About the service: Andover Nursing Home is a care home providing personal and nursing care to up to 87 people. The accommodation was arranged over four floors. The Danebury Unit has 42 beds and covers the ground and lower ground floors. It provides general nursing care. The Rooksbury Unit covers the first and second floors and has 45 beds. This unit is secure and provides care to people living with complex physical health needs. Many were also living with dementia. At the time of our inspection there were 73 people using the service. Both units had registered nurses on duty at all times.

People’s experience of using this service: The leadership of the service was exceptional. The culture they created drove and improved high quality person-centred care. Staff talked with passion about their role and were proud of making a difference to people’s lives. There was a clear leadership and management structure in place. The service was organised and seamless and have a range of sophisticated systems in place to ensure its smooth operation. People, their relatives and staff were treated as partners and were actively consulted and involved on an ongoing basis about their care and wider issues within the home. Staff had gone above and beyond to develop the communities understanding of dementia and its impact on people and their relatives. There was a strong and innovative emphasis on continuous improvement and of taking part in research to enhance the care people received. A strong governance framework was embedded within the service and a range of audits were undertaken to ensure that the registered manager and leadership team had oversight of the quality of care and emerging risks.

People received care that was extremely personalised and responsive to their specific needs and preferences. There was a strong focus on providing meaningful activities which promoted people’s physical and emotional wellbeing. Staff provided people with exceptional, holistic, person centred, end of life care. People expressed confidence that they could raise any issues or concerns with any member of staff or the management team and that these would be addressed.

People consistently told us that staff were exceptionally kind, caring and compassionate and health and social care professionals told us staff were exceptional in the way in which they provided care and support. There was a strong culture of person-centred care. Staff in all roles were motivated to ensure people had the best day possible and all understood how their role and interactions contributed to people’s wellbeing. There was a culture of inclusiveness and one which acknowledged and recognised the different needs of people.

There was an effective, holistic, evidenced based, approach to assessing, planning and delivering care and support and this was achieving positive outcomes for people. Staff were well trained and well supported and had the necessary skills and knowledge to perform their roles and meet their responsibilities. The service had a strong emphasis on the importance of eating and drinking well. The design and layout of the building met people’s needs. Recognised best practice design principles had been used to help ensure that the environment was functional and supportive of people living with dementia. There was a clear focus on the importance of seeking people’s consent, supporting them in the least restrictive way possible and to upholding their right to be involved in decisions.

Care staff were well informed about people’s risks and knew how to deliver their care safely. The leadership team constantly reviewed the staffing levels, in a systematic way, to ensure that there remained sufficient numbers of staff with the right skills and experience supporting people. Overall medicines were managed safely. The service was visibly clean throughout and no malodours were noted. Staff received training in safeguarding adults from harm and had a positive attitude to reporting