed and stored safely. Arrangements were in place to make sure the premises were clean. Staff had completed relevant hygiene training. Incidents and accidents were reported and managed.

People continued to have their needs assessed. Staff received training to ensure they had appropriate skills to carry out their roles. People were supported to have sufficient amounts to eat and drink. People were supported to receive care across different services. People were involved in regular monitoring of their health and wellbeing. People were consulted about decisions about their environment. People were supported to have maximum choice and control of their lives and staff supporte0d them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported by staff who were very kind and compassionate. People were treated with respect and dignity. They had an excellent relationship with the staff, who had a strong emphasis on supporting people’s diverse needs. People experienced positive compassionate care that went above and beyond to ensure people felt at home. Relatives were positive about the care people received. The service used alternative methods to support family to stay in contact if they were unable to visit the home.

People continued to receive personalised care that met their needs. Concerns and complaints were listened and responded to. Discussions took place to support people at their end of life.

Systems and procedures were in place to monitor and improve the quality and safety of the service provided. There was a registered manager in post. Staff were supported to raise concerns and use the whistleblowing policy. Information systems were used effectively to monitor the quality of care.

The service worked in partnership with other organisations including the local authority, safeguarding and CQC.

We carried out an unannounced inspection of the service on 22 October 2015.

St Peters provides accommodation to older people in the Nottingham area. It is registered for a maximum of eighteen people. There were seventeen people receiving care and support at the home at the time of our visit.

There was a manager registered with the Care Quality Commission (CQC). 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 felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Medicines were safely managed.

People received effective care and their needs were met. Staff were knowledgeable about the people they cared for.

Staff received appropriate induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate.

People were treated with kindness and compassion. Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care.

People’s needs were promptly responded to. Care records provided sufficient information for staff to provide personalised care. Activities were available in the home. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the management and that the registered manager would take action. There were systems in place to monitor and improve the quality of the service provided.

During our inspection we spoke with three people using the service, one relative and three members of staff. We also spoke with a visiting healthcare professional from the local GP surgery at which the majority of people were registered for medical and nursing care. We spoke with another relative after the visit. We looked at some of the records in the home including the care files for four people. We observed the care people using the service received and toured the building.

One person using the service told us they were well looked after and that staff made them feel safe. Another person using the service told us staff were pleasant and kind.

One relative of a person using the service told us they had visited a number of homes and their relative had chosen St. Peter’s because it was small and friendly and the staff provided such good care for people. Another relative of a person using the service told us they had found it difficult to accept their relative’s dementia diagnosis but staff at the home had helped them understand more about the condition and had been kind and understanding towards the whole family.

We found that there were arrangements in place to assess and provide care which met people’s needs. We also found that people received adequate nutrition and hydration and there were processes in place to protect people against the risk of healthcare associated infection. Staff told us they were well supported with training and supervision.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant not all were not able to tell us their experiences. We spoke to their relatives and friends. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The people we were able to speak with told us they were happy and content with the way they were cared for. One person said, “All is wonderful.” “The staff treats me well and they support me when I have to go to hospital for my appointments.”

People told us they had plenty to do around the home, there was always something going on. We saw activities taking place during our visit. We were told by the activities coordinator that people were encouraged to join in with the activities, however, it was their choice and they could just watch if that’s what they wanted.

Relatives we spoke with told us they were happy with the care and support that was provided. One relative said, “They (the people who use the service) look healthy enough.” They also said that if they felt the need to raise any concerns they would speak with the manager.