The inspection took place on 16 January and was unannounced. The inspection continued 17 Januray 2017 and was announced.

Fernhill was a purpose-built residential home delivering nursing care and support to older people living with dementia. The home is registered to accommodate up to 58 people. At the time of our inspection there were 48 people living there. People were living across two floors. There were four house groups with up to 15 bedrooms with en-suite facilities in each. Each house had a communal living, dinning and kitchenette area. There was also a main kitchen, reception area, hair salon, sweet shop, cinema room, a sensory room and a café. These rooms were used by people and their families to meet and relax in. The manager’s office was situated in the middle of the home on the ground floor.

The service 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.

People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. We saw that food was discussed and recorded on chef visit sheets. We found that some of these required updating.

People, relatives, a therapist and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about their lives. Each person had care files which included guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.

Medicines were managed safely, securely stored, correctly recorded and only administered by on duty nurses that were trained and qualified to give medicines.

Staff had a good knowledge of people’s support needs and received regular local mandatory training as well as training specific to people’s changing needs. Staff told us they received regular supervisions which were carried out by the management team. We reviewed records which confirmed this.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. Capacity assessments were mostly completed and best interest decisions recorded as and when appropriate.

People were supported to access healthcare appointments as and when required and staff followed professional’s advice when supporting people with ongoing care needs. Records we reviewed showed that people had recently seen the GP, mental health team and a chiropodist.

People, relatives and a therapist told us that staff were caring. We observed positive interactions between staff, managers and people. This showed us that people felt comfortable with the staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes and interests. This meant that people were supported by staff who knew them well.

People had their care and support needs assessed before being admitted to the service and care packages reflected needs identified in these. We saw that these were regularly reviewed by the service with people, families and health professionals when available. There was an Admiral Nurse who supported the families at Fernhill and could be contacted by staff to assist in best practice when managing people’s individual needs and during pre-assessments.

Relatives and people were encouraged to feedback. We reviewed the relative’s satisfaction survey results for 2016 which contained mainly positive feedback. An action plan was in place and actions were comple