Our inspection took place on 5 December and 6 December 2017 and was unannounced.

Ascot Grange is a 'care home' with nursing located in Ascot. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Ascot Grange can accommodate 106 people across four separate floors, each of which has separate adapted facilities. One of the floors specialises in providing care to people living with dementia. The premises are modern and purpose-built. At the time of our inspection, there were 28 people living at the service and there were 70 staff.

People live in self-contained apartments and have access to communal facilities such as a bistro, restaurant, café, hairdresser, cinema and lounge areas. Each apartment has an ensuite shower and there are communal bathrooms on each floor. A large landscaped garden is located at the rear of the premises.

The provider is required to have a registered manager as part of their conditions of registration. 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. At the time of our inspection, there was a manager registered with us.

People were protected from abuse and neglect. Appropriate systems were in place to safeguard people from the risk of preventable harm. People’s care risks were appropriately assessed, mitigated and recorded. Recruitment practices and supporting documentation met the requirements set by the applicable legislation. We found appropriate numbers of staff were deployed to meet people’s needs.

The service was compliant with the requirements of the Mental Capacity Act 2005 and associated codes of practice. People were assisted 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 induction, training, supervision and performance appraisals were satisfactory and ensured workers had the necessary knowledge and skills to effectively support people. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was appropriate access to other community healthcare professionals. People were supported to maintain a healthy lifestyle. People complimented the food and drink and we found the risks of malnutrition and dehydration were satisfactorily managed.

The service was caring. There was complimentary feedback from people who used the service and relatives. People told us they were able to participate in care planning and reviews and some decisions. People’s privacy and dignity was respected when care was provided to them. People told us staff were respectful.

Care plans were appropriate and contained information of how to support people in the right way. We saw there was a complaints system in place which included the ability for people to contact any staff member or the management team. Questionnaires were used to determine people’s satisfaction with the care. We made a recommendation about care in the unit for people living with dementia.

People had positive opinions about the management and leadership of the service. There was a good workplace culture and we saw the staff worked cohesively to ensure good care for people. Audits and checks were used to gauge the safety and quality of care. The provider met the conditions of registration and complied with other relevant legislation related to the adult social care sector.