This inspection took place on the 22 August 2018 and was unannounced. The Grange 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. The Grange provides accommodation and personal care for up to nine people. The home is located in a retirement village on the outskirts of Woking. There were four people living at the service at the time of our inspection. This was our first inspection of the service since it was registered under the current provider.

The home had a registered manager in place. 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 were safeguarding procedures in place and staff had a clear understanding of these procedures. There was a whistle-blowing procedure in place and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work. There were enough staff on duty to meet people’s needs. Risks to people had been assessed and reviewed regularly to ensure their needs were safely met. There were systems in place to monitor infection control, the safety of the premises and equipment used within the home. Medicines were managed appropriately and people were receiving their medicines as prescribed by health care professionals. There were system’s in place for monitoring, investigating and learning from incidents and accidents.

Staff had completed an induction when they started work, they had received regular supervision and training relevant to people’s needs. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and acted according to this legislation. 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. People’s care files included assessments relating to their dietary support needs. People had access to health care professionals when they needed them. The home was clean, very well decorated, furnished, maintained and adapted to meet people’s needs.

Staff treated people in a caring, respectful and dignified manner. People had been consulted about their care and support needs. People received appropriate end of life care and support when required. Care plans and risk assessments provided guidance for staff on how to support people with their needs. There was a range of appropriate activities available for people to enjoy. People knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

There were appropriate arrangements in place for monitoring the quality and safety of the service that people received. Notifications were submitted to the CQC as required. The provider took people and their relatives views into account through surveys and residents and relatives meetings and action was taken to make improvements at the home. The registered manager worked with external organisations to ensure people received good quality care. Staff said they enjoyed working at the home and they received good support from the registered manager. There was an out of hours on call system in operation that ensured management support and advice was always available for staff when they needed it.