This inspection took place on 10 and 11 January 2017 and the first day was unannounced. This means the provider did not know we were coming. This was the first inspection of this service following a change in its registration in April 2016.

Hawksbury House is a care home for older people, some of whom have a dementia-related condition. It does not provide nursing care. It has 35 beds and 34 people were living there at the time of this inspection.

The service had a 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Without exception, people we spoke with during the inspection were highly complimentary about the kind and caring nature of the staff who supported them.

The majority of staff members had been employed by the service for a significant period of time. As a result they had built up very strong, positive, caring relationships with the people they supported and were very knowledgeable about their individual needs and preferences.

The ethos of the home was to care for people in a way that met their individual needs. People’s individuality was respected and staff went out of their way to ensure people felt comfortable and at ease in their surroundings. Whether this be through ensuring people were provided with the food of their choice or making adaptations to their rooms.

Care staff were very attentive to people’s needs and relatives we spoke with told us they were exceptionally good at picking up any changes in people’s health or well-being. This meant people received prompt medical intervention where required and as such were actively supported to maintain good health.

Staff encouraged people to maintain their independence. People were actively encouraged to socialise and engage in activities or outings into the local community. A varied activities programme was provided, both within the home and in the local community, to prevent people from being socially isolated.

People’s wishes were respected and their privacy and dignity maintained. All staff were aware of the importance of maintaining people’s privacy and dignity and had received appropriate training to enable them to do this.

Systems were in place to ensure people’s wishes in relation to their end of life care were captured and acted upon. People were supported to be comfortable and pain free when receiving end of life care. An external healthcare professional we spoke with described the end of life care provided by the service as exceptional. They told us the staff team provided very high levels of care to both people and their friends and family members during this time. One relative told us after the inspection, "The end of life care is second to none. It was very important to me that my mother was not moved to hospital or nursing care. She was cared for by all staff as if she was their own mother. Who could ask for more?"

Measures were in place to protect people using the service from abuse. Staff received safeguarding training which was refreshed on a regular basis and were aware of their roles and responsibilities for ensuring people’s safety. Risks to people, staff and visitors were assessed and monitored. Action was taken to manage and mitigate risks in order to keep people safe.

Robust recruitment processes were in place to ensure staff members were suitable to work with vulnerable people. People and their relatives were encouraged to take an active part in the recruitment of new staff members. Works trials were undertaken to enable the provider to better assess applicants suitability for employment within the service. Staffing levels were based on people’s dependency levels and were subject to regular review. People told us staff resp