This care service is owned by Weatherstones House Care Limited.

Weatherstones Nursing Home is a large sandstone detached property in two acres of grounds. It is situated on the A540 close to the village of Willaston and the town of Neston. The home has 24 bedrooms, 15 of which have en-suite facilities. There are two floors with a passenger lift and staircase.

The service had a registered manager who was registered with us in 2014. 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 manager was present during the days of our visit.

On our last visit, we rated the service as good. This inspection found that overall the service remains good.

Staff understood the types of abuse that could occur and measures were in place to ensure that people who used the service were protected.

Staffing levels were appropriate to meet people’s needs.

Medication management was robust with medicines appropriately stored and accounted for, however improvements were needed to make medication administration more person-centred. These steps have subsequently been taken.

Recruitment procedures included checks on new staff to ensure that they were suitable to support vulnerable people.

The premises were well maintained and all checks on equipment such as portable hoists or electrical equipment had been made.

Staff received the training and supervision they required to perform their role. A structured induction process was in place for new staff.

The registered provider had demonstrated a clear process for determining people’s capacity in line with the principles of the Mental Capacity Act 2005.

Signage had been put into place for one person living with dementia. This assisted in orientating this person around the building.

The nutritional needs of people were met. People were referred to other health professionals in order to promote their wellbeing.

People were supported in a kind and patient manner. Staff ensured that people’s privacy and dignity was upheld at all times. People were enabled to be as independent as possible and have their wishes respected.

Care plans were in place. These were reviewed and include key information about each person. Care plans included reference to the preference, likes and dislikes people had and how they wished to pursue daily routines.

Activities were provided and subsequent action has been taken to ensure that this was person centred.

A complaints procedure was in place. No complaints had been received but people felt confident that their views would be listened to.

People commented that the service was “home-like” and staff considered the culture of the registered manager to be supportive and approachable.

People had the opportunity to express their views about the support they received and these were positive.

Audits were in place to measure the quality of the service provided.

The inspection was unannounced and took place on 28 September and 10 December 2015. This location was last inspected in March 2014 when it was found to be compliant with all the regulations which apply to a service of this type.

Weatherstones Nursing Home is a large sandstone detached property set in two acres of grounds. It is registered to provide care to frail older people. It is situated on the A540, close to the village of Willaston and the town of Neston. A private drive leads to the house with good parking facilities. The home has 24 bedrooms, 15 of which have en-suite facilities. There were 19 people living in the home at the time of our visits.

There are two floors with a passenger lift and staircase to the first floor. There are a variety of aids and adaptations around the building to allow residents to move about independently.

There is a dining room and two lounges and a conservatory sitting area which overlooks the private gardens.

There is a registered manager at Weatherstones Nursing 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.

We found that care was provided by a long term staff group in an environment which was friendly and homely. People were well supported by experienced well trained staff. All staff spoken with said they had received good training to help them to understand and care for people who lived at the home.

The relationships we saw were caring, respectful and dignified and the atmosphere was one of calm and comfort. Everyone in the service looked relaxed and comfortable with each other and with all of the staff.

Staff members had developed good relationships with people living at the home and care plans clearly identified people’s needs, which ensured people received the care they wanted in the way they preferred.

Activities were provided when people wanted them and reflected the hobbies and interests of the people living at the home. The home employed an activity co-ordinator to ensure activities were also formally arranged.

Staff knew about the need to safeguard people and were provided with the right information they needed to do this. They knew what to do if they had a concern. There was sufficient staff to meet the needs of the people who lived in the home.

The home was generally clean and hygienic and adapted where required. People had their own bedrooms which they could personalise as they wished. However we saw some heavy soiling of communal carpets throughout the premises and the registered manager told us that a refurbishment of the home was due to take place and the communal carpets were to be replaced.

The registered manager had been registered as manager with CQC since 2014 and was fully conversant with the policies and practices of the home. Staff told us that they were very well supported by the management team who were transparent, knowledgeable and reliable and that the home was run in the very best interests of the people who lived there.

We spoke with four people who used the service. They all told us they were happy at Weatherstones House and had no concerns with the care provided. Comments from them included: “It is nice to wake up and know I will be looked after” and “The carer’s are super. I couldn’t praise them enough." We spoke with staff about people who used the service. We found they were knowledgeable about people's preferences and their social history.

We found that care plans demonstrated people's weight was monitored on a regular basis. We saw that nutritional assessments to identify if people were at risk from malnutrition also formed part of people's care plans. Where a risk had been identified additional care plans were in place.

We found that fire alarms were tested weekly. Discussions with staff demonstrated they were knowledgeable of the fire safety procedures the service had in place and knew what to do in the event of an emergency.

We looked at five staff files. They contained copies of the relevant qualifications for each staff member in line with the role they were undertaking within the service. This showed that the people who used the service are supported by staff that had the right skills and competencies.

We found that no concerns were raised in the survey's that had been completed by people who used the service and/or their representatives.

We found that staff understood their responsibilities so that records were kept accurate and fit for purpose.

During a previous inspection we identified concerns in relation to assessing and monitoring the quality of service provision. We found the service did not have any written audits or evidence to show regular monitoring and assessment of the management of health and safety, training, complaints, medicines management and the management of finances for people living at the home. We also identified concerns in relation to supporting workers as training was not current in a number of core areas. The service also did not have a manager that was registered with us.

We revisited the home and found training was now current for all core areas. Audits were now in for place health and safety, training, complaints, medicines management and the management of finances for people living at the home. However, the provider did not have an effective system to regularly assess and monitor the quality of service that people received. The service still did not have a manager that was registered with us.

We spoke with five people who used the service. Comments from them included “I’m very happy here. The staff are very kind and nice”, “I couldn’t be better. They(the staff) really look after you."

We spoke to people using the service who told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

We spoke with seven people living at the home and two relatives. They told us that they were happy with the service they received. Their comments included “they tell me what they are doing, if they don’t tell me I ask”; “you always get a choice of what you want to do”; “very respectful”; "they will always oblige if you want to do or try something different”; “I only have to say I want to see the doctor and the doctor visits” and you “can go to bed and get up when you want.”

A visiting relative said 'all clothes have to be marked with a person's name but the staff get to know the clothes and they don’t get mixed up. Residents are kept spotless, the clothes are kept perfect.'

People told us told us positive things about the meals they received. Their comments included “there is a choice of wonderful food”; “food is marvellous”; “I am quite partial to Chinese food. I mentioned it to the chef and we had sweet and sour chicken”; “I have toast or teacake before I settle down for the night. My food levels have to be kept up as I am diabetic.”

A visitor told us that they once visited when their relative was in bed ill. They told us that as they arrived a member of staff was “sitting by her bed encouraging her to drink sips of water. The assistant chef visited her taking suitable food to encourage her to eat.”

People spoke highly of the service they received. Their comments included “I am very lucky to be here, they’re wonderful to me” and “they’re excellent. I’m treated well.”

People told us that if they had any concerns they would feel comfortable in approaching the manager.

People told us “if I ring the buzzer the staff come, sometimes they pop their head around the door and tell me they will come back soon.”

People also told us “nothing is too much trouble for the staff” and “they’re excellent, I’m treated well.”

We spoke to six people who lived at the home and asked their views about living at Weatherstones House.

They felt the standard of care provided by the staff was very good and that staff were very kind.

Everybody told us they would ask to talk to the staff if they had any concerns or queries.

People living at the home made the following comments about the staff that supported them:

“We are all very happy here and the food is good.”

“We like the new chairs and what they are doing to decorate the home and do it up.”

“All of the staff are really kind, there’s just not enough of them.”

People living at the home also made various suggestions how they felt the home could improve in some areas such as,

“We would like more to do in the day time and would love to go out more often, we went to a garden centre recently and really enjoyed that.”

“We like the menus in the dining room but some people who are near sighted cant really see them”

“The conservatory is nice but it gets very warm.”

We had also contacted the local authority contracts and monitoring team for Cheshire West and Chester before we visited the service. They were positive about the service and they had no issues of concern to report.

We also met a visiting general practitioner during our visit. They were very positive about the home and acknowledged a lot of improvements in the development of the home.