Formations Care Home is a Care home. People in care homes receive accommodation and 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 service provides care to predominantly older people and those living with dementia in one adapted building.

The home is registered to accommodate up to 24 people at any one time however the service had reduced its capacity to 19. On the day of the inspection there were 19 people living in the home.

The inspection took place on 28 August and 6 September 2018 and was unannounced. This was the service’s first inspection since it registered in July 2017. A registered manager was 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.

Feedback from people, relatives and health professional about the service was exceptional. They all said that people received extremely person-centred care that resulted in very positive outcomes for people.

There was an innovative approach to staff training based upon the needs and learning styles of staff and the needs of people who used the service. People and relatives were fully involved in delivering and receiving training. Staff were highly knowledgeable about people and their individual needs.

Staff were exceptionally kind and caring and knew people very well. Staff spent quality time with people meeting their social needs at every opportunity.

Staff had developed extremely caring and compassionate relationships with people which helped them fully understand people, their histories and their future needs. The service was exceptional at helping people maintain and develop their independence through creative methods and activities.

People and their representatives were truly at the heart of the service. People were fully involved in how the service was run including recruitment decisions, chairing meetings and monitoring quality. The service did not see communication difficulties as a barrier and took steps to fully involve all using innovative approaches, patience and dedication.

The service had developed exceptionally strong relationships with local health professionals whose expertise was used to develop and improve the service. The service was highly effective in its approach to meeting people’s individual healthcare needs. The service worked very effectively with other organisations to ensure the service worked to and contributed to the development of best practice guidance.

Management and staff had an excellent understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Working practices in this area were excellent and focused on involving people to the maximum extent possible, even where people lacked capacity to make decisions on their own.

A thorough and person-centred assessment process was in place resulting in detailed care plans. Everyone said care needs were met and the service was very responsive. We saw very positive outcomes had been experienced by people.

End of life care within the home was exceptional. People, relatives and health professionals were fully involved in the planning process.

The service had strong and effective vision and values. People, relatives and staff were fully involved in the creation and review of these values. We saw the service was true to their values and produced exceptional results.

There was a strong focus on continuous improvement of the service. Robust improvement plans were in place and people and relatives had been involved in quality processes through creative methods.

The service had developed exceptionally strong links with the local commu