This inspection took place on 22 November 2016 and was unannounced.

Victoria Chartwell is a nursing home registered for up to 22 people. It provides nursing care and personal support to older people with nursing care needs usually over sixty-five years of age. There were 19 people living at the service. The service is in a large detached house, arranged over three floors accessed by a passenger lift. The ground and first floor was used to provide people with nursing care, support and treatment. Long term care and respite care was provided. At the time of the inspection a contract was in place to provide six community short term beds (CSTS.) This is where people have been in hospital, or to prevent hospital admission and need a short period of rehabilitation before returning home.

This short-term rehabilitation is a joint partnership between Brighton and Hove City Council and the Sussex Community NHS Trust who work together to provide co-ordinated care. People have the guidance and regular support from the physiotherapists, occupational therapists, consultants for elderly care, GPs and a community mental health nurse. These specialists had worked with people to improve their independence and mobility prior to returning home.

There was a registered manager for 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 2008 and associated Regulations about how the service is run.

Senior staff carried out a range of internal audits, including care planning, checks that people were receiving the care they needed, medication, and infection control. However, we examined fluid charts and saw that care staff were offering fluids to people at risk of dehydration hourly, but there was no record on the amount of fluids to be given in a 24 hour period. Charts were not totalled to give care staff information on the level of fluids people had had during the day. We spoke with the care staff who demonstrated a good awareness of the fluids which had been provided, but the recording did not fully support this. Regular fire and health and safety checks of the building had not been completed in line with the provider’s policy and procedure. Residents meetings had not been regularly held to enable them to give their views on the care and support provided. Although there were opportunities for people to give feedback using the Choices NHS website, questionnaires had not been used to gain feedback in the service. Therefore people had limited opportunities to formally give their feedback, and for the staff to demonstrate how the service has moved forward and made improvements following feedback received. These are areas of practice which require improvement.

People told us they felt safe. One person told us, “I am safe because there are always staff available and I wake up to a happy face.” Another person told us about one member of staff who was, “A lovely jolly person, he really cares and looks in often to see if I am alright.” A member of staff told us, “We are here to protect them from harm and we know the numbers we need are in the office.” Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Staff were aware of their responsibilities from the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) Where people lacked capacity to make decisions about their care and treatment this had been considered in their best interests.

People and their relatives told us staff were kind and caring. They said there were adequate care staff on duty to meet people’s care and support needs. A compliment received by staff was, ‘Thank you for all the laughter and kindness, tea and cakes support and care that you all gave in your own ways to (Perso