We carried out an unannounced comprehensive inspection on 1 November 2016. The Sandhurst Rest home is registered to provide accommodation for 24 people who require personal care. The service is intended for older adults. The responsible person made us aware that they operate on having 20 people using the service so people have single occupancy rooms. There were 17 people using the service on the day of our inspection which included two people receiving respite support.

We last inspected the service in January 2014 and found they were compliant with the regulations inspected.

The service had a registered manager who was on leave at the time of our inspection. 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 responsible person and the provider’s representative referred in the report as the owners were at the service when we visited. They had taken on additional responsibility for the day to day running of the service in the absence of the registered manager.

Everyone was positive about the registered manager and owners and felt they were approachable and caring. The owners were very active at the service during our visit and were seen to be caring and supportive to staff. They said they felt this was then the culture in which staff cared for people at the service. They and the staff demonstrated the principles of care as recorded on their website. ‘The aim of Sandhurst is to provide a happy, caring and secure home in a way that enables all the residents to retain their dignity, privacy and independence. We aim to achieve this by providing just the right amount of assistance for each resident.’

There were sufficient and suitable staff to keep people safe and meet their needs. The staff undertook additional shifts when necessary to ensure staffing levels were maintained and there was flexibility. The provider used the services of a care agency where there were staff shortages due to sickness.

The registered manager was able to explain to us their understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. They were aware where people lacked capacity, mental capacity assessments had to be completed and best interest decisions made in line with the MCA. Staff were not all clear about the MCA. The owners made us aware after the inspection that they had scheduled MCA training for themselves and new staff that required MCA training.

People were supported by staff who had the required recruitment checks in place. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns. Staff had the skills and knowledge to meet people’s needs.

People were supported to eat and drink enough and maintain a balanced diet. People, visitors and staff were on the whole positive about the food at the service.

People said staff treated them with dignity and respect at all times in a caring and compassionate way. People received their prescribed medicines on time and in a safe way.

People were positive about the activities at the home. Staff supported people to follow their interests and take part in social activities. Staff undertook activities at the home.

Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. They were personalised and people had been involved in their development. People were involved in making decisions and planning their own care on a day to day basis. They were referred promptly to health care services when required and received on-going healthcare support.

The provider had a quality monitoring system at the service. Th

The home has a very relaxed, friendly atmosphere which one person described as “just like home from home”. People told us that the staff were very caring, well trained and had an in depth knowledge of the people’s individual personalities and care needs. One relative told us that he staff were very reassuring and responded quickly and effectively in an emergency situation.

We spoke with staff who demonstrated an understanding of consent and how the people they cared for gave and withdrew consent. They were able to tell us what actions they would take if they felt unsure about the person’s decisions or capacity.

Management undertook a full assessment of the person’s needs and wrote a provisional care plan that was then adjusted and refined during the first week of residence. This assessment included the person and relatives. Care plans and risk assessments were signed by the person who uses the service.

The service had a robust medication policy in place detailing procedures for the supply, management and administration of medicines within the home. The policy included information about consent and capacity relating to the safe use of medicines.

The manager had a comprehensive training schedule recording that all staff were up to date with all annual mandatory training. There were records of supervision and appraisals.

Every person had a folder in their room which contained concise instructions on the complaints policy and some complaint forms.

On the day of our visit there were 17 people living at Sandhurst rest home. During our visit we spoke with four people who were using the service, five members of staff and one visiting professional. People who used the service told us that they liked living at the home and that the service met their needs. People told us that staff were very helpful and that there was always someone around to provide help and support. Comments included the following: "the home is very good , I am well looked after", and, "I am very happy the care is exceptional."

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat or what activities they wanted to take part in during the day. We saw people being addressed in a respectful manner by staff. We looked at peoples individual care plans and saw that they were person centred and the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitored the quality of care that people received.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

People told us that staff were respectful of peoples’ privacy and dignity and that they were consulted about the care they received.

Two people told us how the home’s link with a local church was important to them, and that this had influenced their choice on moving to the home.

People told us that they were well looked after and liked living at Sandhurst Rest Home.

People spoken with were very complementary about the food provided. People told us that they liked their own rooms that were clean.

People told us that they felt that there were sufficient staff working in the home and that staff were very caring and responsive.

People said that they were listened to, and that they felt able to discuss any matters about the service and care, with the manager.