The inspection took place on 30 November and 2 December 2016 and was unannounced. The service was last inspected in January 2014. There were no breaches of the legal requirements at that time.

OSJCT Bemerton Lodge Care Home is registered to provide personal care for up to 56 people. On the day of the visit, there were 54 people at the home.

There was a registered manager for the service. 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 constant friendly and caring interactions between staff and people. People received care that respected privacy and dignity and promoted their independence. There was a welcoming, homely atmosphere in the home. Links with family members were promoted and encouraged. Mealtimes were sociable and made into a very enjoyable experience where people could invite guests to join them. This meant that people were helped and encouraged to maintain relationships with those who mattered to them.

The staff understood how to keep people safe and knew their responsibilities to protect people from the risk of abuse. New staff were recruited only after a through safe recruitment process.

People were cared for in a way that was kind and compassionate. Staff had built strong and caring relationships with people, their families and friends. People were treated with dignity and the greatest respect at all times. Staff treated people as individuals and respected their lifestyle choices.

The home was run in an open and inclusive way for people who lived at the home. Their views and wishes were central to how it was run. For example, their opinions were actively sought about how the home was decorated and maintained. People told us they were regularly asked by the registered manager to give their opinions of the staff and whether they felt well supported by them.

People who lived at the home were very well supported to take part in activities of their choosing. People enjoyed the activities and the opportunities made available to them. There were active links with the local community and people were encouraged to be part of their own community. The management used research and learning. This was to improve and develop the care people received and their overall quality of life.

The service was very responsive to the needs, preferences and wishes of people who lived at the home. The care provided was very person centred and met people's individual and diverse needs. People and their families, continually review people's needs. When people's needs change, they take action to ensure they provide the best care possible for the individual. The service was good at helping people to enjoy their lifestyle.

People were aware of how to complain and make their views known .The provider actively sought the views of people and their families. These views were acted upon and changes were made to the services when needed.

Feedback about the home from people and others involved in their care was very positive. Regular reviews were carried out of the care people received to see where improvements were needed and the service could be further developed. There were quality checking systems in place to monitor the service to ensure people received care that was personalised to their needs.

Staff and people who lived at the home spoke very positively about the management structure of the service. They said that the registered manager provided strong and very caring management and leadership. The staff team told us they were very well supported by the registered manager, who spoke very positively about their role. Staff and people at the home said they saw them daily and they were always there and helped them whenever they needed s

We observed all staff consistently treated people with respect. People said they could choose what they did during the day. One person told us “there’s a nice garden here, which I can go into whenever I want.” People said they were supported in continuing to practice their chosen religion. One person told us “I see the priest often”.

People said they liked living in the home and received the care they needed. One person told us “the home is quite perfect for me.” The relative of a person described the home as “brilliant, they really know how to look after X”. We saw people who were at nutritional or pressure ulcer risk had clear assessments and care plans. These were regularly reviewed.

The home followed national guidelines on infection control. The member of staff who led in this area performed regular audits. All parts of the home we inspected were clean, this included light switches, grab rails and undersides of raised toilet seats.

People told us there were enough staff to meet their needs. One person said “oh they’re very prompt in coming when I ring my bell.” A visitor told us “staff have always got time” for their relative.

We saw the home had a clear, auditable complaints procedure. A person told us the manager’s door was “always open”. They said any issues or questions they raised were always dealt with promptly.

We met with fourteen people living in the home, four of their relatives and an external health care professional. People were complimentary about the service. A person told us “it’s lovely here”. People said they liked the staff. A person told us staff were “so obliging” and another said staff were “quite quick at coming – no problems” when they used their bell. This was echoed by relatives. A relative told us “I’ve seen a difference in them since their admission” about how their relative had improved since they had been admitted.

People commented favourably on the food. A person told us “the food‘s lovely, oh yes there’s choice” and another “we get good food here”. We saw the chef was closely in involved in serving meals, so they could gain direct feedback on what people thought about them. We observed that people who were frail received the support they needed to eat their meals.

We met with twelve members of staff, including domestic workers, care workers, the manager and an area manager. Staff said they were trained and supported in their role. One member of staff told us “training for new staff is very good” and another “the Trust are very good about training”. Staff also told us about regular supervision from their line manager.

The home was regularly reviewed by the provider to ensure people received a quality service. Where areas for improvement were identified, action plans were put in place. One relative described how they appreciated the “very open door policy” from the manager. The home was clean throughout and there were effective systems to reduce risk of infection.

People told us they liked living in the home. One person said “it’s a very good place” and another “they certainly look after me”. People told us they could choose about their care. One person said “I know if I wanted something altered about my care they’d soon do it”. People said they felt safe because of the staff. One person told us “you don’t have to wait for your bell to be answered”. We observed staff were prompt in supporting people who needed assistance, including people on the dementia unit.

There was a lack of consistency in assessment of people’s needs and care was not always planned and delivered in a way that met individual’s needs. People were not supported to participate in recreational activities in the way they wanted or needed. The home’s quality audit was detailed, however it did not document all areas which could have benefitted from action by the provider.