This inspection took place on 18 and 19 October 2017 and was unannounced. At the last inspection on 03 and 08 November 2016 the service was rated as ‘Requires Improvement’ overall and specifically in the key questions of ‘is the service; ‘Safe’, ‘Responsive’ and ‘Well-Led’. At this inspection we found the provider had made significant improvements in these areas.

Wyndley Grange Nursing Home provides accommodation and nursing care for up to 64 people. At the time of our inspection there were 49 people living at the service. The location is divided into two units, Wyndley Grange and Wyndley Mill which are adjoined by a court yard.

There were two registered managers in post, who shared the managerial responsibilities for the 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.

People were kept safe by staff who understood how to identify when they were at risk of harm and abuse. People were supported by a staff team who had the skills to support them effectively.

Staff sought people’s consent before providing care and support. Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People’s rights to privacy and confidentiality were respected by the staff that supported them and their dignity was maintained.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there were positive interactions between staff and the people living at the location.

People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed.

The provider had quality assurance systems in place in order to develop service delivery.

Relatives and staff were confident about approaching the registered managers if they needed to and they responded to complaints and concerns appropriately.

The inspection took place on 3 and 8 November 2016 and was unannounced. We last inspected on 28 September 2015. At that inspection we found the provider was meeting all the regulations inspected.

Wyndley Grange provides nursing and personal care and support for up to 64 people. At the time of this inspection 35 people lived in the home. There were two registered managers in post who job shared. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was brought forward following concerns that had been raised with us in relation to people care needs not being met.

Staff had received training and felt this gave them the skills and knowledge they needed to meet people's needs. Staff understood the different types of abuse and knew what action they should take if they thought a person was at risk of harm.

Although risks to people were assessed, the systems and processes to address these risks were not always implemented to ensure people were kept safe.

People’s medicines were not always given as prescribed

Staff promoted people's privacy when they were supported with personal care. People felt staff were kind and had a caring approach to them. People felt involved in making decisions about their day to day care and people dignity and independence was maintained.

Where appropriate people were supported to access health and social care professionals however information was not always recorded to ensure that instructions from other health care professional were followed monitored and records maintained.

Staff did not feel supported or listened to by the management team. Although staffing levels were appropriate and agency staff were used to maintain the staffing levels. Permeant staff felt that the use of agency impacted on people care by not being familiar with people care need. People told us that agency staff did not always know their needs as well as other staff.

The provider had quality assurance and audit systems in place to monitor the care and support people received, but these were not effective and routinely implemented to ensure that processes and procedures were followed. The provider had not identified areas for improvement which we found during our inspection.

There were 30 people living at the home on the day of our visit, no one knew we would be visiting. We spoke to two people who lived at the home, three relatives, three staff, one visiting professional and the manager.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and as part of SOFI, we observed staff caring for them.

The two people we spoke with told us they were offered choices about their care and how they wanted staff to help them. One person using the service told us, “Staff are so kind to everyone, it’s a friendly place, have no worries’’.

A relative told us,” I am very happy they look after X well, staff are helpful and I know everything there is to know about X’s care’’.

Staff spoken with were able to tell us about people's needs so that they received care in a way that they preferred. All five relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care.

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support the people who lived in the home.

There were systems in place to monitor how the home was run, to ensure people received a quality service.

We visited the service on 25 November 2011. The majority of people living in the home were unable to express their views about their experience of living there. To enable us to see how people were being cared for we observed care worker and looked at peoples healthcare records.

Our observations told us care workers spoke to people with respect and ensured peoples' dignity was maintained.

We saw people being given one to one attention at lunch time. Care workers were discrete when assisting people.

The records we sampled showed us that the service monitors their own performance and takes action when they feel improvements are needed.

We spoke with two people living in the home who told us:

" The staff are very nice, nice home good food all you could ask for really''.

"The home is nice and clean and the staff are friendly, help me when I want them to. I see a doctor when I need one. If you ask for anything its done''.

This inspection took place on 18 and 19 October 2017 and was unannounced. At the last inspection on 03 and 08 November 2016 the service was rated as ‘Requires Improvement’ overall and specifically in the key questions of ‘is the service; ‘Safe’, ‘Responsive’ and ‘Well-Led’. At this inspection we found the provider had made significant improvements in these areas.

Wyndley Grange Nursing Home provides accommodation and nursing care for up to 64 people. At the time of our inspection there were 49 people living at the service. The location is divided into two units, Wyndley Grange and Wyndley Mill which are adjoined by a court yard.

There were two registered managers in post, who shared the managerial responsibilities for the 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.

People were kept safe by staff who understood how to identify when they were at risk of harm and abuse. People were supported by a staff team who had the skills to support them effectively.

Staff sought people’s consent before providing care and support. Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People’s rights to privacy and confidentiality were respected by the staff that supported them and their dignity was maintained.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there were positive interactions between staff and the people living at the location.

People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed.

The provider had quality assurance systems in place in order to develop service delivery.

Relatives and staff were confident about approaching the registered managers if they needed to and they responded to complaints and concerns appropriately.