This inspection took place on 18 September 2017 and was unannounced. Westcroft nursing home provides personal care and accommodation, diagnostic and screening procedures and treatment of disease, disorder or injury for up to 28 older people some of whom are living with dementia, at the time of the inspection there were 24 people living at the service.

There was a registered manager in post at the time of our inspection. 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.

At the last inspection on 16 August 2016, we asked the provider to take action to make improvements to medicines that were not managed safely, people had not always had their rights protected and audits were not always effective. At this inspection we found action had been taken to make improvements but further improvements were required.

People felt safe and staff understood how to safeguard people from abuse. Risks to people’s safety were assessed and plans were put in place to mitigate these risks which were reviewed regularly. Peoples' medicines were managed safely. There were sufficient staff to support people and the provider had systems in place to safely recruit staff.

People received support from knowledgeable staff that had access to good support from the provider. 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. People enjoyed the food, could choose what to eat and had their dietary needs met. People received support to access health professionals to maintain and improve their health.

People told us staff were caring. People were able to make choices about their care and support and their independence was encouraged by staff. People’s privacy and dignity was maintained by staff.

People’s needs were assessed and plans were in place to meet those needs. Staff were aware of people’s preferences for care and support and these were met. People had access to individual and group activities. People were able to make complaints and felt these would be dealt with effectively.

The provider had systems in place to improve the quality of the service people received however some improvements were required to the effectiveness of these systems. People were positive and complimentary about the service and felt the management team were supportive and approachable. People were able to express their views about the service and felt they would be listened to.

This inspection took place on 16 August 2016 and was unannounced.

The service was registered to provide accommodation for 28 people who require nursing or personal care. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 26 people were living in the home.

The service had 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.

Medicines were not always managed safely and correctly as records showed that stock levels were incorrect.

The least restrictive route to keep some people safe and manage their risks had not been considered. This meant that the service could not be sure they were acting in accordance with the MCA.

We saw that systems were in place to monitor the quality of the home; however these were not always effective as they had not identified issues found during the inspection.

Care plans were not detailed so that staff had the information they needed to be able to provide support to meet people’s needs and requirements around behaviours that may challenge. However, people received support from staff that met their individual needs and preferences and they were provided with opportunities to participate in activities that interested them.

People felt safe and staff knew how to protect people from avoidable harm and abuse. People's risks were assessed and managed to help keep people safe. There were enough staff to meet people's needs. People told us and we saw that requests for support were responded to promptly by staff.

Staff were able to meet people's needs and were supported and supervised to help them deliver the care and support people needed

People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with support when required to ensure their nutritional needs were met.

People's health was monitored and access to healthcare professionals was arranged when required.

People were treated with kindness and compassion and they were happy with the care they received. People were encouraged to make choices about their care and their privacy and dignity was respected.

People and their relatives knew how to complain and complaints were encouraged to give feedback on the care provided. The registered manager and provider responded to feedback and changes were made to improve the quality of the service provided.

There was a relaxed and homely atmosphere at the service and people felt the registered manager was approachable.

We spoke with a number of people during our inspection of Westcroft nursing home; these included five people who used the service, five relatives of people who used the service; five members of staff, the registered manager and a director of the company. We wanted to know their views about how the service was delivered and the quality of service provided.

We reviewed care records and other documents to ensure that people who used the service received care appropriate to their needs.

We observed that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes when it was in their best interest.

People told us that they were happy with the care and support they received. One person who used the service told us, "I love my days here”. And speaking of the manager they told us, “This man is marvellous”.

We saw that medication was dealt with correctly. Procedures were followed and records made which kept people safe.

Training, support and supervision enabled staff to deliver care to an appropriate standard. A member of staff told us, "The manager is really approachable".

There were systems in place to monitor and assess the quality of the service provided. People's health, welfare and safety were monitored.