This inspection took place on 14 September 2016 and was unannounced. This meant that the registered provider did not know we would be visiting. The home was last inspected on 25 April 2014 and the registered provider was compliant with the regulations in force at that time.

The home is registered to provide accommodation and care for up to 45 older people, including people who are living with dementia. On the day of the inspection there were 44 people living at the home. The home is situated in Heckmondwike, in West Yorkshire. The premises had two floors; the ground floor accommodation had easy access to an enclosed garden and the first floor was accessed by a passenger lift. People had single bedrooms with an en-suite shower and toilet, and there was a communal bathroom on each floor.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). 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.

On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. New staff had been employed following the home’s recruitment and selection policies and this ensured that only people considered suitable to work with vulnerable people worked at Avery Mews.

People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The registered manager recorded and monitored accidents and incidents so that any patterns that might be emerging could be identified and the risk of reoccurrence could be reduced.

We checked medication systems and saw that medicines were stored, recorded and administered safely. Staff who had responsibility for the administration of medication had received appropriate training.

People who lived at the home and relatives told us that staff were very caring and that they respected people’s privacy and dignity. We saw that there were positive relationships between people who lived at the home, relatives and staff. People's care plans recorded information about their individual care and support needs and their life history, which helped staff to have an in-depth knowledge of people’s needs .

A variety of activities were provided to meet people’s individual needs, and people were encouraged to take part. People’s family and friends were made welcome at the home.

People told us that they were very happy with the food provided. We observed that people’s nutritional needs had been assessed and individual food and drink requirements were met. Efforts had been made to make meal times and morning and afternoon snacks an ‘occasion’.

The premises were clean, hygienic and well maintained. We saw there was appropriate signage, decoration and prompts to assist people in finding their way around the home.

There were systems in place to seek feedback from people who lived at the home, relatives and staff. People told us they were confident their complaints and concerns would be listened to. Any complaints made to the home had been investigated and appropriate action had been taken to make any required improvements.

Staff told us that they were well supported by the registered manager and senior staff group. They confirmed that they received induction training when they were new

The inspection visit was carried out by one inspector. During the inspection, they spoke with the home manager, a senior care assistant, 2 care assistants, three people who lived at the home and the relatives of two people. The inspector also looked around the premises, observed staff interactions with people who lived at the home, and looked at records.

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five key questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were cared for in an environment that was clean and hygienic.

There were enough staff on duty to meet the needs of the people who lived at the home.

One person's relative told us, “They seem to have plenty of staff around and they’re always friendly. He’s enjoying the meals.”

Is the service effective?

We looked at four people’s care files we saw their individual needs were assessed thoroughly and care and support was developed from an assessment of their needs.

One person’s care records showed they were receiving care and treatment for a pressure sore. They had also lost weight in recent months. Their care records showed the pressure sores were now healing and they were gaining weight.

People were provided with a healthy nutritionally balanced diet to support their health, this protected people from the risks of inadequate nutrition and dehydration.

Is the service caring?

People were supported by kind and attentive staff who obviously knew people well. We saw that care assistants were patient and encouraging when supporting people.

The manager told us, “The care here is 150%, I really can say that.”

The two relatives of people we spoke with all told us they were very happy with the care provided at the home. One person’s relative told us, “He seems to like it here and he’s doing better than he was at home.” “The staff here are always friendly. He’s enjoying the meals.” Another relative told us "The care is good although they could do with more one to one activities."

The care assistants we spoke with told us they felt confident the service provided to people who lived at the home was good and they had a good staff team. When we looked around the home we saw people’s bedrooms had been personalised and contained personal items such as family photographs.

Is the service responsive?

We saw from the care records that people’s needs had been assessed before they moved into the home. Records confirmed people’s preferences, interests and life histories had been recorded. The care, treatment and support provided at the home met their individual needs.

People had access to appropriate activities and were supported to maintain relationships with their friends and relatives.

Is the service well-led?

The home manager has held the position for a number of years since the home opened. Staff we spoke with told us they felt well-supported by the home manager. One of them said, “The manager is really lovely; very approachable and encouraging.”

When we visited the home we spoke with two people who lived at the home and they both told us they thought the home was a lovely place to live and the staff were very good. They also told us the food is excellent and they felt well looked after. We also spoke with two people's relatives. One of them told us 'It is like a weight has been lifted off my shoulders knowing my relative is living here. The home is excellent and the staff are too. I can visit whenever I like and am invited to join in activities or events. The manager is always around the home. Its a great place'. Another person's relative told us 'We know our relative receives good care here. The staff are great and we are kept informed of any changes. There's a real family feel to the place and you can tell the staff know what they're doing'.

At the time of our visit we spoke with two relatives of people who live at the home. One relative told us that a friend had recommended the home to the family. They also told us the home is fantastic and she could not thank them enough for the care they gave to her mum and the staff had always involved them in all aspects of their mum's care. Another relative said 'I love it, its like a hotel and the staff are brilliant. The manager is very supportive and understood how difficult the decision was for us to move our relative into a home'. We also spoke with four people who live at the home. They told us the home is lovely, the food is good, they have many activities on offer and their visitors and relatives are made very welcome and enjoy attending events at the home.

People told us that they were very happy with the care that they were receiving in the home. They said they feel safe in the home, and that they were happy with the staff. They said that they really like the quiz because their families join in. They told us that they were very happy with the food. They said that the home was nicely kept and that they were comfortable and that the home is always clean. Nobody made any complaints to us, but they were confident about complaining to the manager, if they had a complaint to make.