This inspection took place on 5 and 6 December 2018 and was unannounced. Abbeyfield Winnersh is a purpose built residential care home for older people who all have some degree of dementia. 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. The home is arranged over two floors with en-suite bedrooms on both floors and communal areas comprising of dining areas, lounges, quiet rooms a cinema, library and a hair dressing salon. It can provide accommodation and personal care for up to 62 people at any one time. On the day of the inspection 44 people were living in the service of which three were in hospital.

The service was registered on 3rd August 2016. This was the second comprehensive inspection since the home opened. At the last inspection we found that improvements were needed in relation to the clarity and relevance of risk assessments and the accuracy of information within care plans overall. Staff training was not up to date and many of the senior staff who were new to their roles and the required responsibilities were not adequately supported. Whilst the last inspection demonstrated that improvements were being made these were at an early stage. The scale of the task was such that a period of sustained improvement needed to occur in many areas of the home including communication within the team and with relatives and health and social care professionals. At this inspection we found improvements in all areas. Whilst it was acknowledged that improvements were still needed the home was now functioning to a good standard overall. There was a registered manager in post. He was an experienced manager who had transferred from another of the providers services. 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 provider continued to complete thorough recruitment checks on potential members of staff. Maintenance and checks of the property and equipment continued to be carried out promptly and within required timescales. Checks on the fire safety systems and equipment were completed in accordance with the provider’s policy and manufacturer’s instructions. The medicines management systems were conducted safely and appropriately. The provider had plans in place to deal with any emergencies that may arise.

People who use the service were able to give their views about the quality of the care provided. The majority of relatives and community professionals told us they were happy with the direction the service was going in. In addition, there was more satisfaction with the standard of care provided by Abbeyfield Winnersh and confidence that people were safe using the service. The service had improved systems to manage risks to both people and staff, and we saw more person-centred initiatives had been implemented to enhance the care provided. Staff were aware and confident about keeping people safe and the procedures for reporting concerns promptly was well understood. Information and guidance was readily available for staff to access in the event they had any concerns.

People were treated with kindness, dignity and compassion. People were respected and had their privacy safeguarded by staff who understood these principles. Feedback from relatives confirmed this. We saw that people and staff interacted in a positive manner, choices were offered and explanations were provided. Throughout the two-day inspection there was a relaxed and friendly atmosphere where a range of activities were being provided and engaged with by people. We saw people laughing and smiling with staff as th

This inspection took place on 14 and 19 September 2017 and was unannounced. Abbeyfield Winnersh is a purpose built residential care home for older people who all have some degree of dementia. The home is arranged over two floors with en-suite bedrooms on both floors and communal areas comprising of dining areas, lounges, quiet rooms a cinema, library and a hair dressing salon. It can provide accommodation and personal care for up to sixty two people at any one time. On the day of the inspection forty four people were living in the service of which one was in hospital.

The service was registered on 3rd August 2016. This was the first comprehensive inspection since the home opened. At the time of the inspection there was no registered manager in post. The previous registered manager had left in April 2017 following concerns raised about the quality of the care provided. The current manager was temporary pending the recruitment of a registered manager. During the inspection we were informed that an appointment had been made and the new manager would take up the position once their notice period had been completed. 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 home had experienced difficulties with establishing an effective management presence from the point of registration and subsequent opening. It only became apparent that the registered manager had been struggling with their responsibilities when a number of safeguarding concerns had come to the attention of the local authority. The business manager who was the former line manager to the home took on the position of interim manager when the registered manager left in April 2017. A permanent manager was appointed in May but left within a few weeks. The interim manager has been a constant and stable presence in the home during this period of time. There was evidence of considerable improvement in all areas under their direction. Whilst the home is rated requirements improvement overall the inspection team had confidence that the developments and improvements seen would continue. The rating of requirements improvement in the well led domain is an acknowledgement of the work still to be undertaken and not a reflection of the interim manager’s performance.

The provider completed thorough recruitment checks on potential members of staff. Maintenance and checks of the property and equipment were carried out promptly and within required timescales. Checks on fire alarms and emergency lighting had been completed in accordance with the provider’s policy and manufacturer’s instructions. There was a system to ensure people received their medicines safely and appropriately. The provider had plans in place to deal with emergencies that may arise.

People who use the service were able to give their views about the quality of the care provided. The majority of relatives, community professionals and commissioners told us they were happy with the service provided by Abbeyfield Winnersh and felt that people were safe using the service. The service had systems in place to manage risks to both people and staff. However, there was still work to be undertaken to eliminate inconsistencies in recording. Staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood. Information and guidance was available for them to use if they had any concerns.

People were treated with kindness, dignity and compassion. They were respected and had their privacy and dignity maintained by staff who understood these principles. People and staff interacted in a positive manner, choices were offered and explanations provided when staff supported people with daily living activities.