This unannounced inspection took place on Tuesday 8 November 2016.

Braemar Care Home provides personal care and support to older people with both physical and dementia care needs. The home is registered with CQC (Care Quality Commission) to provide care for up to 26 people. The bedrooms are located on two floors with dining rooms and lounge areas located on the ground floor. The home is situated in Southsea, Hampshire and is within walking distance of the local shops and amenities. At the time of the inspection there were 24 people living at the home.

People living at the home told us they felt safe living at the home. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

We found that medication was given to people safely, with staff receiving appropriate training. Management also undertook audits to ensure there were no shortfalls in practice.

Staff were recruited safely with references from previous employers being sought and DBS (Disclosure Barring Service) checks undertaken.

There were sufficient staff working at the home to meet people’s needs. Feedback from people living at the home, visitors and staff was that staffing levels were sufficient.

Staff received an induction when they started working at the home, as well as receiving appropriate training and supervision to support then in their role.

The home worked within the requirements of the MCA (Mental Capacity Act), with the manager completing appropriate assessments if there were concerns about a person’s capacity. The home also worked within the requirements of DoLS (Deprivation of Liberty Safeguards) and made referrals as necessary.

We saw people received enough to eat and drink, with people also making positive comments about the food provided at the home.

All of the people we spoke with during the inspection including people living at the home, visitors and health professionals made positive comments about the care provided.

People told us they felt staff treated them with dignity and respect and promoted their independence where possible.

People felt the home was responsive to their needs and we saw examples of staff doing this during the inspection.

Each person living at the home had their own care plan, which was person centred and detailed people’s choices and personal preferences.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they received. There were no active complaints at the time of the inspection.

All of the people we spoke with told us they felt the service was well-led and that they felt listened to and could approach management with concerns.

There were systems in place to monitor the quality of service such as audits, resident meetings, staff meetings and accident/incident monitoring.

Staff told us they enjoyed their work and liked working at the home and told us they felt there was an open positive culture.

This inspection took place to follow up the compliance action made when we inspected the home on 19 April 2013. The home sent us an action plan on 15 May 2013 which confirmed action had been taken to ensure people were protected from injuries whilst in bed. At this inspection we found the home had assessed individuals regarding the safe use of equipment such as bed rails and that protective cushioning was now in place over bed rails. We also found the home had liaised with the local NHS trust so that people had the correct equipment to protect them from injuries whilst in bed.

We spoke to two people and to two relatives of people living at the home. We also spoke to two staff.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff. We spent one hour observing at lunchtime and found that people had positive experiences. Staff were observed assisting people in a calm, friendly and polite manner. People were given choices about the food they would like to eat.

We saw that each person’s needs was assessed and a care plan devised so that staff had guidance on how to support people. People and their relatives told us they were satisfied with the standard of care provided by the home.

It was not clear that equipment was being used correctly to prevent injuries to people at risk of falling out of bed.

People and their relatives told us the home was a safe place for people to live. The home had procedures for the safeguarding of vulnerable people. Staff were aware of these and who they should report any concerns to.

We saw the home was clean and well maintained. People had personalised their rooms with their own possessions including their own furniture.

We spoke to five people who used the service. People told us that staff were "very nice" and that "they were happy living in the home". We spoke with three relatives who told us that they visited at least weekly. They told us that the service "was a lovely place and that people’s needs were always met", " it is not a service but a home" We also spoke with four members of the care staff who told us that they felt supported and enjoyed their work.

We spent time observing people going about their day and we saw that people were relaxed with the staff that supported them. Staff were seen to be responsive to the needs of the people who used the service.

We looked at six care plans and these showed that people's needs were assessed prior to their admission into the service. The life history of each person, family contacts, health needs and end of life wishes had been recorded.

We spoke with five people who lived at the

home. They all confirmed that their privacy and dignity was maintained at all times. People also said that they were able to make day to day decisions such as what time they got up and how and where they spent their time. People gave us examples of when their choices had been respected, for example if they wished to use their own bed, brought from home. We also spoke with two relatives who visited the home regularly, always arriving unannounced. They told us that the care was safe, appropriate and individualised.

To help us understand the experience of people using the service, we used our Short Observation Framework for Inspection tool (SOFI). This allowed us to spend time watching what was going on in a service and to record how people spend their time, the support they got and whether or not they had positive experiences. Using this, we found that staff had the necessary time and skills to care for people well.

People said that they had no concerns about how their personal care needs were met. They said that if they were unwell then staff would contact a doctor for them. People said staff were available when they needed them and knew what care they required.

We also spoke with other health and social care professionals involved in the care of people. They stated that they had no concerns about how people’s health and care needs were met.

People told us they had a choice about what they had for their meals and could influence menu planning through residents meetings.