Trowbridge Oaks provides accommodation and nursing care for up to 52 older people. At the time of our inspection 49 people were living at the home. The home was last inspected in February 2014 and was found to be meeting all of the standards assessed.

This inspection took place on 10 January 2017 and was unannounced. We returned on 11 January 2017 to complete the inspection.

There was a registered manager in post at 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 and associated Regulations about how the service is run.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I am very happy here. The staff are excellent”, “The staff are very kind. I love it here” and “The nurses and carers are always there when you need them”. A relative told us, “I am very happy with the care that has been provided”. We observed staff interacting with people in a friendly and respectful manner. Staff respected people’s choices and privacy and responded to requests for assistance.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Comments included “I feel very safe here. Moving in was the best decision I made” and “I feel safe living here”. Systems were in place to protect people from abuse and harm and staff knew their responsibilities to protect people and keep them safe from harm.

Staff understood the needs of the people they were providing care for. People told us staff provided care with kindness and compassion.

Staff were appropriately trained and skilled. They received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.

The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback about their care and there was an effective complaints procedure.

The provider regularly assessed and monitored the quality of care provided at Trowbridge Oaks. The information from these assessments and people’s feedback was used to make improvements to the service provided.

On the day of our inspection, a high number of people were being nursed in bed due to their frailty. Many of these people were unable to give us detailed feedback about the care they received. We therefore observed interactions they had with staff and spoke with available relatives about their experiences of the service. Relatives and those people who were able to talk to us said they were happy with the service they received.

People presented as being well supported and their rights to privacy and dignity were maintained. Staff interacted with people in a caring and considerate manner.

A high number of people required staff assistance to eat and drink. Meals were served in a structured, organised manner. Staff were attentive to people’s needs and gave people time without rushing. There was an emphasis on good nutrition to enhance people’s wellbeing. People were supported to join in with various social activities which met their needs.

The environment was clean and systems were in place to minimise the risk of infection. Staff received infection control training and regular audits took place. Well maintained records demonstrated a comprehensive auditing system. People’s care plans were detailed, up to date and reflected the individual’s needs. Care charts and medication administration records were fully completed and well maintained. Records demonstrated a robust staff recruitment procedure was in place.

People told us that they were very happy with the care they received and the way in which staff supported them. They said their rights to privacy and dignity were maintained and staff spoke to them in a polite, friendly and respectful manner. People told us they met with the manager before their admission to the home. This meant they could talk about their personal preferences, their beliefs and the care they felt they needed. People told us they were involved in the development of their plan of care, which staff used a reference guide to support them effectively. People said their families were involved in these discussions if they wanted them to be. People had their care plan in their room so they could look at the information written about them at any time.

People looked well cared for with clean, laundered clothing, manicured nails and clean glasses. Those people in bed looked comfortable and relaxed. People were supported to have regular drinks and a choice of food which met their individual preferences. People in bed were supported to change their position at identified times to minimise their risk of developing a pressure sore. Attention was given to people’s social needs and a range of group and individual activities were provided. People had their call bell within easy reach so they could call for staff assistance as required. They said staff generally came to them quite quickly when they called them.

People told us that they liked the staff. They said they were well trained and competent in their role. Staff told us they had very good opportunities to undertake training which helped them to do their job effectively. They felt well supported and were aware of their responsibilities to recognise and respond to an allegation or suspicion of abuse.

People told us that they felt safe within the home and were aware of how they could raise a concern. People said the manager was very approachable so they felt any issues would be quickly addressed and resolved. People said they were asked about their views of the service they received and were encouraged to give suggestions about how the home could be improved upon.

One person living at the home said “we get choice about meals, they give as much choice as they can. One relative said of staff “they seem to ask".

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One relative said “staff are extremely caring and supportive. I have no complaints, all basic needs are met”. One person living at the home said “staff are cheerful, relaxed, and willing. They arrange for me to see the doctor or go to hospital”.

Staff received supervision, training, and professional development. One staff member said “I feel well supported”.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.