We inspected Millcroft on 13 September 2016. The inspection was unannounced. Millcroft is a residential care home registered to provide accommodation and personal care for a maximum of 24 people. The home specialises in providing care to older people. At the time of our visit there were 16 people living in the home. At the time of our inspection there was a registered manager at the home. 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.

Risks to people’s safety had been assessed and actions taken to protect people from the risk of harm. The provider had systems in place to protect people against abuse and harm. The provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered manager had robust systems in place to record and investigate any concerns. Staff were trained to identify the different types of abuse and knew who to report to if they had any concerns.

Medicines were managed safely and people had access to their medicines when they needed them.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly. There were sufficient staff to provide care to people throughout the day and night. When staff were recruited they were subject to checks to ensure they were safe to work in the care sector.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People’s special dietary needs were clearly documented and staff ensured these needs were met.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff sitting and sharing mealtimes with people as equals. Staff knew the people they cared for well and treated them with kindness, compassion, dignity and respect. People could have visitors from family and friends whenever they wanted. People spoke positively about the care and support they received from staff members.

People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people’s decisions.

People felt well cared for and were supported with a variety of activities. However, activities were not always structured meaning that people could potentially become under stimulated. We have made a recommendation about this in our report.

Support plans ensured people received the support they needed in the way they wanted. Peoples health needs were well managed by staff so that they received the treatment and medicines they needed to ensure they remained healthy. Staff responded effectively to people’s needs and people were treated with respect. Staff interacted with people very positively and people responded well to staff.

The culture of the service was open and person focused. The registered manager provided clear leadership to the staff team and was an active presence in the home.

We found that the registered manager was no longer managing the home. An acting manager was in place, with the support from two officers from the East Sussex Home Care Owners Association. However as the registered manager had not deregistered with the CQC at the time of the inspection, their name will still remain on any report until such time this information is received. We spoke with the acting manager, two officers, one head of care, the service manager, three care workers, a person responsible for maintenance, six people who used the service and three relatives.

We found that people's privacy, dignity and independence were respected. A person told us, "All the staff treat me with respect".

We found that people's care and treatment was planned and delivered in line with their care plan. One relative told us, "The care was always good but now it is even better".

We found that there was an appropriate recruitment procedure in place. A member of staff said, "We know and understand what is expected of us".

We observed care being given to people and found that that there were sufficient numbers of suitable persons employed. One person told us, "The staff never rush me, there are enough of them".

Staff were supported and received appropriate induction, training, supervision and opportunities for professional development. A staff member told us, "The heads of care and new acting manager are very approachable, we can talk freely and discuss any concern".

At this inspection the registered manager told us they were leaving. Information we have received since the inspection confirms they longer manage this home. However as registered manager had not deregistered with the CQC at the time of the inspection; their name will still remain on any report until such time this information is received. As part of this inspection we spoke with four of the nine people who lived there, visitor's of two people, the management team, chef and three care workers.

We found that people that lived in the home had been able to express their views and preferences and that these had been taken into consideration in the planning and delivery of their care. People had been treated with dignity and respect. We saw that people's needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. People's nutritional needs had been met.

We found that where people did not have the capacity to consent, the provider had ensured that they had acted in accordance with their legal requirements.

People told us they felt safe and the provider had taken steps to ensure that staff knew how to identify abuse and raise a safeguarding concern. People had been cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People had been protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We visited at night in response to some concerns that were shared with us about staffing and as such did not disturb residents on this occasion. When we undertake a follow-up inspection we will speak directly with the people who use the service.