Cleves Place provides accommodation, nursing and personal care for up to 60 older people some of whom may be living with dementia and/or have complex nursing needs. At the time of our visit there were 55 people using the service. The home was situated in the town of Haverhill in Suffolk.

Cleves Place 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. This inspection took place on 5 April 2018 and was unannounced.

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 2008 and associated Regulations about how the service is run.

At our last comprehensive inspection on 30 November we found that the home was safe with effective and responsive care. We rated the home as Good in each of the five questions that we ask and overall. At this inspection we found that the home had developed further. We have rated the service Outstanding in caring and responsive making the overall rating for the service Outstanding.

People and their relatives were extremely complimentary about the care they received. Staff were particularly positive about the people they provided care to and supported and the management and leadership inspired them to deliver a high quality service. People received exceptionally personalised care and support which they were in control of. Activities were planned by staff who worked closely with people to establish their individual and unique preferences. People were supported to take part in activities of their choosing.

There was an exceptionally strong ethos within the home of treating people as individuals and with respect. People were at the forefront of their care. Information was given to people about how to raise any concerns they may have and where concerns were raised these were dealt with speedily and in detail. Staff were passionate about providing the best, most compassionate and respectful end of life care to people.

People were involved in developing their support plans, which were highly personalised and detailed to ensure their individual preferences were known. The home was extremely responsive to people's specific and individual needs and preferences. Activities were planned by staff who worked hard to ensure that all people were able to be involved. People were supported to take part in stimulating activities of their choice, which had a positive impact on their well-being.

There were sufficient staff to meet people’s needs in a timely manner and ensure that care was person centred and not task focussed. The provider completed relevant pre-employment checks to ensure staff were safe to work with older people. The registered manager analysed staffing needs to ensure staff had the right mix of skills to meet people's needs safely. High standards of cleanliness and hygiene were maintained within the home.

Staff felt well supported in their role and had received training and supervision which ensured they

understood how to do their job well. Meals were of a good quality, varied and people were given choices. The staff were knowledgeable about the support people required to enjoy their meals and drinks safely and this was provided.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people had been unable to make a particular decision at a particular time, their capacity had been assessed and best interest’s decisions had taken place and recorded. Where people were being deprived of their liberty for their own safety the registered manager had made Deprivation of Liberty Safeguard (DoLS) applicati

The inspection took place on 30 November 2015 and was unannounced. This was the first inspection of this newly built service which opened in February 2015.

The service provides accommodation for up to 60 older people some of whom may be living with dementia. At the time of our inspection 55 people were living at the service and two people were in hospital. The service provides accommodation in four different areas, one of which is for people with nursing care needs.

A registered manager was 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 2008 and associated Regulations about how the service is run.

Everybody we spoke with in connection with the inspection of this service commended the caring and professional way care and support is provided. People who used the service and their relatives told us how pleased they were to have found the service. All the staff we asked told us they would happily place a relative at the service.

Staff were trained in keeping people safe from abuse and understood their responsibilities should they suspect abuse had occurred. Staff were able to outline how they would report any concerns they had both within the organisation and externally.

There were sufficient numbers of staff on duty to meet people’s needs. People were confident that their needs would be met quickly and this is what we noted during our inspection.

Risks to people’s health and wellbeing were assessed and reduced as much as possible. Medicines were well managed and people received the medicines they needed safely.

Staff received the induction and training they needed to carry out their roles effectively. Staff, including those newly employed by the service, demonstrated a good knowledge of the people they were supporting and caring for and knew people’s particular preferences and wishes with regard to their care.

We saw that staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards DoLS) and the service acted in accordance with them. The MCA ensures that, where people have been assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation.

People who used the service were positive about the food and were able to exercise choice about their meals. Mealtimes were seen to be very sociable occasions which people greatly enjoyed. People identified as being at risk of not eating enough were promptly referred to appropriate healthcare professionals and monitored to ensure no further unplanned weight loss. Support around people’s nutrition was managed discretely and sensitively.

People were supported to access healthcare professionals when they needed them and the staff acted promptly when a person’s health declined.

Staff were caring and committed and we saw that people were treated respectfully and their dignity was maintained. The atmosphere was of a friendly and happy place and the good relationships between staff, the people they were supporting and visiting relatives were observed throughout the service.

People were involved in assessing and planning their care and we saw that care plans had been signed by them to reflect their involvement. People’s care was regularly reviewed and the registered manager and deputy demonstrated that they had an in depth knowledge of people’s care needs.

People were supported to follow a wide range of interests and hobbies and were involved with the local community. People who did not wish to take part in any structured activities had their wishes respected. People living with dementia received individualised care and were given meaningful tasks to carry out related to the running of the service such as helping fold laundry.

Formal complaints were logged and investigated promptly in line with the provider’s complaints procedure and people were satisfied with the outcome. Concerns raised informally via meetings and satisfaction surveys were responded to and resolved to people’s satisfaction.

Staff understood their roles and were well supported by the management team. People who used the service, relatives and staff were very positive about the registered manager and deputy and praised the open culture of the service.