Wellington House Nursing Home is a care home which provides personal and nursing care for 30 older people. There are two floors to the home; there are bedrooms and communal rooms on both floors.

At our last inspection we rated the service good. However the safe domain was rated requires improvement because medicines were not always managed in a safe way. At this inspection we found improvements had been made to the way medicines were managed which means the safe domain is now rated good. We found the evidence for all other domains 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.

Why the service is rated Good.

The provider had acted upon the feedback in our last inspection report and improved the way medicines were managed at the home. This meant medicines were now managed safely.

Staff had a positive and proactive approach to risk management and staff regularly reviewed and adapted their practices to ensure people were kept safe.

Staff had appropriate skills and training and there were enough available to meet people’s needs.

People received enough to eat and drink and had their weight regularly checked. Staff were proactive in identifying changes, risks and concerns with people’s health and worked in partnership with other professionals to ensure people maintained good health.

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 support this practice.

Staff were kind, caring and had a good knowledge of people which they used to deliver personalised care. People told us they were treated with respect and staff had a high regard for protecting their privacy and dignity

The home was clean, homely and well maintained. There was a relaxed and friendly atmosphere throughout the home and visitors were made to feel welcome.

The services’ core values promoted a person centred approach with an emphasis on dignity, respect and supporting people to make decisions about their care, treatment and daily lives. Staff encouraged people to express their views and listened to what people had to say.

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. They continuously looked for ways to improve the service and had an improvement action plan in place to support this.

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

The inspection took place on 15 October 2015 and was unannounced. There were 27 people who used the service at the time of the inspection.

The last inspection of this service took place in September 2013. At that time the provider was meeting all the regulations inspected.

Wellington House is situated in a residential area of Shipley and provides nursing and personal care to a maximum of 30 people. The home caters for predominantly older people. It is a converted property with bedrooms for single and shared occupancy located on both the ground and first floor. There are communal rooms on both floors. There is a passenger lift.

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.

People who used the service told us they felt safe. The staff were trained on how to recognise and report abuse and had a good understanding of their responsibilities to protect people. The management team took concerns seriously and took action to make sure people were protected. There were effective recruitment procedures and this helped to protect people from the risk of being cared for by staff who were not suitable to work in a care setting.

There was not enough storage space for medicines and this led to staff not using individual boxes of one medication but using a “communal/stock" box for everyone who was prescribed this particular medication. We judged this to be a breach of regulation because it was not safe.

There were enough suitably trained and skilled staff to meet people’s needs. Staff were supported to develop their skills and knowledge by means of regular training, one to one supervisions and appraisals.

The home was clean and well maintained which meant people lived in a pleasant and safe environment.

The home was working in accordance with the Mental Capacity Act 2005 which meant people’s rights were protected. People were asked for their consent before care and treatment was delivered. People were supported to access the full range of NHS services to help make sure their healthcare needs were met.

People were offered a varied and nutritious range of food which reflected their preferences. When people were at risk of poor nutrition this was identified and appropriate action was taken to deal with the risk. The home did not have a dedicated dining room which meant people could miss out on the opportunity to experience some of the social aspects of meal times. The registered manager told us there were dining tables in the conservatory and main lounge and people were given the opportunity to dine at these tables if they wished to.

People’s needs were assessed and care was planned and delivered to meet their individual needs and preferences. People were involved in how their care was delivered, they were supported to express their views and their views were respected and acted on. People were supported to plan for their future care to help make sure they and their relatives received the right care and support at the end of life.

People were supported to maintain relationships with family and friends, for example by inviting them to have a meal with them at the home. People told us the staff were caring and compassionate and during the day we observed staff were kind and caring in their interactions with people. The atmosphere was relaxed and we heard staff engaging in friendly banter with people who used the service and their relatives. People were offered the opportunity to take part in a varied programme of social activities.

Any concerns people had were taken seriously and acted on and this meant they did not often find it necessary to make a formal complaint.

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 family and friends and staff were supported to share their views of the service by way of quality assurance surveys and meetings. The management team had a visible presence in the home and there was a culture of openness and transparency. The provider had a service improvement plan and was continually looking at how they could improve the service for the benefit of the people who lived there and others.

We identified one breach of regulation in relation to the safe management of medicines. You can see what action we told the provider to take at the back of the full version of the report.

People received care and support they agreed to. We spoke with seven people who used the service and two relatives. They told us they could make decisions about their care and support. One person said, “I always chose what I’m doing. I decide when I go to bed and when I get up. We can have breakfast in our room or in the lounge. Staff are always very polite. ” Another person said, “They always pop in to my room and ask if I’m ready to get up. There’s never any pressure.”

People said they were happy with the care and support they received. Everyone was complimentary about the staff who supported them and told us they were well looked after. One person said, “The staff are very good. We’re very well cared for.” Another person said, “The carers know what they are doing.” A relative said, “We chose this home because it was highly recommended and it’s lived up to its expectations.”

People who used the service, staff and visitors were protected against the risks of unsafe premises. People told us they were comfortable in their environment and could choose to spend time in communal areas or time in their room. Everyone we spoke with said the home was clean, tidy and well heated.

People who used the service were supported by suitably skilled and experienced staff.

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

People 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 and drink 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.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

People spoken with told us they were treated with dignity and respect and said staff would not enter their bedroom without knocking first. One person said, “They cover me up when I have a bath.” People also told us staff protected their dignity by making sure clothes were covering them when they were transferred between chairs.

None of the people spoken with had any concerns about their care and how they were supported by staff.

People spoken with said they enjoyed their meals and had enough to eat and drink. Comments included, “I always like the food but I’m a slow eater and like to eat a bit then leave it and try later”, “I see the dietitian” and “Staff help me to eat if I need it.”

People spoken with told us they would report any problems to care staff or to a relative. They said staff were very helpful and they felt safe and well looked after. One person told us that concerns they had in the past had been dealt with.

People spoken with told us they liked the staff. Comments included, “I couldn’t be happier”, “My care couldn’t be better”, “On the whole, they look after me well”, “Staff check on you pretty often” and “The staff come and see if I am managing.”

People spoken with were unsure if they had seen their care plan or contributed to it. However, we found people who used the service or their families had contributed to assessments and care plans as they contained information about preferences for care.