Drovers House provides accommodation and personal care for up to 75 older people who may live with dementia. Seventy-one people were living at the home at the time of our inspection visit. At the last inspection, the service was rated Good overall and Outstanding in well-led. At this inspection we found the service has maintained an Outstanding rating for well-led and improved the rating from Good to Outstanding in responsiveness to people’s individual needs. This has raised the overall rating from Good to Outstanding.

There were two registered managers for this service. 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.

One registered manager had managerial oversight of the service, but did not work at the home on a day-to-day basis. The second registered manager had transferred to another home in the provider’s group two weeks before our inspection. A new manager had been in post for two weeks. The new manager was already registered with us as a manager at another of the homes in the provider’s group, which had been rated as Outstanding under their leadership. The provider had notified us of these changes.

People were at the heart of the service. Staff and the management team shared and demonstrated the provider’s philosophy that, ‘every day should be a day well lived’. Staff received training in the provider’s values, which included, ‘play, make their day, be there and choose your attitude’. People were supported to maintain their purpose and pleasure in life and to plan ahead with staff.

The provider employed lifestyle coaches, who were dedicated to supporting people to make the most of each day through physical activity. The group and one-to-one activity sessions were effective and the positive impact on people’s moods was visible. Care staff ran a nightly ‘wide-awake’ club so people who did not sleep well spent their waking hours in purposeful activity. Healthcare professionals were complimentary about staff’s skill and willingness to engage people’s interest.

People were encouraged to maintain their preferred and familiar routines and habits, which made them content and relaxed. People were supported to maintain and improve their self-esteem by pursuing their individual interests by running and attending in-house clubs and events and celebrations, with days out in the local community.

The provider was innovative and creative and constantly strived to improve the quality of people’s lives. The provider had researched and reflected on how an internationally recognised provider of excellence in dementia care provided care. They had implemented technological systems that promoted undisturbed sleep, ensured staff and management had access to the most up-to-date information at the press of a button and enabled relatives to be fully informed and involved in their relations’ care. People benefited from the technology because staff had more time to care for them.

The registered manager participated in research projects aimed at improving the quality of people’s day-to-day lives by encouraging people to spend time outdoors every day with the aim of improving their sleep at night. People, their relatives and healthcare professionals were encouraged to share their opinions about the quality of the service, to ensure planned improvements focused on people’s experiences. The provider listened and acted on people’s views to improve the service.

People were involved in planning their care with the support of their relatives and staff, to make sure their care plans met their individual needs, abilities and preferences. Staff showed insight and understanding in caring for people, because they understood people’s individual motivations and re

We inspected this service on 26 and 27 February 2015. The inspection was unannounced. This was the first inspection since the service registered in September 2013.

There was a registered manager 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.

The service provides accommodation and personal care for up to 75 older people who may have a physical disability, dementia or sensory impairment. On the day of our inspection, fifty-seven people were living at the home, in five individual households. One household was not occupied.

There were policies and procedures in place to minimise risks to people’s safety. Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks. Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff until they knew people well.

There were enough staff on duty to meet people’s physical and social needs. Staff had enough time to make sure people felt important.

The provider checked staff’s suitability to deliver personal care during the recruitment process. Staff’s attitudes and behaviours were tested at recruitment to make sure people were treated with kindness and compassion.

The premises were well maintained and regularly checked to ensure risks to people’s safety were minimised People’s medicines were managed, stored and administered safely.

Staff received training and support that ensured people’s needs were met effectively. Staff were valued for their individual skills and abilities. Senior care staff observed staff’s practice by working with them in delivering care and support. Staff were encouraged to reflect on their practice and to develop skills and knowledge, which improved people’s experience of care.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). No one was subject to a DoLS at the time of our inspection. For people who were assessed as not having capacity, records showed that their advocates or families and other health professionals were involved in making decisions in their best interests.

Risks to people’s nutrition were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs and staff understood the importance of helping people to maintain a balanced diet.

Staff were attentive to people’s appetites, moods and behaviour and understood when to implement different strategies to minimise people’s anxiety. Staff ensured people obtained advice and support from other health professionals when their health needs changed.

People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs, abilities and preferences and care plans were regularly reviewed. Innovative thinking by the provider had created a physical environment, which supported people’s independence and sense of community.

The provider’s quality monitoring system included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.

People who lived at the home, their relatives and other health professionals were encouraged to share their opinions about the quality of the service. The provider and registered manager took account of others’ opinions to make sure planned improvements focussed on people’s experience.

The provider had researched and reflected on how international exemplar services provided care and designed the home on current best practice principles. The provider had implemented innovative technologies to minimise medicine errors and obtain prompt health care advice. People could access a virtual health advice service, which reduced the time it took to relieve any anxiety about their health.

The provider’s philosophy, vision and values were understood and shared across the staff team and resulted in a culture which ensured people were supported maintain their purpose and pleasure in life.