Well Springs is a care home with nursing and can accommodate up to 52 people. It is a converted property. The grounds are secure and accessible to people living in the home. At the time of our inspection there were 46 people living at the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service was exceptionally caring. Everyone we spoke with was highly complimentary about the service and said they would recommend the home. There was a strongly embedded culture within the service of treating people with dignity and respect and going the extra mile to enhance people’s quality of life.

People and their relatives told us staff were helpful, attentive and caring. We saw people were treated with the utmost respect and compassion.

Staff were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff were supported by the management team and were receiving formal supervision where they could discuss their ongoing development needs.

Care plans were up to date and detailed what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. People felt safe at the home and appropriate referrals were being made to the safeguarding team when this had been necessary.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s healthcare needs were being met and medicines were stored and managed safely.

Staff knew about people’s dietary needs and preferences. People told us there was a good choice of meals and said the food was good. There were plenty of drinks available for people in between meals.

Activities were on offer to keep people occupied both on a group and individual basis. Visitors were made to feel welcome.

The home was well decorated, clean and tidy.

The complaints procedure was displayed. Records showed complaints received had been dealt with appropriately.

Everyone spoke highly of the management team saying they were approachable and supportive. The provider had effective systems in place to monitor the quality of care provided and where issues were identified they took action to make improvements.

We found all the fundamental standards were being met. Further information is in the detailed findings below.

The inspection was carried out on 15 September 2015 and was unannounced. There were 48 people who used the service at the time of the inspection.

The last inspection took place on 17 March 2014 and at that time the provider was meeting the regulations inspected.

Well Springs Nursing Home is registered to provide care and treatment for up to 52 people requiring nursing care. The home is a converted house with large gardens which can be used by the people living there. Accommodation is provided over two floors. The service is well located for access to local amenities and public transport.

The home has a registered manager. 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.

Staff knew how to recognise and report abuse and any concerns about people’s safety and welfare. Information about whistle blowing was included in people’s care records which helped to keep it at the forefront of people’s minds. Checks on new staff were carried out to make sure they were suitable to work in a care setting before they started work and this helped to protect people.

There were enough staff to provide people with the care and support they needed. The numbers and skill mix of staff was kept under review and changed as necessary to take account of people’s changing needs. Staff were supported to develop their skills and knowledge through a planned training programme and individual supervisions which helped to make sure they were competent to meet people’s needs. We observed staff were attentive to people’s needs and were patient and compassionate. We observed staff interacted respectfully with people who used the service, visitors and each other.

People’s medicines were managed safely. The service was working in accordance with the requirements of the Mental Capacity Act which meant people’s rights were protected and promoted.

People were supported to have a varied and nutritious diet and their individual preferences were catered for. When people were at risk of poor nutrition and/or weight loss this was being dealt with. People were supported to meet their health care needs and had access to the full range of NHS services.

The home was safe, well maintained and clean and there were no unpleasant odours. There was an on-going programme of refurbishment and redecoration.

People who lived at the home and/or their representatives were involved in planning how their care and support would be provided. People’s care records were up to date and provided clear guidance for staff on how to support people to meet their needs and maintain their independence.

There was a varied programme of activities tailored to take account of people’s individual preferences. Activities were organised in small groups and on a one to one basis and people were supported to take part in social activities outside the home.

People were given information about how to raise concerns or make a complaint. There was evidence complaints were dealt with and where appropriate action was taken to reduce the risk of the same thing happening again.

There were processes in place to monitor and assess the quality of the services provided and it was evident action was taken to address any shortfalls identified. People who used the service, their representatives and staff were supported to share their views of the service by way of quality assurance surveys, meetings and in the case of people who used the service individual care reviews. The management team had a visible presence in the home and there was a culture of openness and transparency.

A number of people who used the service had complex needs and we were unable to communicate with them. We used an observation tool to look at interactions between staff and people who used the service. We saw that interactions between staff and people who used the service were generally positive, with staff displaying warmth and respect to people.

We spoke with two people who used the service; they said they were given sufficient choice in their daily lives, for example, what they wanted to eat and what activities they wanted to do.

We spoke with two people’s relatives. They told us they were happy with the care and treatment provided by the service, one person said the staff were “Very attentive”. They told us they were kept informed and said if they had any concerns they were confident they would be dealt with appropriately.

Staff all told us they thought people got good or excellent care at the home and nobody had any concerns regarding the standard of care. They all said they would recommend the home to a relative.

We found people were asked for their consent to care and treatment and when people did not have the capacity to give informed consent the provider acted in accordance with the law.

We found people’s care needs were assessed and care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.

We found people were provided with a choice of suitable and nutritious food and drink.

We spoke with four people who used the service and they were satisfied with the care and support they received. One person said “I’m waiting for staff to take me to the toilet, they are good like that, they look after me”. We spoke with four people who were visiting relatives in the home. They said overall they were happy with the care provided. They said their relatives were always appropriately dressed and clean when they visited. However, despite the positive comments people made we found improvements were needed to the way people’s care was planned and delivered.

We also found improvements were needed to the way people who lacked capacity were supported to express their views.

We observed staff knew people and greeted them by name. Most of the staff supported people in a dignified and respectful way, however, we observed some staff interactions which were not appropriate and did not include an explanation of the care being provided.

There were hot and cold drinks available in the communal rooms for people who used the service and visitors. We asked people if they had enjoyed lunch, one person said “the foods ok” and another said “it’s ok, it passes half an hour”. We found improvements were needed to the way people were supported with their dietary needs and preferences.

We found the home was clean.

We found there were enough skilled and experienced staff to meet people’s needs and people described the staff as “friendly” and “helpful”.

During the inspection we spoke with seven people using the service and two relatives. They all told us they were happy with the care they received at Well Springs Nursing Home. One person told us "I would recommend the home to anybody I am well looked after" another "The staff are really lovely and look after me."

A relative told us "They are very good to my relative but they are very good to me as well, the staff are very nice."

One relative told us "I am quite happy with the way that my relative is cared for, I can come anytime night or day and I feel included in the care of my relative."

We spoke with seven people using the service and they all told us they felt safe at Well Springs. The two relatives we spoke with also had no concerns regarding peoples safety.