This inspection took place on the 10 and 13 May 2016 and it was unannounced.

Heaton House is registered to provide accommodation and personal care for up to 14 people. At the time of the inspection 12 people were living at the home. People had various needs including dementia and physical disabilities.

Heaton House is a small residential home situated in a residential part of Worthing, West Sussex in close proximity to local shops. The home has 13 bedrooms which are spread over two floors. All bedrooms were of single occupancy and had en-suite facilities, 10 bedrooms had showers. Communal areas included a dining area which led into a lounge. The lounge windows overlooked a south facing garden; bird feeders were positioned in view of those using the lounge. In addition a separate open television lounge was available for people.

A registered manager had been in post since 2010. The provider manager was also a registered manager at Heaton House Residential Care Home. 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. Both registered managers were present throughout the inspection.

People and their relatives felt Heaton House was a safe environment. There was sufficient staff who had been trained in how to recognise signs of potential abuse and protected people from harm. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks. People’s medicines were managed safely and administered by trained staff. The service followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their new role.

We found the home to be clean and tidy and maintained to a high standard. Home furnishings such as pictures and photographs decorated communal areas and hallways attractively. The ambience of the home was warm and inviting.

Staff implemented the training they received in core subject areas by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the managers.

Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. They also understood the associated legislation under Deprivation of Liberty Safeguards and restrictions to people’s freedom.

Additional drinks and snacks were observed being offered in between meals and staff knew people’s preferences and choices of where and what they liked to eat.

Staff spoke kindly to people and respected their privacy and dignity. Staff encouraged people to be as independent as possible. Staff knew people well and had a caring approach.

People were supported to express their views and were actively involved in decisions about their care and treatment as much as they were able.

People received personalised care. Care plans reflected information relevant to each individual and provided clear guidance to staff on how to meet people’s needs. Staff were vigilant to changes in people’s health needs and their support was reviewed when required. If people required input from other health and social care professionals, this was arranged.

People, relatives and staff told us they were happy with the activities that had been organised. The home organised a variety of entertainers to engage with people. People and their relatives were listened to by the registered manager and the staff team.

There was a complaints policy in place. People and their relatives knew who to go to with any concerns they had.

People and their relatives felt the home was well led. The registered manager was open and approachable. A

Because the people who lived at the home had dementia, they were not able to tell us directly about their experience. We therefore used a number of different methods to help us understand their experiences. We spoke with the relatives of three people. They were all very happy with the care provided. One person said, "X gets excellent care here" and, "I can't praise it enough." Another said, "I can't fault it."

During our inspection we observed that staff treated people with warmth and genuineness. One person said about the staff, "They are so kind."

We looked at the care records of three people. We saw evidence that care had been planned and delivered in line their individual needs. We also saw evidence that arrangements were in place to obtain valid consent from people to the care they received.

We spoke with three members of staff. They said they worked as a team and that they felt there was enough staff on duty to meet people's needs.

We saw that the home had arrangements in place for controlling the risk of infection. When we looked around the home we saw that it was kept clean and free from odour.

The home had a complaints policy and procedure in place. The people we spoke with said they knew who to contact if they had any concerns. They were all satisfied that any concerns were dealt with.

We found that People were supported to express their views and were involved in making decisions about their care and treatment, with support where needed. We spoke to service users, staff members, the manager and visiting relatives and found evidence that peoples’ dignity, diversity, values and human rights were respected. This was also confirmed by records we reviewed and our observations.

Staff received appropriate professional training, development and supervision. There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

We observed staff in their interventions with service users and we also looked at records of care and support for three people in detail. We found that people’s privacy, dignity and independence were respected. People told us they were very satisfied with the quality of service provided at Heaton House.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service and/or their representatives were asked for their views about their care and treatment and they were acted on. The manager was able to demonstrate a good understanding of the needs and wishes of the service users.

All of the people who live in Heaton House have various degrees of dementia. We spoke with people both individually and in groups and they told us that they were happy living at Heaton House. They said the staff were kind and the food was ‘wonderful’.

We spoke to relatives of people staying in the home. They told us that their relative’s needs and wishes were identified, addressed and taken into account. We were told that Heaton House offers professional and personalised care in a homely environment, which is much appreciated by the family and relatives of those that live there.