This inspection took place on 1 and 10 May 2018.

Holcroft House 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.

Holcroft House is a residential care home for up to 34 people who may be living with dementia. On the day of the inspection, 33 people were living there. The accommodation is on the ground level with several communal areas for different activities. There is also a garden, which is secure.

There was a registered manager in place. 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.

People were safe living at Holcroft House. The provider had policies and procedures in place designed to protect people from abuse. Risk assessments were in place to reduce risks to people’s health and safety. Appropriate recruitment procedures were in place and people’s needs were met by suitable numbers of staff. There was a cleaning programme in place to reduce the risk of infection.

Mental capacity assessments and best interests decisions were completed where necessary. People were supported by staff who were trained appropriately for their role. People were supported to eat and drink enough and were offered choices.

People were supported to access healthcare services and ongoing healthcare support when necessary. Staff supported people to take their medicines as prescribed. The environment was suitable to meet the needs of people living with dementia.

Staff developed caring relationships with people and supported them to express their views and be involved in making daily decisions about their care and support. Staff supported people whilst being mindful of their privacy and dignity.

People received personalised care that was responsive to their needs and enjoyed a range of activities, which were tailored to their interests and choices. People and their relatives had access to the complaints procedure. People were consulted about their end of life care choices and wishes.

The service was very well-led. The vision of the service was to improve the lives of people and their health and wellbeing and this was achieved because people were at the heart of the service.

There was a strong emphasis on continuous improvement and the views of people using the service were central to changes made. Governance was well-embedded into the running of the home. There was a system of audits in place to monitor the quality of service provided.

The registered manager was very open to trying new ideas to improve the quality of the care and support given to people. There was a clear management structure in place which demonstrated good management and leadership. The registered manager worked in partnership with other agencies and ensured that the service continued to learn and improve.

We spoke with five people using the service, a relative, three members of staff and the manager. People told us they were very happy with the care and support provided at the service. When asked if they were happy with the care and support they received, one person told us “of course I am”. Another person told us they had “no grumbles”, and that staff supported them in any way they wanted. A relative told us staff at the service “can’t do any more than they do”.

People’s choices and consent to care and support were respected at all times during our visit. We observed staff supporting people with day-to-day activities, and the interaction was sincere, respectful and responsive to individual support needs.

We reviewed care plans for four people and saw they were person-centred and contained essential details about people’s care and support needs.

The premises were well designed, laid out and maintained to a satisfactory standard. They were appropriate for people living there.

The service followed appropriate checking, selection and induction processes to ensure staff were suitable to work with vulnerable people and able to provide them with effective care.

The service was open to complaints, and people were given all necessary support if they wished to complain. Few complaints had been received, and they were resolved quickly and to the satisfaction of those making them.

We spoke with nine people, three visitors and seven who were on duty at the time of our visit. To help us to understand the experiences of people, we spent time observing what was going on in the home. We observed how people spent their time, the support they received from staff and whether they had positive outcomes. People told us that they were treated with respect when receiving care. Two people said that the staff were “very kind and care was excellent”. They confirmed that they were involved and staff offered them choices about the care they received. One person said ”you can get up when you are ready”. Another person said “the staff come and ask you if you want to get up and you can go to your room when you want”.

People commented that the food was very good. One person told us that their favourite meal was fish and the meals were “always beautifully prepared”. We observed that the staff interacted well with people who use the service. People told us that they were treated with respect and that the staff were kind, courteous and supported them as needed. We heard staff talking to people in a calm manner when they got distressed and stayed with them until they were calm. At different times of the day we saw staff supporting people to move around the home and their movements were not restricted.

A relative told us that they visited the home prior to their parent moving into the home and that their relative was very well looked after. They said that there was an “airy feel” to the home and people were helped to move around the home. Another relative told us that “this is the right place for mum” and said their family member was very settled. They said that the staff were “wonderful”.

We were told that people knew how to raise any concerns and they were keen to tell us that they did not have any concerns about the care people were receiving

The inspection took place on 3, 8 and 9 September 2015 and was unannounced.

The home provides accommodation and care for up to 34 people. There were 29 people living at the home when we visited, all of whom were living with a diagnosis of dementia. The home has three units: Woodpecker, Robin and Kingfisher but people can walk around as they wish and spend time in any part of the home. The three units form a square with a secure garden in the middle. There had been a flood at the home the week before our inspection but appropriate action had been taken and people were able to remain in their home with no evacuation being necessary.

There was a registered manager in place, who had recently returned to manage the home after a significant amount of time working at another of the provider’s homes. 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 home is run.

The provider had policies and procedures in place designed to protect people from abuse and staff had completed training with regard to safeguarding adults. Risks were managed so that people were protected and their freedom supported and respected.

People were cared for by suitable staff because the provider followed robust recruitment procedures and ensured satisfactory pre-employment checks were completed. There were enough staff with the right skill mix on duty to meet people’s needs. The staff team included care staff, care co-ordinators, cleaners, cooks, administrators and management.

People were happy with the service offered at Holcroft House and had positive interactions with the staff. Staff received training in a range of subjects which meant they could meet people’s needs.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests. People moved around the home freely, choosing where they wanted to spend time and who with.

People were supported to eat and drink as independently as possible. Lunchtime was relaxed and some people were chatting with each other. Daily activities were planned both indoors and outdoors. People had access to healthcare services when necessary and received their medicines safely and as prescribed. Staff cared about people they supported and met their needs.

The provider had a complaints procedure which was displayed in the hall and people had a copy in their bedroom. There was a positive and open culture at Holcroft House, where people and staff could talk openly, which resulted in improvements to the service. The home was well-led with a range of regular audits being completed.