Gracewell of Sutton is a nursing home which provides care for up to 83 older people. The ground floor was for people who can live independently with some assistance, while the middle floor was called the ‘memory floor’ and was for people with dementia. The top floor was designed to cater for people with nursing needs although it was not yet open at the time of our inspection. The service had a hairdressing salon on the ground floor and a cinema on the top floor. There were several lounges for people to spend time relaxing in across the service. At the time of our inspection 25 people were living in the service. This was the first inspection since the service registered with us in November 2016.

The service had a registered manager at the time of the inspection. 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 felt safe and were supported by staff who understood how to safeguard adults at risk of abuse as they had received training in this from the provider. The home was secure. Staff assessed risks relating to people, the premises and equipment and developed robust plans to mitigate them. The provider mitigated risks to people in the least restrictive ways possible, for example where some people were at risk of falling from bed staff positioned beds low to the ground and positioned crash mats to cushion falls instead of restricting people in bed with bed rails. The service managed risks relating to infection control well and the home was clean.

There were enough staff to meet people’s needs. Staff were recruited through robust procedures to check their suitability to work with people using the service.

People received their medicines safely and procedures to manage people’s medicines within the service were robust.

People received their care and support from staff who were well supported with an effective induction, training and supervision from their line manager. Staff supported people in accordance with the principles of the Mental Capacity Act 2005. People were positive about the food they received and staff catered to people’s dietary needs and preferences. Staff supported people to access the healthcare services they needed. The provider created the ‘memory floor’ following some design best practices for people with dementia, such as memory boxes to help people reminisce.

The service was caring. Staff knew people’s backgrounds and preferences and developed positive relationships with them. Staff treated people with dignity and respect. Staff supported people to maintain relationships with people who were important to them. People were supported to plan how they would like to receive care at the end of their lives.

People received care and support that was responsive to their needs, including their diverse needs and preferences. The provider assessed people’s needs before they came to live at the service and reviewed their needs with them as they changed ensuring care plans remained current and reliable for staff to follow. People were supported people to engage in activities they were interested in. A suitable complaints process was in place and people told us they would speak with the registered manager if they wished to complain.

The service was well led. An effective staff appreciation and reward system was in place which meant staff felt motivated to perform well and enjoyed their jobs. Staff were well supported by the registered manager who had a background in setting up and managing large nursing homes. The registered manager encouraged open communication with people, their relatives and staff and had systems in place to gather their feedback. The provider had a range of processes in place to monitor and audit qual