This inspection was carried out on 16 January 2018 and was unannounced.

Mont Calm Margate is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Mont Calm Margate accommodates 31 people living with dementia in one adapted building. There were 31 people using the service at the time of our inspection.

The registered manager had worked at the service for over 10 years. People and staff told us the registered manager was approachable. 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.

At the last inspection on 4 January 2017, we asked the provider to take action to make improvements to the way they managed medicines and checked the quality of the service. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe and well-led to at least good. The provider had completed all the actions and the key questions, safe and well-led are now rated good.

The provider and registered manager had oversight of the service. They had improved the checks and audits they completed. All areas of the service had been checked regularly to make sure they met the required standards and any shortfalls were addressed. The views of people, their relatives, staff and community professionals were asked for and acted on to continually improve the service. The provider planned to introduce electronic care records and had visited other services which used these to gather information about the advantages and any disadvantages.

Effective action taken since our last inspection to improve the way people’s medicines were managed and they were now managed safely. Staff followed guidance about people’s medicines and people received their medicines in the way their healthcare professional had prescribed.

The provider and registered manager had a clear vision of the quality of the service they expected. Staff shared the provider’s vision of a good quality service and provided the service to the standard the provider required. Staff felt supported by the registered manager, were motivated and felt appreciated. The registered manager was always available to provide the support and guidance staff needed. Staff worked together as a team to provide the care and support people needed.

Staff were kind and caring to people and treated them with dignity and respect. Staff told us they would be happy for their relatives to receive a service at Mont Calm Margate. Staff described to us how they supported people in private and people told us they had privacy. People were encouraged and supported to be as independent as they wanted to be. Staff had asked people about their end of life wishes and further work was planned to make sure staff had all the information they required before they needed it. People’s relatives had complimented the staff on their kindness and care at the end of their relative’s lives.

People had enough to do each day and enjoyed the activities on offer. The provider wanted to improve the activities and occupations people took part in and the activities coordinator was enthusiastic about making changes. They were researching activities and occupations for people living with dementia and planned to introduce them in the weeks following our inspection. People had been asked about their spiritual needs and were supported to attended services if they wished.

Assessments of people’s needs and any risks had been completed. People had planned their care with staff and received the support they

This inspection was carried out on 4 January 2017 and was unannounced.

Mont Calm Margate provides accommodation and personal care for up to 31 people who may be living with dementia. The service is a large converted property. Accommodation is arranged over two floors and a lift is available to assist people to get to the upper floor. There were 22 people living at the service at the time of our inspection.

A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received the medicines they needed. However, medicines were not always stored safely. Guidance had not been provided to staff about how to support people to take some medicines.

Detailed information was not available for staff to refer to about how to manage all the risks to people. This did not impact on people and staff knew how to keep them as safe as possible. The registered manager agreed this was an area for improvement. People had agreed with staff how risks such as cigarettes and lighters would be managed. Plans were in place to keep people safe in an emergency.

The registered manager completed regular checks on all areas of the service. They had not identified the shortfalls we found during the inspection. They worked alongside staff and checked that the quality of the service was to the required standard. Any shortfalls found were addressed quickly to prevent them from happening again. People, their relatives and staff were asked about their experiences of the care and their feedback was acted on.

People’s care was planned with them, to help them be as independent as possible. Detailed information was available to staff about people’s likes and dislikes and care preferences.

Changes in people’s health were identified quickly and staff contacted people’s health care professionals for support. Staff had provided care in the way one person preferred, which was different from the care their health professional had recommended. Following our inspection the registered manager contacted the person’s doctor for further advice and guidance about how to provider care in the way the person wanted to keep them as health as possible. People were offered a balanced diet and were offered food they liked. People had enough to do during the day.

Staff were kind and caring to people and treated them with dignity and respect at all times. Staff knew the signs of abuse and were confident to raise any concerns they had with the providers. Complaints were investigated and responded to.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). People were not restricted. Applications had been made to the supervisory body for a DoLS authorisation when necessary.

The requirements of the Mental Capacity Act 2005 (MCA) had been met. Staff supported people to make decisions and respected the decisions they made. When people lacked capacity to make a specific decision, decisions were made in people’s best interests with people who knew them well.

The registered manager had oversight of the service. Staff felt supported and were motivated. They shared the registered manager’s vision of a good quality service.

There were enough staff, who knew people well, to provide the support people wanted. People’s needs had been considered when deciding how many staff were required to support them at different times of the day. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Discl