This inspection took place on 21 January 2019 and was unannounced. Tremona Care Home 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. Tremona is registered to provide care and support for up to 44 older people. At the time of our inspection there was 40 people living at the service, some of which, were living with dementia.

At our last inspection on 31 May 2016 the service was rated Good, at this inspection the service had improved and is now rated as Outstanding in the responsive and well-led domains.

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 and associated Regulations about how the service is run.

The service was exceptionally well-led. Feedback was unanimously positive about the registered manager and they provided excellent, visible leadership. Staff were passionate about the registered manager’s vision to ensure people were supported to live full and active lives. The provider had been recognised by an independent consumer magazine for having a large number of Good and Outstanding services. The registered manager was knowledgeable and skilled, and understood all of the requirements of their registration. Notifications had been submitted as required, and the rating was displayed at the service and on the provider’s website.

People were supported to be active members of the local community. Regular coffee mornings were held, which were supported by the local authority to welcome the public into the service and raise awareness of dementia. People’s feedback was sought and acted upon and a range of checks and audits were completed to ensure that the registered manager and provider’s high standards were met. The service worked in partnership with the local authority safeguarding and commissioning team, who told us they had assessed the service as ‘excellent’ at a recent visit.

There were a range of unique activities on offer, specifically designed to meet and develop people’s interests. On the day of the inspection a toddler’s music group was held at the service. Diversity was actively celebrated and events such as National Women’s Day, and ‘pride’ were used to reinforce this message.

People’s care plans were detailed and accurate, ensuring staff consistently knew how to support people. People and their relatives told us they knew how to complain, and any complaints received were used to improve the service. We saw positive feedback from people’s relatives regarding end of life care, and the registered manager told us they supported people to remain at the service if that was their wish.

Staff were kind and caring and had built strong relationships with the people they supported. People told us they were treated with respect and dignity, and were encouraged to be as independent as possible. People and their relatives had been involved in planning their care and people’s needs were assessed before they moved into the service.

Staff knew how to recognise and respond to abuse and any safeguarding concerns had been reported and fully investigated. Risks relating to people’s care and support had been assessed and mitigated where possible. Detailed analysis was completed of any falls, and people’s support was changed as a result, to minimise the chances of falling again in the future.

There were enough staff to keep people safe and staff were recruited safely. Medicines were managed safely. The service was clean and had been adapted to meet people’s needs.

Staff received training and support to ensure people were supported effectively. People were support

The inspection took place on 31 May 2016 and 2 June and was unannounced.

Tremona Care Home is registered to provide accommodation and personal care for up to 44 older people who may have a physical disability and/or living with dementia. There were twenty six people living at the home when we inspected.

This was the first inspection since the service was registered in 2015.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People who lived at Tremona told us they were happy living at the home and felt safe. Relatives and professionals involved with people’s care and support were also complimentary about the service and said that they felt people received a good service and they had no concerns about the care people received.

People and their relatives and friends told us they felt people were kept safe and staff demonstrated they knew how to keep people safe. People had detailed care and support plans in place which provided information to assist staff in meeting their needs. Risks to people’s safety and welfare had been assessed and actions put in place to reduce or mitigate risks to enable people to live as safely as possible without restricting peoples choices and wishes. People were supported to engage in a variety of stimulating activities and events suited to individual abilities and interests.

There were sufficient numbers of staff available to meet people’s care and support needs at all times. Staff understood their roles and responsibilities and were supported by the registered manager and management team to maintain and develop their skills and knowledge. People had a choice of food and drinks which helped to ensure their nutritional requirements were met. People had access to a range of health care professionals which helped to make sure their physical health needs were maintained.

There was a happy and relaxed atmosphere in the home and staff interacted with people in a friendly and individualised way. Family, relatives and friends were encouraged to visit whenever they wished and were involved in the developing and review of people’s support plans. People's privacy was maintained and they were treated with dignity and respect.

There was an open and transparent culture in the home and we saw that people, relatives and staff were comfortable interacting with the management team. There was a complaints process in place and people told us they would have no hesitation in raising a concern if they had one. The provider had systems and processes in place to monitor the quality of the service and to make continual improvements.