Chadwell House Residential Care Home is a care home. 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 registered to provide accommodation for persons who require nursing or personal care for 60 older people. Some people were living with the experience of dementia and the service also supported people at the end of their lives. At the time of the inspection there were 58 people using the service.

At the last inspection in February 2016 the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager 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.

The registered manager had various policies, procedures and practices in place, which made people feel safe. Staff had attended various training such as adult safeguarding and knew what to do if they had concerns about people's wellbeing.

The staff recruitment process ensured new staff were appropriately checked, had the necessary skills and experience, and were safe to support people who used the service. The registered manager kept the staffing level under review to ensure there were enough skilled staff to meet people's needs.

People received their medicines safely, as prescribed by their doctors. Care staff worked with local services to make sure people's health care needs were met in the service.

There were systems in place to ensure people were protected from the spread of infections.

Staff had regular supervision, training in key areas and felt supported by their line managers and the registered manager.

The service provided varied and nutritious meals that reflected people's medical, cultural and religious preferences.

People benefitted from a variety of activities in and outside the service.

The registered manager worked well with local organisations such as the health and social care services to make sure people received care and support that met their needs.

Staff sought people's consent before providing care and support. The registered manager understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were not deprived of their liberty unlawfully.

People and their relatives told us staff were kind, caring and treated them with respect. Staff told us they enjoyed working at the service and we observed they showed a caring attitude to people.

Each person had a care plan which was based on their assessed needs and provided guidance for staff on how to support them. The care plans were reviewed to ensure any changes to people's needs were identified and staff responded to them.

Staff ensured people's privacy whilst promoting their independence when supporting them with personal care.

Staff had good relationships with people and their relatives. They knew the needs of each person they supported.

The registered manager and staff supported people at the end of their life to have a comfortable, dignified and pain-free death.

The registered manager recorded, investigated and responded to any complaints they received. People enjoyed a range of activities.

People, their relatives and staff told us they felt the service was well-managed. Survey questionnaires were used to encourage people, their relatives and staff to give feedback about the quality of the service. There were various auditing systems in place to monitor the quality of various aspects of the service and to make improvements.

The inspection was unannounced and took place on 11 February 2016. The service met the five regulations we reviewed at our last inspection on 25 November 2013.

Chadwell House is a purpose built care home for 60 people living with dementia. It is spread over six units housing 10 people on each unit on the ground and first floors. The units are all named after authors whose names are easily recognised by people living at Chadwell House.

There was a registered manager 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.

People, relatives and staff were complimentary about the management team and described them as approachable. There was an open and inclusive culture and an effort was made to ensure that people and their relatives were involved in care planning and activities that went on within the service.

Care delivered was responsive and bespoke to people’s needs. Care plans were comprehensive and contained in depth life histories which were used by staff to actively engage with people. They lay out of the home was conducive and felt homely as it was broken off into six separate units of ten where people lived in communities based on their preferences and interests.

Activities were ongoing throughout the day and were based on people’s personal preferences. Regular outings, birthday celebrations and outdoor activities occurred to keep people occupied and engaged. Investment was made to ensure people were kept as active and as independents as possible.

Staff underwent a comprehensive training and induction program. They were supported by regular supervision and annual appraisal. Staff we spoke with demonstrated a good understanding of the Mental Capacity Act 2005 and how it applied in practice.

People told us that they were treated with dignity and respect and that they felt safe living at Chadwell House.

Staff were aware of what abuse meant and how to safeguard people from preventable harm. Appropriate risk assessments and safety checks for people and the environment were completed to ensure people’s safety. There were aware of the procedures to follow in an emergency in order to prevent harm.

There were robust recruitment practices to ensure that only staff that had gone through the appropriate checks and had the appropriate qualifications and experience were employed. Staffing was based on people’s dependency and both staff and people told us that any absences were filled by other staff.

People were supported to eat and drink sufficient amounts of food according to their preferences. Where needed people were referred to appropriate health care professionals in order to maintain a healthy lifestyle. In addition people were supported to take their medicines at the right time by staff that had been trained and assessed as competent to administer medicine safely.

People and their relatives told us that their consent was sought and their views and experiences were taken into account in the way the service was delivered. Care was planned and delivered in line with individual care plans because people's needs were fully assessed. Staff were caring and supportive to people. People were supported to access health professionals when required. People who used the service and their families told us they were involved in making decisions around their care and support planning. One person told us "they do everything I ask. I have no complaints." Another person told us "they are really good here. I have everything I need."

We found that medicines were safely administered by staff who were trained and competent to carry out this task. The service had appropriate staff recruitment procedures in place. People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative. Appropriate records were maintained by the home to ensure that people received safe care and treatment.

People living at Chadwell House experience varying levels of difficulties expressing their views due to having dementia. We observed that people were happy and comfortable to approach staff members. We met several relatives during the inspection who described Chadwell House as being exceptional. All of the comments that we received were very positive.

People told us that the staff are very friendly and caring, and that the environment was homely, comfortable and welcoming. Staff told us that they were proud to work at Chadwell House. People received personalised care and support which reflected to their individual choices.

People told us that Chadwell House is a great place to live. People told us that the staff are very friendly and caring, and that the environment is homely, comfortable and welcoming. The quality of the care is described as being exceptional. People living at the service and their visitors liked the Chadwell House pets.