Gracewell of Kentford provides nursing and personal care for up to 88 people, some people were living with dementia. At the time of our unannounced inspection of 12 and 13 July 2017 there were 83 people living at the service.

At the last inspection of 17 December 2014 the service was rated Good. At this inspection the service remained Good and met all relevant fundamental standards.

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.

People continued to receive safe care. The staff understood how to keep people safe and knew how to report any concerns. Risks to people's health, safety and wellbeing had been assessed and plans for each person were in place. The nursing staff had a clear system to manage and attend to people’s dressings and nursing needs. There were structured arrangements in place for the safe storage, receipt and management of people's medicines.

There continued to be sufficient numbers of qualified nurses and care staff to meet people's assessed needs. There were effective recruitment procedures in place.

People continued to be supported 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.

The systems in place continued to support people to maintain good health and a nutritious and health diet.

People continued to be treated with understanding dignity and respect for their individual choices and needs. Each person had an individual care plan which had been written with them and relatives as appropriate to identify their needs and how these needs would be met.

The care plans were reviewed on a planned basis and as required as the result of an event. The plans also documented people’s preferences and choices for how they wished to be supported. Activities continued to be planned and were in line with the interests of the people.

There was a complaints procedures in place and a recent change to the monitoring of complaints had emphasised upon the resolution and lessons to be learnt from any complaint.

The registered manager used a number of methods to manage, assess and the monitor the quality of the service. This showed that the service continued to maintain good quality care and identify areas for improvement.

Further information is in the detailed findings below.

We carried out this inspection on 17 December 2014 and was unannounced.

Kentford Manor is registered to provide nursing care for up to 88 people and provides care to people with dementia. The service has four units and is based over three floors with a passenger lift and enclosed gardens. At the time of our inspection there were 55 people using the service.

The service had 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.

There had been a change in provider within the previous two months of our inspection.

All the people we spoke with who used the service told us they felt safe. Relatives we spoke with informed us that they considered their relatives were safe living at the service. People also told us they were well cared for and the registered manager was kind and compassionate.

We were told by members of staff, there were good relationships between the people who used the service and staff. We saw that procedures were in place to help protect vulnerable adults from abuse. The staff had received training about adult safeguarding.

Policies and procedures were in place regarding medication. We looked at the medication records storage and medication audits. We saw that people who used the service received their medication in a timely and safe manner.

People we spoke with all felt that the staff had the skills and knowledge to provide the care that they needed. The training records of the staff employed by the service showed that staff had received mandatory training and training was planned at regular appropriate intervals in 2015. We saw there was an induction process and staff told us they received training, supervision and a yearly appraisal.

We saw that the health of people who used the service was monitored and that changes to peoples care needs were communicated both verbally at handovers and recorded in the care records. People who used the service and their relatives informed us that the service communicated with them and they felt involved in the planning and review process.

We saw that the registered manager and staff all taken part in training with regard to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We saw that people had been assessed regarding their capacity and when appropriate referrals had been made to the Local Authority.

From the care records we looked at, we understood that people who used the service had their weight regularly recorded. When concerns had been raised appropriate action regarding nutrition and fluid intake had been encouraged and recorded.

When we asked people who used the service and their relatives about the food they all thought there was sufficient food with a variety of choice and snacks were also available.

The interactions we saw between the staff and people who lived at the service were positive and understanding. The care plans we saw had information about people’s life histories and their preferences. We looked at seven care plans and found them each to be personalised and clearly identified the person’s needs and how care was to be delivered.

During our inspection we saw people who used the service had been involved with planning activities, this included cooking and baking in the morning, as well as activities arranged on the spur of the moment to respond to the people’s choices at the time. This also included planned activities which had been planned in response to individual needs and enjoyment such as reading to stimulate people’s memories.

The service had systems and checks in place to monitor the quality of the care and service provided. We saw audits and surveys and records how that demonstrated how the service worked with other professionals including Doctors and Chiropodists.