This inspection took place on 17 and 18 November 2016 and was unannounced. The previous inspection of Deerhurst was in May 2013. At that time there were no breaches of the legal requirements.

The service had a registered manager. 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.

Deerhurst is a care home with nursing care for up to 66 predominately older people. People have general nursing care needs or are living with dementia however the service places greater emphasis on looking after people living with dementia. The home is split into four areas. On the ground floor was the butterfly trail for 10 people and butterfly cottage for 16 people. Both were for people living with dementia but the cottage accommodated people who were more mobile. On the first floor there were two areas, the honeysuckle suite and bluebill rise. The building was a purpose built care home designed around the needs of the older person and in particular those people with dementia or cognitive impairment and physical impairments. There was one passenger lift and three secured staircases which meant all parts of the home were accessible for people with impaired mobility.

There was level access into the home was from the car parking area. There was a courtyard garden within the centre of the home. People were able to sit out in this area in warmer weather. The courtyard was also decorated in one part as a seaside theme and in another part was set up as a sporting area. To the rear of the property there were sensory gardens, a greenhouse and a large caged area for the hens.

Just prior to our inspection the registered manager had received the Inspirational Leader of the Year 2016 in the National Dementia Care Awards. The service had also been awarded the highest level Quality of Life butterfly kite mark. In order to achieve this the service incorporated the five principles of person centred care. These were occupation and purpose, attachment and a sense of belonging, comfort, identity and inclusion.

The registered manager provided good leadership and management for the staff team. The service and staff demonstrated their commitment to care for people with dignity, to further improve and to follow best practice for the care of people living with dementia. They linked with care provider forums ensured people had access to the local community. The service had a good reputation within the local community and also with health and social care professionals.

The service was very well-led and well managed. The service had a robust programme of audits in place to monitor the quality and safety of the service. Action plans were developed where shortfalls were identified so that improvements could be made. The provider continually looked to make things work better so that people benefitted from an improved service. Any planned improvement actions were followed up to ensure they were implemented.

People were looked after with a person centred approach care and where possible had been involved in drawing up their care plans. Knowledge of the person’s history and personality assisted the staff team and volunteers to provide the right support and maintain the person’s dignity and choices. Care plans were well written and provided detailed information about how the person wanted to be looked after and how their care was to be delivered. People were encouraged to have a say about things that mattered to them and to raise any concerns they may have.

People were looked after by staff and volunteers who were kind and caring. The staff met not only their specific care and support needs but also their emotional and social needs. The staff formed good

People that we spoke with during our visit told us "Staff are so very kind and caring”, “The staff are hard working and cheerful” and “Staffing is very good here”.

People were cared for in a clean, hygienic environment. We found good standards of cleaning. Bedrooms were checked and were found to be clean and tidy. We observed during that staff were cleaning people’s rooms thoroughly.

Shared lounge areas had been decorated to a high standard and lounge furniture was very comfortable and in good condition. People living at the home told us “The staff are creative” and “Its home from home here”.

Staff we spoke with told us that they regularly reviewed people's care plans, audited daily record sheets and involved people in the process. We saw evidence of this when we looked at care records.

We reviewed care records to determine the support that was in place for people. The records demonstrated that people had been involved in making decisions about their care.

One person who was visiting their relative told us “We chose the home because my relative liked it”. They said they were very happy with the home. They told us “The manager is helpful and approachable and willing to spend time with us and our relative to help with decision making”.

We spoke to a relative who told us “The care is amazing” and felt that communication with the home was good. They said they felt their relative was given choices and that staff listened. We saw an area of the home that served as a library. There was a large variety of books that people could borrow or buy for a small charge.

The daily records were entitled ‘Being with me’. They had sub headings of ‘Know me’, Hear me’ and Support me’ reflecting people’s past, present and future. This reflected what made a good day, people’s routines, likes, dislikes and personal care support.

We saw that the home made appropriate referrals to the local authority safeguarding team and took leadership and advice where needed. Records were maintained of safeguarding alerter forms and correspondence.

One relative commented that "The staff do a good job and know what they are doing” and “My family member is so much better since moving here".