Trees Nursing Home is registered to provide accommodation for up to 21 people who require nursing or personal care. The service provides support for older people, some of whom are living with dementia. Accommodation is provided on one floor. There are areas around the service where people could sit and relax, including the enclosed garden. At the time of our inspection there were 21 people living in the home.

This unannounced inspection took place on 20 September 2016.

The service had a registered manager. 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 not always supported to take their medicines as prescribed and medicines were not always safely managed.

Procedures were in place to check the quality of the care provided in the service.

An effective induction process was in place to support new staff and further training was provided to ensure all staff had the necessary expertise and skills.

People were involved when their needs had been assessed and reviewed so that staff knew how to provide the care and support they needed.

The risk of harm for people was reduced because staff knew how to recognise and report abuse. There was a sufficient number of staff to meet the care and support needs of people living in the home. Satisfactory pre-employment checks were completed before staff worked in the home.

People were supported to be as safe as possible because assessments of risks had been completed and included details of how the risks could be managed. This meant staff had the information they needed to reduce risks.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and could describe how people were supported to make decisions.

People had sufficient food and drink of their choice throughout the day. People were supported by kind, caring and happy staff. People’s privacy and dignity was respected by staff.

A number of systems, including feedback and information from people were used to monitor the quality of the service.

We spoke to four people who lived at the service, one relative of someone living at the service, three staff and the provider.

People were happy with the standard of the food that they were given by the service. We saw that people had a choice of different foods and had access to regular food and drink to help them maintain adequate nutritional intake and hydration. People’s risk of malnutrition was regularly assessed and the service was responsive to people’s nutritional needs to ensure that they were safe.

People told us that they felt safe living at the service and the provider had taken adequate steps to protect people from abuse. The service was clean, odour free and presentable.

People told us that the staff were caring. The provider carried out checks on their staff before they employed them to make sure that they were of good character and had the necessary skills and experience to enable them to care for the people living at the service safely.

People told us that they had no complaints and felt comfortable to complain if they needed to. We saw that the provider responded to complaints when they were made.

During the inspection we spoke with five people who used the service. We also spoke with three members of the care staff.

People who used the service told us that they thought it was a nice place to live. One person said that it was, "Better than where I lived before." They told us that they were encouraged to exercise and often went, "Into the garden to walk round with my daughter when she visits." They also told us that the food was very good with choices always available. Another person said that the staff were, "Very polite" and always, "Willing to help me if they can."

We looked at care records which showed that detailed assessments and care plans were in place to show how the needs of people who used the service had been identified and were met. People who used the service, or their families, were involved in the care planning process. People who used the service were regularly asked for their views on the care and treatment provided.

We found that the premises were well maintained and regular maintenance carried out.