The inspection was completed on 15, 16 and 23 August 2018 and was unannounced. This was the first inspection of the service since registering under new ownership in February 2017.

Admirals Reach 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.

Admirals Reach provides accommodation, nursing and personal care for up to 158 people in five separate units each with separate adapted facilities. At the time of inspection only four of the units (which the service called houses) were being used. These could accommodate up to 127 people. People requiring support with general nursing needs resided in Nelson House. Jellico and Benbow House were specialist dementia nursing units whilst Mountbatton House was home to people requiring residential care. At the time of inspection, a total of 121 people were living at the service across the four separate buildings.

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 and associated Regulations about how the service is run.

People felt safe living at the service. Staff and the management team understood their safeguarding responsibilities and knew what to do to keep people safe from the risk of abuse.

Risks to people had been assessed and were regularly reviewed. Staff were aware of the risks to people and how to manage them to ensure people’s safety and well-being.

Medicines were managed safely and administered by senior staff who had been trained and assessed as competent. There were sufficient staff employed to meet people's needs who had been safely recruited.

Accidents and incidents were recorded and analysed to monitor people’s safety. Lessons had been learned and systems and processes amended to improve the safety and quality of the service.

Staff received an induction, training and supervision to support them to be competent in their role. Staff felt well supported and were regularly observed to check their performance and identify any learning needs.

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 consent was sought before care and support was provided.

People were assisted to have enough to eat and drink and received support to access treatment from healthcare professionals to maintain their health and wellbeing.

Staff were kind and caring and listened to people. People were treated with dignity and respect and independence was encouraged. The service supported people to maintain relationships that were important to them.

People’s needs had been assessed and care plans devised which provided guidance to staff on people's needs and preferences to support staff to provide person-centred care. People's needs and wishes for their end of life care were documented and understood.

There were systems and processes in place to respond to complaints. Feedback from people was listened to and acted upon to address any concerns.

The registered manager was supported by a longstanding deputy and newly appointed clinical lead. People and staff were positive about the management team who were ‘hands-on’ and visible within the service.

Quality assurance systems were in place to monitor the safety and effectiveness of the service. There was robust oversight of the service and clear lines of accountability at staff, management and provider level.

Further information is in the detailed findings below.