The inspection took place on 1 and 6 February 2017. The inspection was unannounced.

Apple Tree Care Home is a care home providing accommodation and personal care for up to twenty older people, some of whom are living with dementia. At the time of our inspection there were 19 people receiving a service. The home is located just outside the City of York in the village of Strensall. The service was previously registered under a different provider name, but had the same owners. Due to being a new provider and legal entity they were required to re-register the service with the Care Quality Commission. The service was re-registered in March 2016 and therefore this was the first comprehensive rated inspection since the new registration.

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.

People told us they felt safe. The registered provider had policies and procedures in place to guide staff in safeguarding vulnerable adults from abuse. Staff we spoke with understood the different types of abuse that could occur and were able to explain what they would do if they had any concerns.

Risk assessments were in place minimise the risk of harm to people. The registered manager agreed to rectify some issues we identified in relation to risk assessment documentation.

The registered provider had a safe system for the recruitment of staff and was taking appropriate steps to ensure the suitability of workers. There were sufficient staff available to keep people safe and meet their needs.

Staff completed a comprehensive induction programme to help them carry out their roles effectively, and there was a schedule for updating this training when it was required. Staff received on-going supervision and competency checks to support and develop them in their roles. Staff meetings were held regularly.

Medication was appropriately administered to people and recorded on their medication administration records. Staff responsible for the administration of medicines had received training and the registered manager completed medication audits and staff competency observations. This showed that there were systems in place to ensure people received their medicines safely.

Staff were able to demonstrate an understanding of the importance of gaining consent before providing care to someone and we found the service was meeting the requirements of law when people's liberty was deprived.

There was a warm and friendly atmosphere in the home, and a range of activities were available to people. The decoration in the home had been chosen with careful consideration for the needs of people with dementia. Colours and textures were used to provide stimulation to people and there was signage around the home to help orientate them.

People were supported to maintain good health and access healthcare services. We saw evidence in care files that people had accessed a range of healthcare support where required, and staff were attentive to any changes in people’s health. Staff at the service had developed positive working relationships and good communication with other healthcare professionals and services. People received support to ensure their nutritional needs were met.

We received unanimously positive feedback about the kind, caring and dedicated manner of staff. It was evident that staff knew people well and that people had very positive caring relationships with the staff that supported them. Relatives provided us with examples of how staff had supported people to gain confidence and develop friendships. We found that staff treated people with dignity and respect.

Visitors were welcomed at any time. Relatives were involved in the development