This inspection took place on 17 January 2017 and was unannounced.

The Lawns nursing home is registered to provide accommodation and care for up to 52 people, some of whom may be living with dementia. There were 50 people living at the service at the time of our inspection.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were appropriate arrangements in place for medication to be stored and administered safely, and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

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 lifestyle preferences or health care needs.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. People were treated with kindness and respect by staff who knew them well and who listened to their views and preferences.

People were encouraged to follow their interests and hobbies. They were supported to keep in contact with their family and friends.

There was a strong management team who encouraged an open culture and who led by example. Staff morale was high and they felt that their views were valued.

The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required.

On a previous inspection in July 2012 we had had some concerns and part of this visit was to see if improvements had been made. We saw that improvements had been made to cleanliness, staffing and records.

We gathered evidence of people’s experiences of the service by talking with people, their relatives and staff. We observed how people spent their time and noted how they interacted with other people living in the home and with staff.

We saw that staff asked people's consent with everyday tasks and people were treated with respect. One person said: “The carers always ask me before doing things, they are very polite in that way.”

People experienced safe care in comfortable surroundings which had recently been refurbished. They were very happy with the standard of cleanliness in the home and with the overall refurbishment. The records showed that people had care plans and risk assessments in place which were regularly reviewed so that their changing care needs were met appropriately.

The required amount of staff to care for people safely had been agreed and this was being monitored.

We found that an effective monitoring and management system to ensure the health and wellbeing of people who used the service and staff was in place.

Where people were unable to provide a verbal response or tell us verbally their

experiences, for example as a result of their limited verbal communication or poor

cognitive ability, we noted their non verbal cues and these indicated that the majority of

people were relaxed and comfortable and found their experience at the home to be

positive.

One relative told us that they had nothing but praise for the care staff and they were very

happy with the care and support provided to their relative. They told us that their relative

was very settled at The Lawns. The only negative comment was in relation to staff

shortage in the recent months; they said staff were always cheerful and attentive but there

seemed to be less of them now.

Two people spoken with told us that they felt safe and that, if they had any concerns or

worries, they would discuss them with a member of staff. One relative spoken with told us

that they were confident that any areas of concern raised would be listened to, taken

seriously and acted upon.

During our visit on 17 January 2012 we spoke with six people and four relatives. Many of the people living at The Lawns Nursing Home have complex nursing needs and palliative care needs. Most of the information about people's experiences of the Lawns Nursing Home was gathered through discussion with relatives and through our observations.

A person living at the home told us that “It’s quite nice here. The staff are very good. They always knock on the door before they come in. They are very kind.”

We received the following comments from relatives “They look after X. They are welcoming, helpful staff. X feels safe. X goes out for lunch and to church.” and “X has never looked so well for years. We have no concerns whatsoever.” and “I sleep at night knowing X is in here. “ and “X feels safe. I have no concerns whatsoever.”

This inspection took place on 9 and 10 April 2015.

The Lawns Nursing home is registered to provide accommodation for 52 older people who require personal or nursing care. There were 51 people living at the home on the day of our inspection.

A registered manager was in post 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.’

Staff had attended training on safeguarding people. They were knowledgeable about identifying abuse and how to report it. Recruitment procedures were thorough. Risk management plans were in place to support people to have as much independence as possible while keeping them safe. There were also processes in place to manage any risks in relation to the running of the service.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. People had regular access to healthcare professionals. A wide choice of food and drinks was available to people that reflected their nutritional needs, and took into account their personal lifestyle preferences or health care needs. People enjoyed the food and drinks provided.

People were supported by skilled staff who knew them well and were available in sufficient numbers to meet people's needs effectively. People’s dignity and privacy was respected. Staff approach to people was kind and caring. Visitors were welcomed and people were supported to maintain relationships and participate in appropriate social activities and outings.

Staff were well trained and used their training effectively to support people. Staff understood and complied with the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and other’s safety.

Care plans were regularly reviewed and showed that the person, or where appropriate their relatives, had been involved. They included people’s preferences and individual needs so that staff had clear information on how to give people the care that they required. People told us that they received the care they needed.

People were able to express their views and were confident that their complaints or concerns were listened to, taken seriously and acted upon.

The service was well led as people knew the manager and found them to be approachable and available in the home. People living and working in the service had opportunity to say how they felt about the home and the service it provided. Their views were listened to and actions were taken in response. The provider and registered manager had robust systems in place to check on the quality and safety of the service provided, to put action plans in place where needed, and to check that these were completed.