This inspection was completed on 21 and 22 May 2108 and was unannounced.

Monkscroft Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Monkscroft Care Centre accommodates up to 80 people in one adapted building. There were 75 people at Monkscroft Care Centre at the time of the inspection. Monkscroft Care Centre is set over two floors and divided into four units known as households in the home. Each household has a small kitchen and adjacent dining room and a variety of lounges and quiet areas to sit in. Each household had access to a secured outside space. The home had a shop, cinema and hairdressers. People could also use the hobbies, music and sensory room.

There was a registered manager in post at the service. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run

The previous inspection was completed in December 2015 and the service was rated Good overall. At this inspection the service is now Outstanding.

Risk assessments were updated to ensure people were supported in a safe manner and risks were minimised. Where people had suffered an accident, action had been taken to ensure the on-going safety of the person. There were sufficient staffing levels to ensure safe care and treatment.

Staff had received training appropriate to their role. Staff had received training around safeguarding and were confident to raise any concerns relating to potential abuse or neglect. The administration and management of medicines was safe. There were sufficient numbers of staff working at Monkscroft Care Centre. There was a robust recruitment process to ensure suitable staff were recruited.

People were supported to access health professionals when required. They could choose what they liked to eat and drink and were supported on a regular basis to participate in meaningful activities. People were supported in an individualised way that encouraged them to be as independent as possible.

People and their relatives were all positive about the care and support they received. They told us staff were exceptionally caring and kind and they felt safe living in the home. We observed staff supporting people in a caring and patient way. Staff knew people they supported well and were able to describe what they like to do and how they liked to be supported. People were supported sensitively with an emphasis on promoting their rights to privacy, dignity, choice and independence. Relatives told us they felt the home went above and beyond to ensure people had the best quality of life. We received no negative feedback. Staff told us there was an open culture and they enjoyed working at the home.

The service was highly responsive to people’s needs. Care plans were person centred to guide staff to provide consistent, high quality care and support. Specific focus was given to getting to know each person as an individual. There was an emphasis of what was important to them. People and their relatives were encouraged to give their views and raise any concerns through a range of feedback implemented by the provider. Daily records were detailed and provided evidence of person centred care.

The service was well led. Quality assurance checks were in place and identified actions to improve the service. Staff and relatives spoke positively about the management team. People’s and their relatives views were sought through regular meetings and questionnaires. People were actively involved in striving to improve the service.

This inspection took place on 22 December 2015 and was unannounced. Monkscroft Care Centre provides accommodation for 80 people who require personal care with nursing.

There were 76 people were living in the home at the time of our inspection. Monkscroft Care Centre is set over two floors and divided into four units known as households in the home. Each household has a small kitchen and adjacent dining room and a variety of lounges and quite areas to sit in. Each household had acess to a secured outdoor space. The home had a shop, cinema and hairdressers. People could also use the hobbies, music and sensory room.

A registered manager was in place as required by their conditions of registration. 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.

Staff delivered compassionate care which was focused on people’s individual needs. They were knowledgeable about people’s wishes and preferred way to be supported. Staff respected people’s decisions and provided support when requested. Both people and their relatives complimented the caring nature of staff. We received many positive comments about the home. A wide range of activities were provided for people in and out of the home. People were encouraged to partake in activities. The home explored different opportunities for people to engage in activities to enhance their well-being. People from the local community had been invited into the home. People enjoyed the meals and food provided. Their dietary needs and preferences were catered for.

People’s care records reflected their physical and emotional needs. They provided staff with information and guidance about people’s support requirements and wishes. People were supported to maintain their health and well-being and access additional care and treatment from other health care services when needed. Their medicines were managed and administered appropriately. However records of when people had received medicinal creams applied to their skin was not always consistently completed.

Staff had been suitably recruited and trained to carry out their role. Their skills and knowledge were checked to ensure they had the skills to carry out their roles. The staff were supported by the teams in their households and senior staff

The home was well-led. The registered manager had a good understanding of their role and how to manage the quality of the care provided to people. Quality monitoring systems were in place to check and address any shortfalls in the service. Where concerns had been raised by people and their relatives these had been addressed immediately. There were sufficient numbers of staff to ensure people’s needs were being met.

We spoke to two people who were using the service with the pharmacist inspector speaking to another two people. We heard positive comments about the service provided such as, "pretty good" and "no complaints". We were also told that the staff were "great". We used an observation tool in the residential dementia care unit and also observed the care given to people in the nursing dementia unit. In both units we found that staff acted to meet the needs of people using the service. There were systems in place to assess and plan care for people to meet their needs. People also told us that they received enough help to meet their needs. We found that there were suitable arrangements in place to store people's medicines and give people their medicines correctly.

Staff had received training to safeguard people from abuse. One person using the service that we spoke to confirmed that Monkscroft Care Centre was a safe place to be. We found that there were arrangements to provide enough staff to meet people's needs. Systems were in place to monitor the quality of the service provided to people.

The care home was organised so that care was provided to people in four units. These were Pittville and Alstone that provided nursing care, Spingbank that provided nursing care for people with dementia and Redgrove that provided residential care for people with dementia.