The inspection took place on 20 September 2018 and was unannounced.

Mountfitchet House is a care home. 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. Mountfitchet House is registered to provide accommodation and personal care with nursing for up to 60 older people who may also have dementia. At the time of our inspection care was provided to 53 people. Care is provided in four units over two floors, residential, residential dementia, dementia and people who have nursing needs.

At the last inspection in 2015, the service was rated Good. At this inspection, we found the service had continued to develop and was therefore rated outstanding.

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.

We found the service was very well managed. The registered manager was a strong leader and highly motivated. The service had a full complement of nurses with the necessary skills to meet the needs of the people using the service. This meant people received continuity of care from highly skilled staff. There was an established management team who regularly supported and audited the service to ensure it provided high quality care.

Staff were extremely motivated in their role and felt valued their focus was on the people that used the service. The manager was visible and actively involved in supporting people and staff. Staff morale was high and they felt that their views were valued. The provider worked extremely hard with the management team to ensure all staff felt valued and appreciated.

People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. Medicines were well managed by staff that had been trained and assessed as competent to administer medicines and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

Staff had excellent relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. Staff showed empathy and understanding.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act.

People had sufficient amounts to eat and drink to ensure their dietary nutritional needs were met. The service worked well with other professionals to ensure that people’s health needs were met. People’s care records showed that, where appropriate, support and guidance was sought from healthcare professionals.

People were encouraged to follow their interests and hobbies and to engage in meaningful person-centred activities. They were supported to keep in contact with their family and friends. People’s care plans were individual and contained information about people’s needs, likes and dislikes and their ability to make decisions.

The service was brightly decorated and stimulating for the people living there. The communal areas were decorated to a high standard were clean and furnished giving an overall homely feel. The o