This inspection took place on 16 and 19 January 2018. It was an unannounced visit to the service.

We previously inspected the service on 24 November 2015. At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Little Oaks Residential Home is a care home for older adults. It is located in a residential area of High Wycombe and we found it to have a homely and family atmosphere. It is registered to provide accommodation for 35 people. At the time of our inspection 31 people lived at Little Oaks Residential Home.

Without exception people and their relatives were extremely complimentary about the service. People told us the enjoyed living at the Little Oaks Residential Home. People and their relatives consistently considered Little Oaks Residential Home as their home. People consistently told us they were treated with dignity and respect and we observed this to be the case throughout our inspection. Comments included “They are respectful and treat me very well,” “It’s homely. Nice people,” “Very cosy, homely” and “They are very good and caring, they treat us all like we are their own family.”

Staff consistently demonstrated kindness and compassion towards people. People told us “Very polite. Treat me very well,” “Everyone is very polite and helpful” and “Staff are very nice, helpful and respectful.” People were supported to live the life they chose and engaged in meaningful activities.

Staff were highly motivated to provide personalised care to each person. People were supported to continue with their hobbies and interests. Staff understood people’s likes and dislikes. People and the staff knew each other well and these relationships were valued by people who used the service

The service ensured staff were recruited through a robust and safe process. People told us and we observed there were enough staff on duty to provide safe care.

People were supported to keep healthy and manage their healthcare needs. We received lots of positive comments from external healthcare professionals about how the staff supported people at the end of their life. Staff demonstrated compassion and skill when providing end of life care.

People told us they felt valued and included in decisions about their care and the care home environment. For instance, people were asked about how they would like the home to be decorated.

People were 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 support this practice.

The home was supported by an experienced and stable management team, who promoted a clear vision to provide a high quality service to people and their relatives.

Further information is in the detailed findings below.

This inspection took place on 24 and 25 November 2015. This was an unannounced visit to the service.

Little Oaks is a care home for older adults, some who may be living with dementia. It is registered to provide accommodation for 35 people. At the time of our inspection 25 people lived at Little Oaks.

We previously inspected the service on 19 July 2013. The service was meeting the requirements of the regulations at that time.

The service had 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.

Little Oaks is a family run and managed business. The home had a relaxed atmosphere and staff supported people in a respectful and friendly way. Staff understood the needs of people they supported and independence was encouraged.

People told us they felt at home at Little Oaks. They felt safe and had confidence in management to deal with any concerns. Relatives told us they were very happy with the service their family member received. They had confidence that people were supported in a dignified manner.

People had access to healthcare services, and any changes in health were quickly reported and responded to.

People’s medicines were stored safely and were administered correctly.

People had access to a range of activities. We observed people undertaking activities that were important to them, for instance reading the daily paper or knitting.

We observed people laughing and joking with staff in a way that was respectful. People had developed good relationships with peers and staff.

Risk assessments and care plans were person centred and reviewed regularly. Risks were assessed for a variety of topics including falls. A falls dairy was used to monitor and evaluate reasons for falls.

The service was led by an experienced team of senior staff and management. The service had a long standing staff team.

We saw that Little Oaks was clean, bright and homely. It had individual touches such as framed photographs of the residents on different social occasions, a piano, many books, and filled fruit bowls dotted around. The atmosphere was pleasant, and we noted happy social interactions between the staff and the residents.

We spoke with four residents and one relative about the choice and quality of food at the home. One person told us the food was "excellent, and lots of it. We have morning coffee, afternoon tea, and three meals a day. It is more than I had at home, and I have put on weight."

People we spoke with praised the high quality of staff, including the managers. They told us the care was of a high standard, and it was delivered by staff who knew them well.

The provider took account of complaints and comments to improve the service.

People’s personal records were accurate and fit for purpose.

We spoke with five people who use the service and a relative of someone who had recently moved in. They told us that they had all the information they needed to be able to make an informed decision about moving into Little Oaks.

Two of the people we spoke with had previous knowledge of the home.They made their decision to move into the home on the basis of the standard of care they had observed. One relative commented after their first visit they were "absolutely certain that this was the best place for their relative".

People we spoke with told us that their views about how they wanted their care and support to be delivered had been listened to and respected. One person told us that they preferred to stay in their room most of the time but that they chose to join other people at meal times.

They told us that they were very satisfied with the standard of care they experienced and saw.They said that the staff team gave them very good care and had the time to talk to them.One person commented that "we can have a good laugh."

The relative we spoke with said that they had been impressed with the improvement in their relative since they moved into Little Oaks. They commented that they "were now the person they used to be".

People who use the service told us that regular resident's meetings took place. They confirmed they were able to raise any issues or concerns they might have. Day to day concerns were dealt with by the manager or care staff.They told us that they were always treated with respect and their views were taken into account.