The inspection took place on 21 March 2017 and was unannounced.

Green Gables is a large detached house in a quiet residential area. It provides care and support for up to 18 older people, some of whom are living with dementia. There were 18 people living at the service when we visited.

There is a registered manager working at the service, they are currently at the service two days a week due to their leave arrangements. The service is being overseen by a deputy manager with the support of the provider and registered manager. 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. This was the first inspection since a change of provider in November 2016.

People told us they felt safe at the service. Staff recognised different types of abuse and knew who they would report any concerns to, they were confident that the registered manager or deputy manager would address any issues. Risks to people were identified, assessed and plans were put in place which gave staff the guidance needed to manage and minimise the risks. People’s medicines were managed safely and in the way they preferred.

The management team had completed audits to identify environmental risks. Fire drills were completed and people had a personal emergency evacuation plan (PEEP) in case of a fire. Additional audits had been completed to monitor the quality of care given to people and checks were carried out on the records completed by staff to make sure they were accurate and up to date.

There were enough staff to meet people’s needs and they were recruited safely. Staff told us they were well supported, they had regular one to one meetings with their line manager and had the training required to meet people’s needs. People, staff and relatives told us that the provider, registered manager and deputy manager were approachable and accessible. Everyone working at the service shared the same visions and values, which were to give people excellent care and support them to have the best lives possible.

People were involved in developing and updating their care plans. People’s care plans were person centred and showed what people could do for themselves and how they preferred to be supported. Staff knew people well, interactions between people and staff were affectionate and relaxed. Staff offered people reassurance and encouragement. People could have visitors whenever they liked and were supported to maintain relationships with family and friends.

There was a board in the dining room letting people know what activities were happening each day, some people said these could be more varied. The deputy manager agreed this was an area for development.

People had a choice of food and drinks each day. People were encouraged to eat a balanced diet to stay healthy. When people were at risk of losing weight they were referred to a nutritionist and any guidance put in place was followed by staff. People had access to healthcare professionals when required and any concerns about people’s health were responded to quickly.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm.

The registered manager asked people for feedback about the service and their care on a regular basis and took action to address any issues raised. People had meeti