This comprehensive inspection took place on 15 and 16 August 2017 and was unannounced on the first day.

Hungerford Care Home offers a service for up to 59 older people with nursing needs, some of whom also live with varying degrees of dementia. Twenty four hour support is provided by a regular team of staff across the three separate units.

A registered manager was in place in the service. 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. Due to changes in the provider’s registration, this was the first inspection of the service under its current legal status.

People and relatives felt people were safe and well cared for by the service and that their dignity, privacy, rights and freedom were supported by the staff. They felt staff were competent and well trained and worked together effectively. If issues were raised, people and relatives said they were addressed and they could go to one of the managers if they needed to discuss anything. People and relatives had been consulted about their views about the service and had opportunities to discuss any concerns.

The service provided an excellent range of activities, outings and entertainment to address people’s social and emotional needs, especially for those living with dementia. The ‘wishing well’ scheme, which identified and fulfilled people’s personal wishes, was exemplary. Activities staff were dynamic and actively sought new and innovative equipment to help engage with people. Cultural and spiritual needs were provided for.

Staffing levels were regularly reviewed and adjusted in relation to people’s needs. Staff received appropriate induction, comprehensive training and ongoing supervision and support.

The environment was well-maintained and work was under way to maximise its suitability to support the needs of people living with dementia. Health and safety and service checks took place as required and action was taken to minimise identified risks to individuals.

People were supported by caring staff who responded to their needs in a timely way. When staff identified concerns these were communicated to senior staff to be addressed. Senior staff were seen to be involved in hands on work with people, which enhanced their awareness of individual's needs.

Care was provided based on detailed care plans which were regularly reviewed in consultation with people and relatives where appropriate.

The service was monitored through a range of detailed audit tools which led to action plans, where necessary, to support its continued development.

We made a recommendation that the registered manager reviews the rights of relatives acting as legal representatives of people who lack capacity under the Mental Capacity Act 2005. This was to ensure they are fully familiar with the rights of people’s representatives in every situation.