This inspection took place on 29 September 2016 and was unannounced.

Bowbrook House provides personal care for up to 30 people. At this inspection they were providing care and support for 29 people.

A registered manager was in post and present at this 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 registered manager was supported day to day by a care manager who was not available at this inspection.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care. Staff knew what to do in order to minimise the potential for harm.

People were supported by enough staff to safely meet their needs. People received help with their medicines from staff who were trained to safely support them. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work.

The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

Staff members had the skills and knowledge to meet their needs of those they supported. Staff members new to the role received an induction period of training. Staff attended training that was relevant to the people they supported and any additional training needed to meet people’s requirements was provided.

Staff members were aware of the guidance and legislation that governed their practice. People were supported in a way that maintained their individual rights. People were involved in decisions about their care and had information they needed in a way they understood. When people were not able to make decisions themselves staff members knew what to do to ensure any decisions made were in people’s best interests.

Staff received support and guidance from the registered manager and care manager who they found approachable. People and staff felt able to express their views and felt their opinions mattered.

People had positive and caring relationships with the staff members who supported them. People’s likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by those supporting them. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.

The provider undertook regular quality checks in order to drive improvements. People and their relatives felt their opinions mattered to the provider and any suggestions they made were valued. The provider had systems in place to respond to the suggestions of others.

We conducted a short period of observation in the lounge whilst people were supported to spend their morning. This was because not all people were able to tell us their views.

We observed that people received caring support from staff on duty. We saw care that was not rushed and the staff knew the people and their individual personal needs well.

We considered that people who lacked the ability to manage their own care received caring support that was responsive to their changing mood and need. Care records were in place that provided staff with instructions on how people should be cared for and why. This meant that the care was responsive to people's needs.

People considered the staff met their current needs and felt assured that if they became unwell that staff would respond.

People believed staff were well trained to do their job and one person said, "They are very adept at understanding how to assist me. They listen and that’s important". They thought that compassionate care was provided by staff. People considered the service was well led.

People who use the service said that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

Staff provided health and social care support well. Community services were accessed to support people when necessary.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. They told us about the training that the service had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. People’s relatives told us that staff were around and available to talk to when they visited. They said that the staff were friendly and always acted professionally. One person said that they were “Very, very happy here“, and another said “The staff are very good”.

People we talked with said their comments were listened to. A visitor said that they would not hesitate to talk to staff if something was wrong. The home’s management regularly talked with the people to find out what they thought about how their care was delivered.

We carried out this review to check on the care and welfare of people who used this service.

We did not review every outcome for this provider. We were proportionate in our approach and focused on outcomes four and 16.

We met with people who used the service, staff and the care manager. People we spoke with shared their experiences of the service that they received. We observed people who used the service and staff interaction in the lounge and around the home.

People told us that they had been involved in the assessment of their needs and development of their care record. One person said “I feel safe living here, I enjoy the activities available and I can choose whether to participate in them or not. Staff ask me questions about my care and are very kind to me”.

People told us that the staff were available to speak with whenever they needed them, day or night. Comments included, “The staff are good to me, this is a happy home and they are always willing to have a chat if something is bothering me”.

People who used the service told us that they were happy with the meals provided and said the service was able to meet their dietary needs. One person said, “There is a very good choice of food and alternative meals are always made available if you do not like the main option”. People told us their rooms were comfortable and that staff respected their privacy and dignity.

We spoke with staff who had different roles in the home. They told us they enjoyed their work and were well supported. They said they were provided with training opportunities to meet the specific needs of the people who used the service and to keep them safe. One person said, “I do enjoy my job, I like giving people freedom of choice”. Another staff member said, “We work together with our service users and support them in their daily life”.