This unannounced inspection took place on 13 December 2016.

The Old Rectory Nursing and Residential Home provides nursing or personal care for up to 34 people. There were 25 people living in the home at the time of our visit, some of whom were living with dementia.

The service had 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, relatives and staff told us the home was well run and that the registered manager was visible and accessible. There were enough staff to meet people’s needs and staff were unhurried. Staff described the home as a happy place to work and told the registered manager was supportive.

Staff told us they received sufficient training to support them to carry out their job roles competently. New staff completed an induction to ensure they were orientated to the home, its policies and procedures and had knowledge about the care and support needs of people living there. Three new staff told us the induction was very good. Staff were supported through regular supervision and an annual appraisal.

People’s risks were assessed and plans developed to ensure care was provided in a safe way and that people’s risks were minimised. A variety of risks were assessed including risk of skin damage, falls and malnutrition. People’s risks were reviewed and if there were changes in the level of risk, plans were updated to reflect the change.

Staff were aware of what constitutes abuse and what actions they should take if they suspected someone was being abused. Relevant checks were undertaken before staff started work. For example checks with the Disclosure and Baring Service were undertaken to ensure staff were suitable to work with vulnerable people.

Medicines were managed safely. Medicine Administration Records (MAR) were signed to indicate that people’s prescribed medicine had been taken. Staff offered people a drink and remained with them when they administered their medicine. There were on-going checks throughout the day to ensure the amount of medicines were correct.

People were supported to eat and drink. They were offered a choice of where they would like to eat and what they would like. People told us the food was very good and feedback on the menus was obtained.

People were treated with dignity and respect and their privacy was maintained. They were supported to remain as independent as possible.

People and their relatives told us staff were kind and caring. There was a relaxed atmosphere in the home and there was appropriate use of humour. Staff told us it was a happy place to work and we saw there were positive interactions between staff and people and within the staff team.

People had the opportunity to be involved in a choice of activities, including one to one time, craft, and entertainers, pets as therapy or cake making. The activity coordinator was exploring resources to offer people more variety of activities as well as alternative activities aimed at people living with dementia.

There were quality monitoring systems in pace which meant areas for improvements could be identified and actions taken to ensure improvements were made. People’s views were obtained through surveys. We saw that responses to surveys was generally positive. Actions had been taken to address any comments made or when results indicated that improvements could be made. For example the activity coordinator had been appointed and was being supported to review activities and provide more variety of activities.

Concerns and complaints were managed appropriately. We saw that any complaints which had been received had been investigated and had a satisfactory outcome. Information on how to raise concerns or complaints