This inspection was undertaken on 3 and 4 September 2018. The first day of our inspection visit was unannounced.

St Johns Nursing 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.

St Johns Nursing Home accommodates up to 46 people across two separate units, the Pines and the Limes, within one adapted building, and specialises in care for people living with dementia and rehabilitation for people with enduring mental health needs. In addition, there are three flats to promote more independent living. At the time of our inspection visit, there were 40 people living at the home.

There was 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 2008 and associated Regulations about how the service is run.

We last inspected the service in October 2016 when we rated it as Good. In August 2018 we re-registered the service to reflect a change in the ownership structure of the registered provider. This change had no impact on the day-to-day operation of the service. Although, therefore, this was our first inspection of the re-registered service.

People were supported to stay as safe as possible by staff who understood what actions to take to reduce risks to their well-being. This included reducing risks to people’s physical health and mental well-being. The registered manager had recruited additional staff so they could reduce the need to use agency staff and to further promote consistency of care which met people’s wishes and choices. People could rely on trained and competent staff supporting them to have the medicines they needed to remain well and free from pain.

People benefited from living in a home where there were systems in place to reduce the risk of infections and staff knew what action to take to care for people if they experienced any infections. Checks on the environment were undertaken and systems for identifying if there was any learning after safety incidents were in place.

Staff considered people’s care needs and involved people who knew them well before people came to live at the home, so they could be sure they could meet people’s needs. Staff received the ongoing training they required so people would be supported by staff with the skills needed to help them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to choose what they wanted to eat and the registered manager was looking at ways to ensure the meals people were offered were to their liking and varied. Staff supported people to obtain care from other health and social care professionals so they would remain well.

People had developed caring relationships with the staff who supported them. Staff communicated with people in the ways they preferred and encouraged them to make their own day to day decisions about their care. People received care from staff who acted to promote their dignity and independence. Systems were in place to respond to any concerns or complaints and to act to resolve these.

People’s care had been planned by taking their individual wishes, histories and needs into account. People’s care plans incorporated advice provided by other healthcare professionals, so they would receive the care they needed. Procedures and processes were implemented to show people’s skin was regularly assessed and wounds were monitored regularly.

Staff had received compliments about the way care was provided. The registered manager and pro