This inspection was unannounced and took place on the 15 May 2017.

This was the first inspection of Thelwall Grange following a change of service provider.

Thelwall Grange Care Home provides accommodation and personal care for up to 43 older people, many of whom have dementia care needs. Respite care is also offered. It is located in an attractive rural part of Thelwall, a suburb of Warrington in Cheshire. The service is provided by Staffordshire Care Limited. At the time of our inspection the service was accommodating 38 people.

Thelwall Grange is a three-storey building situated within its own grounds. There is a large car park at the front of the building for visitors to use and a sensory garden with seating areas at the rear of the building for people to access.

At the time of the inspection there was a registered manager at Thelwall Grange. 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.

The registered manager was present during our inspection and was supported by the owner / director. The registered manager and the owner were open and transparent throughout the inspection process, supportive towards the inspection team and were seen to interact with people using the service, their representatives and staff in a caring and helpful manner.

We saw that people living at Thelwall Grange Care Home presented as clean, appropriately dressed and happy in their appearance. Staff demonstrated an understanding of the need to safeguard people’s dignity, individuality and human rights and the importance of providing person centred and compassionate care. We saw lots of positive interactions, banter and humour being exchanged between staff and people living in the home appeared comfortable and relaxed.

Holistic assessments of need had been undertaken and care plans and risk assessments produced to ensure staff understood how to meet needs of people living in Thelwall Grange and to keep people safe.

Recruitment practices were robust and relevant checks had been completed before staff commenced work which helped to safeguard the welfare of vulnerable people. Staff also received training, supervision and support to enable them to understand their role and how to deliver person centred care.

Policies and procedures relating to the Mental Capacity Act and Deprivation of Liberty Safeguards had been developed to provide guidance to staff on this protective legislation and the need to protect the rights of people who may lack capacity. Likewise, systems were in place to safeguard people from abuse and to ensure complaints were listened to and acted upon in a timely manner.

People using the service had access to a range of individualised and group activities and a choice of wholesome and nutritious meals. People also had access to health care professionals and referrals were made for specialist input when required.

There was a quality monitoring system in place which involved seeking feedback from stakeholders and people who used the service and their relatives about the service provided periodically. This consisted of surveys and a range of audits.

Medicines were ordered, stored, administered and disposed of safely.