This inspection took place on the 27 June 2017 and was unannounced.

Cossins House Care Home is registered to provide the regulated activity of accommodation for persons who require personal care to a maximum of 24 people.

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.

The service provided outstanding end of life care. People were cared for by attentive staff, led by an experienced and compassionate registered manager and were supported by palliative care specialists. Staff ensured people had their final wishes met in relation to spending their final days at Cossins House in a peaceful and tranquil setting. Services and equipment were provided as and when needed. This ensured that people experienced a comfortable and dignified pain free end of life care.

Staff were especially compassionate and people and their relatives were extremely complimentary about the care they received. Relatives especially told us that they felt their family members were truly loved and cared for by all the staff.

People and their relatives told us they felt the home was safe. They told us that staff were kind and they had no concerns about being safe. Staff had received training in relation to safeguarding and were aware of the processes to be followed when reporting suspected or actual abuse. The provider had carried out appropriate recruitment checks so as to ensure that only suitable staff worked with people at the home. Medicines were managed in a safe way and recording of medicines was completed to show people had received the medicines they required. Risks to people had been identified and documentation had been written to help people maintain their independence whilst any known hazards were minimised to prevent harm.

There was sufficient staff on duty at all times to ensure that people’s assessed needs could be met. Staff had a good understanding about people’s life histories, their preferences and how to attend to the needs of people.

Staff had received training, supervisions and annual appraisals that helped them to perform their duties. Staff had received all the mandatory training required and other training that enabled them to provide effective care to people.

Where there were restrictions in place, staff had followed the legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way. The registered manager logged any accidents and incidents that occurred and discussed these with staff so lessons could be learnt to help prevent a repeat of these.

Staff supported people to eat a range of freshly prepared foods. People with specific dietary requirements were provided with appropriate food. People had access to all external healthcare professionals and their involvement was sought by staff when appropriate to help maintain good health.

Staff showed kindness and compassion and people’s privacy and dignity were upheld. People were able to spend time on their own in their bedrooms, could freely access all communal areas of the home and their personal care needs were attended to in private. People took part in a variety of activities that interested them. People’s relatives and visitors were welcomed and there were no restrictions of times of visits.

Documentation that enabled staff to support people and to record the care they had received was up to date and regularly reviewed. People and their relatives were involved in the reviewing of their care.

A complaints procedure was available for any concerns. This was displayed at t