This inspection was unannounced and took place on the 2 and 8 May 2017.

This was the first inspection of Three Bridges following a change of service provider.

Three Bridges Nursing and Residential Home provides accommodation, personal and nursing care for up to 53 older people, some of whom have dementia care needs. It is located in Latchford, a suburb of Warrington in Cheshire. The service is provided by Indigo Care Services Limited. At the time of our inspection the service was accommodating 43 people.

Three Bridges Nursing and Residential Home is a two-storey building with all resident accommodation on the ground floor. The home has 53 single rooms (four of which have en-suite facilities), four lounges (two of which lead onto a patio), a central conservatory that overlooks the garden), two dining rooms and accessible bathroom and toilet facilities throughout the home. The home has car parking to the front and large gardens to the sides and rear.

At the time of the inspection there was a registered manager at Three Bridges Nursing and Residential Home. 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.

The registered manager was present during the two days of our inspection and was supported by her line manager for the first day of our inspection. The registered manager was open and transparent throughout the inspection process and was seen to interact with people using the service and staff in a caring and helpful manner.

We spent time talking with people and undertaking observations within the home and noted that people received care and support in a timely manner, which was also responsive to their individual needs. We noted that staff communicated and engaged with people in a kind, friendly and compassionate manner and that people were encouraged to maintain their independence and to follow their preferred daily routines and lifestyle.

The provider had developed a corporate care planning system and each resident had been provided with a ‘resident care profile’ file which contained information on each person. The needs of people using the service had been assessed and planned for so that staff understood how to provide person centred care and to keep people safe from harm.

A programme of induction and on-going training had been developed for staff to access via e-learning and face to face learning methods. Staff also had access to recognised qualifications in health and social care. This helped to ensure people using the service were supported by competent staff. Additional systems of support such as supervisions, daily handovers and team meetings were also in place.

Corporate policies had been developed relating to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Staff had received training in relation to this protective legislation and those spoken with understood their duty of care.

Staffing levels were structured to meet the needs of the people who used the service. There were sufficient numbers of staff on duty to meet people’s needs.

Recruitment practices were safe and relevant checks had been completed before staff commenced work.

The provider had a complaints procedure and where complaints had been reported, these were responded to appropriately and action had been taken to resolve them promptly.

Policies and systems were in place to manage risks and safeguard people from abuse.

There was a quality monitoring system in place which involved seeking feedback from people who used the service and their relatives about the service provided periodically. This consisted of surveys and a range of audits.

Medicines were ordered, stored, administered and disposed of safely.

People using the service had