Littleport Grange 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.

Littleport Grange is a three storey building and is registered to accommodate up to 59 people. At the time of this inspection there were 56 people living at the service.

The inspection took place on 12 December 2017 and was unannounced. This was the first comprehensive ratings inspection of the service under its current registration.

A registered manager was 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.

Staff were well informed as a result of their training about what keeping people safe meant. Staff empowered people to be safe. People were given as much information as they needed about staying safe. People were involved in decisions about their safety to the maximum possible extent and their wishes were respected by staff.

Risk assessments were in place. Information about risks to people were shared with relevant organisations such as an occupational therapist to help ensure people’s care was as safe as it could be.

A sufficient number of staff had been safely recruited and they were deployed in a way which maximised people’s independence. Staff were provided with the training appropriate to their role.

People’s prescribed medicines were administered and managed safely. The storage, disposal and recording of all medicines was carried out in line with current guidance.

The registered manager and their staff team completely understood their responsibilities. Near misses were seen as an opportunity for learning and to help prevent things from going wrong.

People’s health and nutritional needs were met by trained staff. Staff knew the people they cared for well and that they would recognise and act promptly if people appeared unwell. The premises and equipment that was provided helped improve people’s independence.

Staff worked well with relevant stakeholders to help ensure that people could be as independent as possible. 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 service supported this practice.

Creative ways had been introduced to help people reflect on their personal histories and cultural backgrounds. All staff were particularly sensitive to people whilst providing caring and compassionate support. Accessible ways were used to communicate with people to support their privacy and dignity.

People were provided with, or enabled to access the, advocacy services that they needed.

People’s care was provided by staff who used innovative ways of involving people and their family, friends and other carers in their care and support plans. Staff had outstanding skills and treated people equally regardless of their needs. Staff went the extra mile to ensure that people took part in a wide range of social stimulation, hobbies, interests and pastimes which they thoroughly enjoyed.

Investigations into concerns were comprehensive and the service used innovative ways of examining how best to make improvements. People’s concerns were acted upon before they became a complaint. Support was available if people needed to raise concerns or make a complaint. Staff had the skills to understand and meet the needs of people requiring end of life care.

The registered manager led by example and motivated their staff team with supervision, mentoring and constructive feedback. The registered manager understood their responsibilities and worked with people, staff an