The inspection took place on 5th April 2016 and was unannounced. This was the first inspection of this service which provides accommodation and nursing care for up to 60 people. On the day of our inspection there were 17 people using the service.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 staff had attended training to ensure they had good understanding of their roles and responsibilities. The training included safeguarding so that staff were knowledgeable about what to do if they suspected abuse was happening. The manager had shared information with the local authority when needed. An assessment to determine the person’s needs was carried out prior to admission to the service and was updated as required. The service also assessed risks to the people using the service and considered actions that could be taken to reduce these risks and keep them to a minimum.

People were supported by a sufficient number of suitably qualified nursing staff, supported by care staff. The provider had ensured appropriate recruitment checks were carried out on staff before they started work. Staff had been recruited safely and had the skills and knowledge to provide care and support to people in the ways they preferred.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Senior staff were also aware of best interest meetings and last power of attorney.

Understanding and empathic relationships had developed between people and staff. Staff responded to people’s needs in a compassionate and caring manner. People were supported to make day to day decisions and were treated with dignity and respect. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects of their lives. The service had set some lounges aside for various functions and had a cinema room plus a small garden terrace which staff and people using the service worked together to maintain.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. The manager and deputy manager supported and supervised staff in their roles. People, where able, were involved in the planning and reviewing of their care and support with families and nursing staff input as appropriate.

People’s health needs were managed appropriately with input from relevant health care professionals to support the resident service staff. People were treated with kindness and respect by staff who knew them well. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health. Staff ate meals with the people using the service at meal times which provided opportunities to discuss information and build relationships. Staff had t