This inspection took place on 25 and 26 October 2018 and was unannounced. Hawkhurst House is a purpose-built modern building and provides accommodation and nursing care for up to 85 people. The service also provides personal care and nursing care for people who rent or buy their accommodation within Hawkhurst House. There were 16 people living at Hawkhurst House during our inspection; of which all were receiving accommodation and nursing care. The service provides nursing care on the ground floor and supports adults living with dementia. The first floor was not operational and the second floor was used as staffing accommodation.

The service has a registered manager, who was present throughout the inspection. 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.

Hawkhurst House was first registered with CQC to provide regulated activities on 17 December 2017 and this is its first inspection.

Accidents and incidents were reported and responded to in most cases.

Staff knew how to keep people safe from abuse and neglect. The registered manager referred most incidents to the local safeguarding authority.

The provider had not kept CQC informed of all events that happened in the service as required by legislation.

Risks to people had not always been mitigated to protect people for harm. Prospective members of staff were living at the service without the relevant checks being completed. We have made a recommendation about the assessment of risk.

Audits and checks had not been fully effective in identifying and remedying shortfalls. The service had a Practice Development Manager in place working alongside the registered manager.

Care plans, risk assessments and guidance were in place to give staff knowledge about how to support people in an individual way.

The management of medicines was effective, people received their medicines safely and in a timely manner. Policies and procedures were in place for staff to follow ensuring safe storage and recording of medicines.

The safety of the premises was assured by regular checks on utilities and equipment. Fire safety had been addressed through training, fire drills and alarm testing. Maintenance had been carried out promptly when repairs were needed.

People had a choice of nutritious meals, snacks and drinks, and could choose where they would like to eat. Staff encouraged people to eat their meals and gave assistance to those that required it.

There were enough staff on duty that had received relevant training and supervision to help them carry out their roles effectively. Staff were observed putting their training into practice in a safe way. A dependency tool had been introduced to enable the registered manager to make sure that staffing levels remained adequate. Recruitment files contained all the required information about staff.

A range of professionals were involved in people’s health care and individual plans of care were mostly in place if people had specific health needs like diabetes, catheters or pressure wounds. Some care plans required review to ensure they contained clear, detailed guidance for staff to follow.

Staff and registered manager worked within the principles of the Mental Capacity Act 2005 (MCA) which ensured people’s rights and wishes were protected.

Staff treated people with kindness, compassion and respect. Staff took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives.

Care plans were person-centred; they reflected people’s individual preferences and gave staff an understanding of