The inspection took place on 01 December 2017 and was unannounced. This was the provider’s first inspection since they registered with CQC in December 2016.

Tilford Care & Nursing Home is a nursing home providing care to people older people, people with physical disabilities and complex medical conditions. Some of the people who lived at the service were also living with dementia. The home is registered to provide support to up to 42 people and there were 38 people using at the service on the day of our visit.

There was a registered manager in post. 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 received appropriate support to meet their clinical needs. Staff worked alongside healthcare professionals to meet people’s needs. Risks relating to people’s medical conditions were routinely assessed and appropriate plans were implemented to keep people safe. People received their medicines safely from trained staff. Nursing staff had access to appropriate training and clinical supervision to keep them up to date with current practice. The provider had systems in place to reduce the risk of cross contamination and responded robustly when we identified an infection control concern.

People were supported by staff that understood their roles in safeguarding them from abuse. Staff had been trained to carry out their roles and had regular meetings with their line managers. Where any incidents had occurred, staff responded to these appropriately. The provider monitored accidents, incidents and complaints. People and their relatives were aware of how to raise a complaint and the provider responded to any concerns appropriately. There were sufficient numbers of staff to keep people safe and the provider carried out the appropriate checks on all new staff to ensure that they were suitable for their roles.

People received person centred care from kind and compassionate staff. Care plans contained important information about people’s needs as well as their routines and what was important to them. A thorough assessment was carried out before people came to live at the service. People told us that the staff that provided care to them were kind and caring. Care was provided in a way that involved people and helped them to maintain their independence. Staff were respectful of people’s privacy and dignity when providing care. The provider prepared appropriate plans where people received care at the end of their lives and staff were trained in this area.

The provider regularly sought feedback from people and relatives about the quality of the care that they received. People gave feedback about food and activities that was responded to by the provider. People’s dietary needs were met and people were prepared food in line with their preferences. People gave us positive feedback about the food that they received. There were regular activities taking place at the home and these reflected people’s interests.

There was clear leadership at the service and the provider had systems in place to enable effective communication between staff. People, relatives and staff had regular meetings where they could have their say about how the service was run. The provider carried out regular audits in areas such as documentation, dignity and infection control. Where improvements were identified, these were added to the provider’s ongoing plan to improve the service and were actioned by staff. The provider kept accurate and up to date records to ensure people received the right care.