St Stephens Nursing Home

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 17 people. There were 16 people living at the service when we inspected. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People continued to be safe at St Stephens Nursing Home. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them. People felt a part of their local community and were supported to use local resources such as library, community park and pubs.

People were involved in the running of the service and were consulted on key issues that may affect them.

People received the support they needed to stay healthy and to access healthcare services. Each person had an up to date support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. One visiting support worker said, "Oral hygiene is excellent."

We observed people's rights, their dignity and privacy were respected.

Staff supported people to maintain a balanced diet and monitor their nutritional health.

Medicines were stored and managed safely by the registered nurses. The registered nurses were responsible for medicine administration. There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People received care from staff who were well supported with induction and training. Registered nurses'

competency was checked once a year with the Nursing and Midwifery Council [NMC].

People knew how to complain and that any concerns would be listened and responded to by the provider.

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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.