This inspection took place on 14 September 2016 and was unannounced. The service provided accommodation for up to 20 persons who require nursing or personal care. There were 20 people living in the home when we inspected, all of whom were living with dementia.

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. There was a registered manager in post.

People were safe living in the home and staff understood their responsibilities to protect people from harm or abuse and had received relevant safeguarding training. The home had thorough risks assessments in place to provide guidance to staff to keep people safe. There were enough staff to provide people with safe care.

Staff were competent in their roles and received relevant training, and they had dementia champions in place. The home supported people to access healthcare when they needed, as well as to eat a good choice of freshly made and to drink a sufficient amount. There were drinks available throughout the day in all areas of the home.

People had individualised support plans in place which included their likes and dislikes, and their personal histories. Staff knew people well.

Without exception, people were treated with dignity and respect. Staff asked for consent before delivering care, and supported people to make their own choices. People’s relatives were involved with their care when appropriate, and the home actively supported people’s relationships with their loved ones.

There were activities on offer which included daily in house sessions such as games or pampering, as well as regular visiting entertainment such as singers. People were engaged with staff and supported with their communication.

The registered manager was supportive to their team, who had a good morale and consistent approach to working with people. There were systems in place for monitoring and improving the quality of the service.

We used different methods to help us understand the experiences of people living at Munhaven. People living here had complex needs which meant they were not able to tell us their experiences. We spoke with relatives for two people living at the home and spent time observing staff interaction with people over the lunch period and throughout the day. One relative told us they had no worries about their family member’s safety, cleanliness or whether their needs were being met. Another relative was complimentary about the food but was concerned that the home had stopped taking people out on day trips on the mini-bus.

We saw that staff interactions with people were relaxed and friendly. Where we observed that tasks were being carried out staff spoke with people light-heartedly and calmly. This helped ensure that the person’s experience of being supported was positive.

Information was provided in various formats to help people make decisions. A written menu for lunch was on a blackboard outside the dining room. Pictorial menus were on tables and when the food was served the options were taken to people so they could see and choose what they would like.

We viewed the care records for four people living at Munhaven. Information was available on people’s life histories which helped ensure that staff could relate to them as individuals.

Improvements to the environment had been made since our last inspection in December 2012.

People we spoke with told us they liked living at the home. One person said staff were, "Very, very good and very, very kind", and another person said, "They are very good to me". Visitors told us they were asked for their views about how their relative should be cared for and they felt involved in the decision making on the person's behalf.

We saw that people were offered a varied and nutritious diet that was appropriate to their individual needs. Special diets were catered for. We saw people being discreetly assisted to eat their lunch and to have drinks throughout the day.

We looked at the processes in place for the safe storage and handling of medicines. We saw that only trained staff dealt with medicines and that safe procedures were in place.

People spoke warmly about the staff although they felt there were not enough of them. Staff were busy but always gave a cheerful response when walking past people living at the home.

Staff were aware if people were unhappy or ill at ease and spoke with people to establish what they could do to make them feel better. The complaints procedure was not on the noticeboard when we arrived, but the acting manager placed a copy in the entrance hall when we left so that people were informed on how to complain.

People said they were very happy and liked living at the home. They said that staff were kind and helpful although sometimes there were not enough staff about and they had to wait for support. They said the food was good although one person felt the choices were limited due to her dietary preferences.

Because some people were not able to communicate verbally with us, we observed how staff treated them. We saw that staff were respectful and kind. They offered care and support discreetly and ensured that people’s privacy and dignity was not compromised. Staff engaged people in meaningful activities and this produced much laughter and fun.