The inspection took place on 11 and 14 October 2016 and was unannounced.

Avon Manor is registered to provide accommodation and care for up to 28 people living with dementia and/or other health needs. At the time of our inspection 27 people were in residence. Avon Manor is a large, older style property which is situated close to the town centre of Worthing and to the seafront. Communal areas include two large sitting/dining areas, a further quiet lounge with access to the gardens and a sun lounge which is used as a dining room. All bedrooms are of single occupancy.

A registered manager was in post. 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 protected from the risk of harm by trained staff, who recognised the signs of potential abuse and knew what action to take. People’s risks had been identified and assessed appropriately and guidance and advice provided for staff on how to mitigate risks. Staff had been trained in safe moving and handling techniques. Staffing levels were sufficient to meet people’s needs and keep them safe. Generally, medicines were managed safely, although we observed that some topical creams did not have the date of opening recorded on the tube or packaging. This issue was discussed with the registered manager so that appropriate action could be taken to address this.

Staff received a range of effective training and new staff complete the Care Certificate, a universally recognised qualification. Staff received regular supervision with the registered manager and attended staff meetings. Staff had been trained on the Mental Capacity Act 2005 and in Deprivation of Liberty Safeguards and understood their responsibilities under this legislation. People had sufficient to eat and drink and were encouraged with a healthy diet. People and their relatives expressed satisfaction with the meals on offer and people were supported by staff to ensure that mealtimes were an enjoyable experience. People were supported to maintain good health and had access to a range of healthcare professionals and services.

Staff knew people well and kind, caring relationships had been developed. The atmosphere at Avon Manor was warm and inviting and the resident pets: two dogs, a cat and three tortoises, were engaging and enjoyed by people living at the home. Relatives spoke highly of the caring attitude of staff. People were encouraged to be involved in all aspects of their care and relatives were also consulted and involved. People were treated with dignity and respect. At the end of their lives, people were supported to have a private, comfortable, dignified and pain-free death.

Personalised care plans were in place for people which included information about their lives before they came to Avon Manor. Detailed, comprehensive information enabled staff to provide people with the care they needed, in line with their personal preferences and choices. A range of activities had been organised and people were enjoying the activities on offer at the time of the inspection. There were limited opportunities for people to access the community on minibus outings. Relatives knew how to make a complaint, but no complaints had been received within the last year.

People, their relatives and staff were all asked for their views about the service and overall feedback was extremely positive and complimentary. Staff felt well supported by the registered manager and relatives expressed satisfaction with the quality of care delivered at Avon Manor. Audits were in place to measure and monitor the quality of care delivered. Some notifications that needed to be sent to the Commission had not been completed by the registered

We met all the people living at the home. We spoke with three people who used the service and three relatives who were visiting. One person said “the staff are very good.” Another said "I’m happy here.” One relative said “I couldn’t praise the home enough. I would recommend it to anyone.” Another said “It’s a really friendly home.” A third told us “(my relative) is really well looked after. It is absolutely fantastic.” We also spoke with two visitors who were looking for a home for a relative. They said “It is so welcoming here. The manager has made it easy and has relieved the stress.” A visiting nurse told us “It’s brilliant. The staff are really good. They follow our advice and contact us when they need to.”

We spoke with the manager, the cook, the care manager, one of the senior care staff, one day and one night care staff. One said “It’s a friendly atmosphere here”. Another said “It’s a home from home”.

We reviewed care records for three people who used the service. We found that people who lived at the home experienced safe and effective care because their needs were assessed and reviewed, and care plans kept current.

People could choose from a varied menu and had the support they needed to help them eat and drink.

There were sufficient staff with the right knowledge, experience and skills to meet people’s health and welfare needs.

People using the service benefited from a staff team who were well trained and supported to do their job.

During the visit we observed how people spent their time, the support they received from the staff and whether they had positive outcomes. We also spoke with six people who use the service, their relatives and the staff who were providing care to people. People told us that they received care from staff who were “kind and excellent”. A relative said that the staff were very good and knew “what to do” when supporting their relative. People expressed a high degree of satisfaction with the care and support they were receiving. Another relative said “you could not recommend them highly enough” when describing the home and staff. They commented the staff were courteous and respectful. Another person told us care “was very good” the staff engaged very well with them and their relatives. They described the staff as “very good people” another person said “I am very comfortable living here.”

People were assessed prior to receiving care. Risk assessments and care plans were detailed and person centred. People said that they were treated with respect and were asked for their preferred form of address.

There was a robust recruitment procedure that the staff followed. We found that all necessary staff’s checks were completed prior to them starting work. There was a complaint procedure that the manager and staff followed. People told us that they would approach the manager with any concerns and they were confident that this would be addressed.