Highgrove House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home can accommodate 19 people and at the time of the inspection it was full. People within the home had a variety of needs and the home cared for older people with a range physical disabilities and mental health issues, including dementia. Care was provided over two floors and there were large communal areas, including a large dining room, conservatory, separate lounges and communal gardens.

We inspected Highgrove House Residential Home on 11 and 12 July 2018. This was an unannounced inspection. The home had previously been owned by a different provider and this was the first inspection since the home had been managed by Highgrove House Care Home Limited.

At the time of the inspection a registered manager was not in post. 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. However, there was a new manager in post and it was their intention to become the registered manager. They had submitted their registered manager application to the Care Quality Commission (CQC) which was currently being processed. The owner of the home was also actively involved in the running of the home and present on the day of the inspection.

The home was accepting more people with dementia. This was impacting on the level of care people required. At the time of the inspection there were sufficient staff on duty and people told us that staff responded to their needs quickly. However, staff expressed some concerns about the impact of their increasing workload. This was discussed with the manager, who assured us they regularly reviewed people's dependency needs and staffing levels were kept under review.

There was a recruitment system in place and appropriate checks had been made to ensure new staff were suitable to work within a care setting. However, some of the details were stored in a different folder and the recruitment files did not always state the reason for any breaks in employment. This was discussed with the management team and they we taking appropriate action to improve the documentation. Staff received regular training to ensure they had the relevant knowledge and skills to care for the people in the home. There was also a programme of supervision and appraisals, which provided staff with support and guidance.

People told us they felt safe and well cared for. There was a safe-guarding procedure in place and staff could discuss the actions they would take, to ensure the continued safety of people under their care. Medicines were administered appropriately and there was a clear method for ordering and disposing of medicines. Medicines were stored according to current recommendations. The home was clean and staff followed procedures to maintain infection control. Environmental and personal risks were assessed and kept under review. There was a system in place to ensure equipment was maintained and the environment was safe. The environment had been adapted to suit the needs of the people, with an accessible garden, a lift and railings for ease of access.

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. People were cared for in a kind and compassionate manner. They spoke highly of the staff and the staff were proud of the care they provided. We observed staff gaining consent from people and offering choices. Staff were aware of requir