Ogwell Grange is a residential care home for 20 people older people, some of whom live with dementia. Accommodation is available over two floors with a passenger lift and stair lifts providing access to the first floor.

At our last inspection in October 2015, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service Good.

Why the service is rated Good.

People told us they felt safe at the home and with the staff who supported them. Relatives also confirmed their loved ones received safe care and support. Staff were safely recruited and there were enough staff available to meet people's needs and support them to join in with social activities. People received their medicines safely.

People received effective care and support from staff who were trained and competent. 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. People’s capacity to consent to their care and treatment was assessed. However some further assessment were required to demonstrate why decisions had been taken in people’s best interests. People enjoyed the food served in the home and people were offered a wide variety of meals. People at risk of not eating or drinking enough to maintain their health were monitored by staff and guidance sought appropriately. We received positive feedback from healthcare professionals about the quality of care provided at the home.

Staff were very caring and had built close relationships with people and their relatives. There was a very happy atmosphere in the home and people and relatives told us staff were always kind. People's privacy and dignity was respected.

The staff provided care and support which was responsive to people's individual needs. Care plans contained information about people’s care needs and guided staff about how to provide support. People and relatives knew how to make a complaint, but told us they had not had cause to do so. People were assisted to take part in a variety of activities and trips out and photographs of events were displayed around the home and included in the home’s newsletter.

The service was well led by a registered manager who had worked at the home for many years and whom we were told was open and approachable. Throughout the inspection we observed people and relatives in conversation with them.

Further information is in the detailed findings below.

Inspection reports are produced in different formats, such as easy read, audio or large print and are available upon request.

Twenty people lived at Ogwell Grange at the time of our inspection. People we spoke with were positive about their life at Ogwell Grange. Comments included, “I love it here. I love my room and the people”. People told us they were treated with respect and dignity by care workers and we also observed this to be the case. We found that care workers supported people to make choices in their everyday lives. People were encouraged to maintain independence and pursue their interests.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were positive about the care they received. Comments included, “I am well looked after”. Relatives told us their family members were, "extremely well cared for here”. Care plans contained detailed personal histories. Care workers demonstrated an in depth knowledge of the people they supported.

The provider had effective recruitment procedures to ensure that staff were suitable to work with vulnerable people. Staff turn over was low, which supported consistent care. People were cared for in a safe environment and the provider maintained the property to a high standard.

The service was well lead with a robust system of spot checks and monitoring of the quality of care. People and their families, health professionals and care workers had opportunities to influence the service.

Twenty people were living at Ogwell Grange at the time of our inspection. We spoke with five people. They told us that staff were respectful to them. Comments included, "Yes they are all very polite and lovely." and "We are treated well, you can see that."

One relative told us the care was, "better than brilliant." People took part in a range of activities and were encouraged to maintain independence

We found that people's privacy and dignity was protected. Care workers showed an interest in people as individuals and were familiar with their life history and achievements. People exercised choice in their daily lives.

People and their relatives were involved in planning their care, as much as they wished to be. Where people did not have the capacity to take decisions about their care their rights were protected.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were reviewed regularly and as necessary. Records showed that prompt referrals were made to health professionals and their advice was followed. Procedures were in place to deal with emergencies.

The provider had taken steps to prevent, identify and respond to abuse. Effective recruitment procedures were in place and there were sufficient trained staff to meet people's needs.

Ogwell Grange was clean, homely and well maintained. Required safety checks were up to date. There was an effective quality assurance system.

Ogwell Grange provides personal care for a maximum of twenty people. Nursing care is not provided. People access health services through the local community health teams.

The home had a registered manager. 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.

This inspection took place on 26 and 27 October 2015 and the first day was unannounced. There were 20 people living in the home at the time of the inspection. People had a range of needs including those who were physically frail and those who were living with dementia. The service was last inspected in October 2014 and was compliant with the regulations relevant at the time.

Since the previous inspection two concerns had been raised with the local authority’s safeguarding team over the welfare of people living in the home. The first related to a delay in the home contacting the community nursing team for advice. The second was received shortly before this inspection and raised concerns about how people with restricted mobility were supported and whether staff had the equipment they needed to assist people safely. The safeguarding team confirmed an occupational therapist would be visiting the home to discuss people’s needs and provide safe practice guidance for staff.

People and their relatives told us they saw their GP and or the community nursing service promptly when they needed to. The health care professionals we spoke with prior to and following this inspection confirmed people’s needs were being met. However, they felt the home needed to seek advice more promptly regarding people’s moving and transferring needs and the necessary equipment to keep people and staff safe.

During this inspection we found improvements were required in the way the home manages people’s medicines. Some changes had been made to people’s medication administration records (MAR). The date these changes had been made and the GP who made the changes had not been identified on the MAR, although some changes had been recorded in people’s care notes. Ssome medicines no longer in use had not been disposed of.

Staff were knowledgeable about the people they supported. People were able to express their views and were involved in making decisions about their care and support. However, people’s care plans did not contain the same level of detail as described by staff. The plans did not record what the person could do for themselves and how staff should assist them.

People told us they felt safe living at the home. For people who were not able to tell us, we observed how staff interacted with them. We saw people enjoying physical contact from staff and they were smiling and taking hold of staff’s hands, indicating they felt safe in the staff’s company. People and their relatives told us staff were skilled to meet people’s needs and spoke positively about the care and support provided. They told us the staff were always kind and caring. One person said “I’ve been here for five years and it’s very nice. I love it here.” One relative said, “this is the best care home” and another said “I can’t find fault, it’s excellent.” People told us staff treated them with respect and dignity when providing personal care. Throughout our observations there were positive interactions between staff and people. Staff demonstrated empathy and compassion for the people they supported. They told us they enjoyed working at the home. One staff member said, “it means so much to me to care for people well, to see them smile.”

There were enough staff on duty to meet people’s needs. We saw staff sitting and talking to people and supporting them to be involved in activities. Staff told us they were very well supported in their role and they received regular training as well as supervision and appraisals of their work performance. Robust recruitment practices ensured, as far as possible, only suitable staff were employed at the home. Newly employed staff members were required to work alongside experienced staff and to undertake induction training until they and the registered manager felt they were competent to work unsupervised.

Staff were knowledgeable about safeguarding people from abuse and had an understanding of people’s rights under the Mental Capacity Act 2005. Staff knew how and to whom to report any concerns they may have. Where accidents and incidents had taken place, the registered manager reviewed how these had come about to ensure risks were minimised. Some people’s freedom to leave the home was restricted to maintain their safety. Where this was the case, the home had made application to the local authority to do this legally.

People told us they enjoyed the meals provided by the home and they could have drinks and snacks whenever they wished. People who were at risk of not eating enough to maintain their health had been referred to their GP and advice sought from a dietician. Their daily food intake was monitored and they were reviewed regularly.

People were encouraged and supported to maintain relationships with their relatives and others who were important to them. Visiting times were not restricted; people were welcome at any time. One person told us, “my daughter can come at any time, and she is always offered a meal.” Relatives told us “we’re here every day, it’s a good home.” A newsletter kept relatives informed of events in the home and people had access to a computer to keep in touch with family and friends using Skype and Facetime.

People enjoyed a range of social activities. During our visit we saw people enjoying an exercise session and music sessions where they were encouraged to play musical instruments, to sing and to dance.

People and relatives said the home was well managed and the registered manager and staff were very approachable. They said they were aware how to make a complaint and all felt they would have no problem raising any issues.