About the service: Deansfield is a ‘care home’ registered to accommodate up to 15 people. At the time of this inspection the service was providing personal care to 14 older people, a number of people were living with dementia.

People’s experience of using this service:

People felt safe and care and support was of a very high standard.

People were very satisfied with the quality of the service provided and feedback from relatives, visitors and health professionals was exemplary.

People received their medicines as and when they needed them.

Risks to people were monitored and procedures were in place to help keep people safe.

People were protected from the risks associated with the control and spread of infection.

Staff understood the importance of ensuring people's rights were understood and protected. Individuality was celebrated.

People's health care needs were monitored and responded to promptly with cooperation and support from health care professionals.

There were sufficient staff to meet people’s needs flexibly. Staff felt very well supported and trained.

Support was very personalised to meet individual’s individual needs.

People told us staff fully understood their needs and were extremely kind and caring.

People were confident that complaints would be addressed and they could talk to the management team about anything.

Quality checks and audits enabled the registered manager to ensure improvements were made and excellent quality standards were maintained.

People received excellent support at the end of their lives.

The management of the service was innovative and inclusive. New initiatives were developed and tested to drive continuous improvement.

The service had excellent community links.

Rating at last inspection: The service was rated Outstanding at the last inspection in September 2015.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection visit took place 14 September 2015 and was unannounced. The last inspection visit was carried out 27 November 2013. At that inspection the provider was meeting all of the requirements of the regulations we reviewed.

Deansfield is registered to provide accommodation and personal care for a maximum of 15 older people. On the day of the inspection 15 people were living at the home.

The home had a registered manager in post who was present for the inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Clear guidance was in place and staff knew how to report any concerns about bad practice. Staff were trained in protecting people from harm. Risks were managed to keep people safe while promoting their independence. Care was regularly reviewed with people and their representatives where appropriate to reflect people’s changing needs. People were supported by sufficient numbers of staff so that their needs as individuals were met and their preferences respected. The provider believed that people should receive care and support that was not rushed or task focused. People were valued and their views and opinions were always sought.

Staff were recruited following a robust recruitment procedure and there were clear expectations from managers about work performance of staff. People received their medicines safely and as prescribed. Staff were trained in the safe handling and administration of medicines and their competency was regularly assessed.

The provider was committed to creating and developing a skilled workforce. People spoke highly about the skills and attitude of the staff team. Staff were supported through one-to-one meetings and annual development reviews to reflect on their practice and to look at ways of developing themselves by identifying future learning needs.

The registered manager and staff understood how to protect people’s human rights and worked within the current legislation to do this. People had regular access to healthcare professionals to monitor their wellbeing such as doctors, district nurse, chiropodists, dentists and via the memory clinic. We saw staff acted swiftly to engage the support of healthcare professionals where people needed specialist advice and assessments. The provider ensured the correct equipment was in place if people’s needs had changed in order not to place people and staff at risk.

Everyone we spoke with was happy with the care they or their loved one received. Staff knew people well and had positive relationships with them. The registered manager ensured that staff fully understood people’s needs before they were admitted to the home. Visitors were made welcome and people were supported to keep in contact with people who were important to them. People felt their dignity was promoted by staff and that staff were respectful and polite to them at all times. The service provided home cooked food and meal times were made a relaxed sociable experience for people and their families who chose to eat with their loved ones.

The provider and staff supported people in a number of creative ways to lead a fulfilling life when they went to live at Deansfield. Their commitment and determination to promote people’s quality of life was recognised in everything people told us and our observations. People told us they were able to raise any concerns they had and felt these would be acted on by the registered manager. The provider had a system to deal with any complaints.

There was strong leadership at the home which provided staff with drive and enthusiasm and ensured that there was regular evaluation of the work they carried out. The management team fully involved people and put them at the h

During our inspection we spoke with people who used the service, with the staff and management.

People told us that they were happy with the support they received, and that the staff looked after them well. They told us they liked the food, there was a choice of menu and that they chose where to eat.

Care records seen showed that people were supported with their care in a way that was individual and in accordance with their wishes. The care records reflected the health and personal care that people needed, and was appropriately checked and agreed with people or their next of kin.

We saw comments from relatives that included, “We are so grateful that X is so well looked after by you and your staff”. “Thank you for all the support you gave to my mother. We know it was not always easy but we knew the care she received was always first class”.

There were effective systems in place to reduce the risk and spread of infection.

We sampled recruitment records and saw that appropriate checks and interview processes were carried out. This ensured that suitable staff were employed to work in the home.

Staff were available in sufficient numbers to care for people and they received the training and support they needed to carry out their roles.

People told us what it was like to live at this home and described how they were treated by staff and of their involvement in making choices about their care. This inspection was part of an inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by one of two CQC inspectors joined by an Expert by Experience; people who have experience of using services and who can provide that perspective.

Deansfield Residential Care Home had new owners (provider) from August 2011. They were able to show us the improvements they had made to the environment and care since they had owned the home. Whilst the kitchen needed refurbishment we found that the provider had evidence of plans and expected this refurbishment to be completed later this year.

People told us they were happy living in the home. Comments included “I am satisfied and settled here. They look after us well,” and “The manager is a wonderful lady and the other staff.”

People could make choices about their life, such as when to get up, when to go to bed, whether to join in or spend time alone and when to eat. People had choices about what food they ate.

We found that efforts had been made to involve people living in the home with the village community. The manager had organised for people to go to events held in the village hall and at the church and the village had been invited to events at the home. This had resulted in more activities being available to people in the home.

We found there was good information about people and their nutritional and hydration needs and care staff knew about these needs. People received support from health professionals when this was needed. We observed that the lunch time meal was a social occasion with care staff eating with people in the home and supporting them when necessary. There were enough staff on duty for people to be cared for well.

Comments from care staff included "The manager tells us personal care takes as long as it takes, it should not be rushed," and it is like "A big family."