This inspection of Grange-Lea was carried out on 29 and 30 August 2017 and was unannounced on the first day. Grange-Lea is a large detached property in a residential area of Paignton. The home is registered to provide accommodation for up to 32 people who require nursing or personal care. At the time of our visit, 30 people were resident at the home, some of whom were living with dementia.

The home had a registered manager that was also the registered provider. 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 and associated Regulations about how the service is run.

People told us they were extremely happy with the care and support being received. People enjoyed living at Grange-Lea and they considered it their home. We saw staff were extremely polite, friendly and caring in their approach to people and their relatives. People received care that enabled them to live their lives as they wished and people were supported to remain as independent as possible. Staff were aware of the importance of protecting and maintaining people's privacy and dignity. Staff knew the people they were supporting well. Relatives we spoke with described the staff as very good and caring.

People told us they felt safe at all times. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were systems in place to protect people from abuse. Policies and procedures were in place to manage safeguarding concerns.

The home had a robust recruitment process in place. Appropriate checks were carried out before staff began working at the home to ensure they were suitable to work with people. Staff had received appropriate induction, supervision, appraisal and training, which allowed them to fulfil their roles effectively and develop trusting relationships. Staff understood their roles and responsibilities and would seek people's consent before they provided any care or support. There were sufficient numbers of staff to support people safely and staffing levels were adjusted to meet people's changing needs and wishes.

Staff respected people's rights to make their own decisions and choices about their care and treatment. People's permission was sought by staff before they helped them with personal care. 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 home supported this practice. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well. Where people may have restrictions on their liberty and freedom in order to keep them safe, applications had been made to the local authority to make sure people were not unlawfully restricted.

Staff were knowledgeable about people's needs and how to meet those needs and care records were detailed, person centred and accurately reflected the care people received. The care records showed the personalised care people required to help staff consistently meet people's needs and we saw staff followed these.

We saw care plan documentation contained risks assessments which covered areas such as pressure area care, moving and handling, nutrition and mobility. Each risk assessment had a corresponding 'risk plan' which detailed how the risk was managed and any control measures that were in place.

Medicines were managed safely and in line with current regulations and guidance. Staff had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered and audited appropriately.

Staff were caring and respectful towards people with consideration for people's int