The Old Rectory Nursing Home

There was a strong, visible person-centred culture. This was evident from all staff within all roles. From care staff, domestic staff and management. The person-centred culture was embedded at all levels. The service ensured staff focussed on building and maintaining open and honest relationships with people and their families, friends and other carers. This really helped to promote and ensure the service was person-centred. A staff member commented: "It's about enriching people's lives. It's amazing here. We are like a family here. Everyone wants to make the residents happy, if they aren't happy, we aren't. Lifelong friends with staff and relatives. I love making the residents smile."

People were respected and valued as individuals, with staff thinking 'outside of the box.' For example, the staff were pro-active in ensuring care was based on people's preferences and interests, getting to know people as individuals, seeking out activities and opportunities in the wider community and helping people to live fulfilled lives, individually and in groups.

Staff were good at anticipating people's needs. We observed this throughout the inspection. Sensory stimulation is a very important part of the care provided to people living at The Old Rectory to aid their well- being. The service had created a haven of relaxation and therapeutic opportunities, including sight, sound and smell. People were enabled to relax in a lavender garden populated by bees and butterflies in the summer, watch the ducks and listen to running water from the duck pond. This gave people a sense of enjoyment and engagement. A relative commented: "(Relative) had a lovely summer here last year. She loves the garden. Her health improved last summer."

Staff were motivated to ensure people received care which was compassionate and kind. The atmosphere in the home was warm and friendly. We saw people had developed strong relationships with staff, and it was evident that this was an important ethos of the service. Staff told us they spent quality time chatting and building interpersonal relationships with people and saw this as a vital part of their role. They recognised how this gave people a sense of overall well-being and ensured the family feel of the home. This

was evident throughout our inspection with the general conversations and banter which were observed.

Staff had an excellent understanding of people's individual needs which protected their values and beliefs in a way the person wanted to receive care and support. The approach to care and support meant there was a multi-professional process which aimed at maintaining continuity, independence and autonomy for the person.

The service supported people to learn new skills and maintain their independence. For example, one person had learnt to paint, something they thought they would never be able to do. Their relative commented: "My aunt has become a talented painter! In the past she always said she couldn't draw or paint, but a few months ago she painted a large Van Gogh Sunflowers picture, which the home framed and now hangs in her room. It's amazing! Thank you to The Old Rectory for encouraging this latest talent."

A number of methods were used to assess the quality and safety of the service people received and continuous improvements were made in response to the findings.

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

The service provided safe care to people. One person commented "The staff are brilliant. I feel safe here and well cared for." A relative commented: "My (Mum) is very safe here. I feel reassured."

We did find certain issues with regards to medicines management, repositioning times and recruitment. However, these had been promptly addressed by the registered manager and provider following our inspection.

Staff ensured infection control procedures were in place. Personal protective equipment was readily available to staff when assisting people with personal care. For example, gloves and aprons. Staff had also completed infection control training.

Care files were personalised to reflect people's personal preferences. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

People received effective care and support from staff who were well trained and competent.