The inspection took place on the 4 and 6 December 2017 and was unannounced.

This was the first inspection of Holcroft Grange Residential Care Home following a change of service provider. The service is therefore going through a period of transition.

Holcroft Grange Residential Care Home is a ‘care home’ run by Croftwood Care (Cheshire) Limited. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home is single storey building that is situated in the centre of the village of Culcheth. A range of shops and other local facilities are within walking distance of the home and the village is supported by good public transport services

The care home accommodates up to 40 older people (some of whom are living with dementia) in one adapted building. All rooms are for single occupancy and four are equipped with en-suite facilities. Communal bathing and toilet facilities are located throughout the home. At the time of our inspection, the care home was accommodating 40 people.

The home had a Registered Manager. 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.

During our inspection we spoke with people living in the care home and undertook a Short Observational Framework for Inspection (SOFI) during a mid-day meal. We saw staff taking the time to talk and interact with people throughout the day and were helpful and supportive when people asked for help. We also noted that staff interactions were positive and that people living in the care home had access to activities and were treated with dignity and respect.

We found that assessment and care planning records were in place that confirmed the holistic needs of people were identified and kept under review. This helped staff to be aware of the support needs of people living in the care home and the importance of providing responsive person-centred care.

Policies and procedures relating to the Mental Capacity Act and Deprivation of Liberty Safeguards had been developed to provide guidance to staff. Management and staff spoken with demonstrated a good understanding of this protective legislation and the need to protect the rights of people who may lack capacity.

Systems had been established to ensure that staff working in the care home had been correctly recruited and to ensure people were protected from abuse. A complaints process was also in place to ensure concerns and complaints were listened to and acted upon. Furthermore, a range of quality assurance and auditing processes were in place to ensure key areas were monitored. This involved seeking the views of people using the service periodically.

People had access to health care professionals subject to their individual needs and medication was ordered, stored, administered, recorded and disposed of safely.

The provider had established a range of induction and training opportunities for staff who benefited from on-going supervision and appraisal. Key staff had also been nominated as champions to lead on key areas such as safeguarding, end of life care and infection control.

We received mixed feedback regarding the standard of catering in the care home and this is an area that the registered manager is looking to further develop. We also noted that the service had obtained a range of generic policies and procedures that were not bespoke to the care home and that some of the care related documentation and audit tools in operation had been developed by the previous provider.

We have therefore recommended that the registered manager undertakes a full review of all