The inspection took place on the 25 and 26 October and was unannounced.

Cranleigh Paddock is registered to provide care for up to 32 people. The home is registered with the Care Quality Commission to provide accommodation and personal care for older people. There were 26 people using the service at the time of our inspection including people living with dementia. The accommodation is provided at ground floor level and is divided into four units, each of which accommodates up to eight people.

The home had a registered manager in place. 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 and staff were aware of the procedure to take if abuse was suspected.

People's needs had been identified and the risks associated with people's care and support had been assessed and managed. Where risks had been identified these had been minimised to better protect people's health and welfare.

Staff were recruited safely and records included appropriate checks as well as proof of identity to ensure they were suitable for the role they were employed to undertake.

There were enough staff deployed to meet the care and support needs of the people living in the home. The registered manager monitored staffing levels on a monthly basis to ensure appropriate numbers of staff were deployed.

People received their medicines as prescribed. Systems were in place to regularly audit the medicines held at the service and appropriate records were being kept.

The registered manager was knowledgeable about the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). When people were assessed as unable to make decisions for themselves the MCA 2005 process had been followed. DoLS are put in place to protect people where their freedom of movement is restricted to prevent them from possible harm. The registered manager had taken appropriate action for people who needed their movement restricted.

People had sufficient to eat and drink and were supported to maintain a balanced diet. They had access to a range of healthcare professionals and services.

People were looked after by kind and caring staff who knew them well. They were supported to express their views and to be involved in all aspects of their care. People were treated with dignity and respect.

People and their relatives thought that the home was well-led. They all spoke positively about the registered manager and the staff group.

Complaints policies and procedures were in place and were available to people and visitors. Relatives told us they were confident that they could raise concerns or complaints and that these would be dealt with accordingly.

We inspected against the regulated activity of accommodation for persons who require nursing or personal care. The provider is also registered to provide the regulated activity of treatment of disease, disorder or injury, however this was not being provided by the service.

During this inspection we spoke with a person who was using the service, who praised the care and support they received and said “I don’t know where I’d be if not here”. They told us they ate well and “The food is good”. They said the “Staff are marvellous”. We also spoke with the registered manager, the assistant unit manager and six members of staff. People’s needs were assessed and care and support was planned and delivered in line with their individual care plan. Their health needs were monitored and referred to health professionals appropriately.

People were supported to be able to eat and drink sufficient amounts to meet their needs. There was a relaxed atmosphere in the home and we saw that staff communicated well with people and promoted an inclusive, supportive environment. Training and supervision was provided to staff to ensure they were supported to deliver care and support safely and to an appropriate standard. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

During this visit we met some of the people who use the service and spoke with the registered manager, the deputy manager and four members of staff. We used a number of different methods to help us understand the experiences of people using the service, because they had complex needs which meant they were not all able to tell us their experiences. We spoke to a relative of one person who used the service, observed care and support being given and how staff interacted with people. We saw that staff communicated well with people who used the service and promoted a supportive environment.

A person who uses the service confirmed that staff discussed their care and support with them and told us they were happy with the way care was given. They said that living at Cranleigh Paddock was like “a home from home” and that they felt “looked after and cared for”. They said they were able to “have a laugh and a joke” with the staff, who were “always cheerful”. A visiting relative told us that staff consulted them about the care their mother was given and that they had no concerns in relation to the care she was receiving at the home. Both the person using the service and the relative were confident that the management would respond appropriately to any concerns or issues they might have.