This was an unannounced inspection which took place on 26 and 27 September 2017. Gracewell of Newbury is a care home with nursing which is registered to provide care for up to 66 people, some of whom may be living with dementia. There were 47 people resident in the service on the days of the inspection visits. Most people who live in the home are self-funding (pay for their own care). This is the first inspection of the service which was registered in October 2016.

The service did not have a registered manager, at the time of the inspection visits. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager running the service at the time of the inspection was registered with the CQC on 28 September 2017.

People, staff and visitors to the service were kept as safe as possible because staff had been appropriately trained and were confident they knew how to protect themselves and the people in their care. Care staff were recruited via robust recruitment processes to ensure they were suitable to provide safe care to people. There were enough staff to meet people’s needs safely. General risks and risks to individuals were identified and action was taken to reduce them. People were supported to take their medicines safely, at the right times and in the right amounts by trained and competent staff.

People were provided with highly individualised and effective care that fully respected their diversity, preferences and choices and effectively met their needs. They were supported and encouraged to make decisions and choices about their care. Staff upheld people’s legal rights with regard to decision making and choice.

People benefitted from living in an excellent environment which was designed for their comfort and to meet their needs. Staff ensured it was kept exceptionally clean and hygienic whilst it remained comfortable and homely. The atmosphere of the service was friendly, accepting and welcoming. These attitudes were modelled by the management and staff team who ensured everyone felt included and important.

People’s rights were protected by a management and staff team who understood the Mental Capacity Act (2005) exceptionally well. This legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

People’s needs were met by a highly committed and caring staff team who worked exceptionally closely together in the best interests of the people they offered care to. All staff were passionate and highly knowledgeable about the specific aspects of care they provided. Staff built positive relationships with people and others who were important to them, as quickly as possible. People’s individuality and differences were recognised and respected and they were treated with kindness, respect and dignity at all times. Any special needs were taken into account and people were offered the appropriate care.

People were offered a large variety of well organised and meaningful activities which enhanced their lifestyle. They were encouraged to enjoy and participate in them by highly talented and skilled staff.

The service was exceptionally well-led by a manager who had been in post for approximately eight weeks and a deputy manager who had been in post approximately six weeks. The management team were described as approachable, supportive and highly effective. The service had a large number of ways to monitor and assess the quality of care they offered. Any shortfalls or impro