We held an unannounced comprehensive inspection at Tonbridge House Care Home on 17 October 2018. Tonbridge House is a ‘Nursing home’ for people with dementia and accommodates up to 63 people in one purpose built new building. The care is provided over two floors. The upper floor catered for people with more advanced dementia and the lower floor for people with more nursing needs. All bedrooms had en-suite bathrooms and people had access to a luxury bathroom on each floor. There was a nursing station positioned in the middle of each floor. Each floor had their own dining room and lounge. There was also a private dining room which could be booked by people and their relatives, a hairdressing salon and an activities room. On the day of our inspection 24 people were living at the home, seven of which were upstairs.

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.

This is the first time the home has been inspected since it registered on 29 May 2018. There was a registered manager 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.

People and relatives told us they had no concerns with their safety and could speak to the registered manager if they did. Safeguarding and whistleblowing policies were in place and the provider had notified us of any concerns. Risks to people were assessed on an individual basis and there was comprehensive guidance for staff. There were enough suitably trained and safely recruited staff to meet people’s needs. The registered manager had ensured the environment was safe and staff understood how to prevent and control infection. The property was well maintained and cleaned to a high standard. The registered manager had an overview of accidents and incidents, had analysed these through their electronic system and learnt from these.

Medicines, including those ‘as required’ were ordered and given safely through an electronic system. Medication was stored safely, stock levels were managed and discarded medication was disposed of appropriately. There was one incident of a liquid medication where an incorrect expiry date had been recorded and it had been given after it should have been discarded. We spoke to the registered manager about this who took immediate corrective action and the pharmacy advised there would be no adverse effect to the person.

People had assessments which were person centred, included all their needs and their rights to equality. The provider ensured managers, nurses and care staff had the right induction, training and on-going support to do their job. People were supported to eat and drink enough to maintain a balanced diet. People had the involvement of a dietician and there was information in the kitchen regarding people’s dietary needs. Feedback on the food was very positive and we observed people were enjoying the mealtime experience. People were offered choice and were encouraged to have as much as they wanted to eat and drink.

People accessed the healthcare they needed and the provider worked closely with other health professionals to ensure people were supported with various health conditions. People’s needs were met by accessible facilities and the environment had been tailored to maintain the independence and dignity of people with dementia. 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.

Staff knew people well and interacted with people in a caring and re