This was an unannounced inspection which took place on 6 and 7 March 2017. We last inspected the service on 9 and 10 March 2015 when we rated the service as Good overall.

Wellcroft is registered with the Care Quality Commission (CQC) to provide residential care and support for up to 42 people with a dementia. At the time of the inspection 37 people were using the service. The home provides permanent, short stay and day care services. Accommodation is provided over two floors in three self-contained living areas. The first floor can be accessed via a passenger lift. All bedrooms are single occupancy with nine having en-suite facilities. The home is set in landscaped gardens and is located in Gatley village Stockport. Wellcroft is one of eleven care homes owned by Borough Care Limited a not-for-profit registered charity.

At the last inspection, the service was rated Good and the registered manager told us of his plans to improve the service to make sure people on their dementia journey received high quality person centred care. Further information regarding our findings are detailed in the effective, responsive and well led domains of this report.

The service was rated as Outstanding in the Well-Led key question.

A registered manager was in place at the home. 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. The registered manager showed passion and enthusiasm for promoting dementia care and had a very strong value base which was reflected throughout the service. The registered manager and deputy manager had spent two days with the dementia research team at Sterling University to gather further dementia initiatives to support, develop and improve their approach to meet the needs of people living with dementia at Wellcroft.

The registered manager told us that because the provider ran as a non for profit organisation and care workers were not paid as highly as similar care homes in the area, it was important when recruiting new care workers to make sure they were adaptable and were willing to go the extra mile to put people first. They told us that it was important for people who used the service to be cared for by care workers who shared the same vision and values as they did and that they only want the best care workers for the residents and want the residents to live happily at Wellcroft.

Since our last inspection in March 2015 the service was recognised locally as a ‘Stockport Star Award Winner’ and was voted the ‘Best Care Home in Stockport’ and a care worker was voted the ‘Best Care Assistant in Stockport’. They received an award in recognition of their ability to exceed their job role expectations and reflect an inherent sense of compassion towards people who used the service. The award was presented by Stockport Together, which is a partnership organisation across Stockport. In addition to this the registered manager was awarded the, “Most effective manager 2016” award and the housekeeping team had been awarded the, “Most effective team 2015” at the Borough Care company awards ceremony. This is an annual award designed to recognise Borough Care Ltd manager achievements based on specific results and behaviours.

Care workers we spoke with told us they had undergone a thorough recruitment process and employee induction. Training appropriate to the work care workers carried out was on going and always available to them. Care workers spoken with confirmed they had received safeguarding and whistle blowing training, and knew who to report concerns to if they suspected or witnessed abuse or poor practice. Some care workers were working towards a nationally recognised qualification in care such as a National Vocational Qualification (NVQ

During our inspection on 28 October 2013, we spoke with the manager, the acting deputy manager, three members of staff, two people visiting the home and several people who lived at the home. All of the people living in the home had varying degrees of Dementia, which limited the number of people we could speak with who were able to reliably give their verbal opinions on the service they received. The people we did speak with they told us they were happy at the home.

We found that the care records identified the individual needs of the person and the support they required to meet their needs and encourage their independence.

We looked around the home and saw that the layout of the premises was safe and suitable for carrying out the regulated activity.

We found that staff had been recruited appropriately to carry out their role and to meet the needs of people who used the service. Staff spoken with told us they ensured that care and support was delivered privately, was person led and reflected the care instructions detailed in peoples individual support plans.

We spoke with two visiting relatives both of whom confirmed they were happy with the care received by their relative. Some comments included; “I wouldn’t want her anywhere else,” “I feel happy that she (her relative) is safe and very well looked after here,” and “I can’t fault them here.”

People living in the home and their friends and family were involved and consulted in their care treatment. People told us that the staff always consulted with them regarding their individual care needs and friends and family were made aware of any changes. Records of day to day living were available for viewing and all personal records were kept secure and stored appropriately.

People told us that the staff were "very good" and it was "all very nice". Friends visiting people who lived in the home told us that they were "very impressed with the staff". They also told us that the food was "very nice" and that "there is plenty of it". We also saw that there was a choice at meal time and alternatives were available should they be required.. There is a key worker system and people are involved in the planning and choices of their day to day care and treatment. The personal files had information on peoples family life, their likes and dislikes and things that they like to do so that staff members had a good understanding of peoples needs and their backgrounds.

As the people who lived at Wellcroft had dementia we have sought feedback from family members, district nurse, care workers, pharmacists and Stockport contracts and compliance department. We also spent time observing the care provided particularly during meal times.

Family members told us that they were able to visit the home and look around when first looking for a care home for their relative. They also said that they were given an information pack which told them about the organisation.

A senior member of staff usually visited people in their home or hospital to make sure that they could meet the person’s needs. People were also offered a day visit. One person told us “We received an information pack and were invited to look round and X had a trial day. We visited several homes before visiting Wellcroft, which was the best of what we looked at.”

After people had visited Wellcroft or Managers had been to see the person in hospital or at home an assessment form was completed which formed the basis of a plan of the person’s care needs.

Families were encouraged to be involved and have a say in the care plan. A family member told us “We were involved with the care plan at the time of admission and have been throughout the time X has been at the home. We are happy that we are allowed to be involved as much or as little as we want which we feel is a real plus. We feel it is a partnership.”

We saw that the care workers were patient and encouraged people to eat. The family members we spoke with had no concerns about the food. We were told “The food is fine, nutritious and there is plenty of fruit. The food is certainly adequate probably more than adequate.”

Everyone we spoke with felt that the people who lived at Wellcroft were safe. There had been one safeguarding investigation which had been resolved to the satisfaction of the family.

The activities organiser who worked part time showed us the work they had done with the people who used the service which included trips out from April to October. They spend one hour on each of the three units within the home. They were particularly proud of the grandchildren’s day which had included all staff and relatives. This they felt had been a big success and we were able to see the pictures on the wall. One of the family members we spoke with also told us about this day and what a success it had been.

The home was in need of refurbishment and this was discussed with the manager. However everyone said that the home was always clean, tidy and there were no unpleasant odours.

The organisation had a training programme in place for all staff. However we felt that staff would benefit from training delivered from experts in dementia care to further improve the service.

We have found Wellcroft to be compliant in all the essential standards we inspected however we have discussed with the Manager areas that could be improved so as to make sure that Wellcroft remains compliant and keeps people safe and healthy.

We discussed with the Manager the care plans and the daily recordings which could be more centred round the person. This would help other staff and professionals to know more about the person. This is particularly important when recording what people have eaten. It is not enough to record “eat well” it needs to say what people have eaten and how much.

Family members or representatives were asked to complete questionnaires to help the organisation improve the service. Wellcroft was visited regularly by senior managers from head office to make sure that the home was meeting people’s needs.

The people who we spoke with were generally happy with the care that the people who lived at Wellcroft received. No one had any concerns about people’s safety and well being. Everyone said that if they had any concerns they would have no hesitation in speaking with the Manager or staff. Another comment we received was; “It is a lovely atmosphere, staff so nice to everybody. They talk to X and are very patient. Always tell us about the good things X does and don't leave people sitting on their own for long periods.”

This was an unannounced inspection.

A registered manager was in place. 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.

Wellcroft is one of twelve care homes owned by Borough Care Limited, a not-for-profit registered charity. Wellcroft is a two-storey home which provides permanent, short stay residential and day care services for up to 41 people with dementia. All bedrooms are single occupancy. Nine have an en-suite toilet and wash basin facility. The home is located in Gatley village Stockport and is set in its own grounds with a car park. The home was fully occupied at the time of our visit.

Relatives spoke positively about staff and we saw relationships between individual staff and people using the service were warm, compassionate and caring and staff showed empathy in their approach. Relatives told us they were more than happy with the care being provided and with the staff working at the home.

Staff working in the home understood the needs of the people who lived there and we saw that care was provided with kindness and dignity. We saw that people who used the service looked clean, well dressed, relaxed and comfortable in the home.

Staff employed at the home had the skills and knowledge to make sure the care provided was in line with best practice and written care plan instructions. We found that people’s care was delivered consistently by staff and they knew how to monitor people’s health care and made sure people had enough to eat and drink to maintain good health and wellbeing.

Staff were appropriately trained and skilled and provided care in a safe environment. They had all received a thorough induction when they started work at the service and fully understood their roles and responsibilities, as well as the values and philosophy of the home. The staff had completed appropriate training to help make sure that the care provided to people was safe and effective to meet their needs.

Throughout our inspection we saw examples of people and their families being included and consulted in the planning of the person’s care and were treated with dignity and respect by the manager and staff.

There were daily planned group activities for people and opportunities for people to pursue their own hobbies or leave the home for a short while with assistance. The service supported people to access the community to prevent them from being isolated

A system of maintaining appropriate standards of cleanliness and hygiene was being followed regularly. The home was clean and there were no offensive odours.

Medicines were stored, administered and returned safely and records were kept for medicines received and disposed of, this included controlled drugs (CD’s).

Risk assessments had been completed and clearly stated how risks should be managed.

The registered manager consistently assessed and monitored the quality of care using an established in house system that was being completed regularly. The workforce management was being monitored using an in house system that was effective.

We saw that the correct safeguarding procedures were in place. The manager and staff team had a clear understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where appropriate the DoLS was in place for people who lacked capacity to make a decision.

The provider encouraged feedback from people using the service and their families. Feedback was given in the form of complaints, comments, compliments, face to face meetings with the manager, relative meetings, service user care plan reviews and an annual service user satisfaction survey.

Relatives spoken with knew how to make a complaint and felt confident to approach any member of the staff team if they required. Feedback received was used to make improvements to the service.