About the service: Bradwell Court Residential Care Home is registered to provide accommodation for people who require help with their daily lives such as assistance with personal care and who may be living with dementia. The three-storey building is set within its own grounds on a residential estate in Congleton. It is about one mile from the town centre. Staff are on duty twenty-four hours a day to provide care and support for the people who use the service. At the time of the inspection 26 people lived in the service.

People's experience of using this service: Everyone we spoke with told us Bradwell Court was a comfortable home to reside in and visit, that staff were kind and caring and that people were treated with respect. Staff showed genuine care and passion to deliver care in a person-centred way, based on what people’s likes and dislikes were. People were observed to have good relationships with the staff team.

The registered manager and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us they were approachable and that they listened to them when they had any concerns or ideas.

Staff had received appropriate training and support to enable them to carry their role out effectively and safely, including the management of medicines. There were enough staff to meet people’s needs and people’s rights, privacy and dignity were maintained at all times.

Staff were recruited using safe recruitment procedures and processes. Staff told us that they were supported by the management and found them to be approachable. and the training they received enabled them to be effective in their roles. Staff received supervisions to ensure a good quality of care was delivered and they received support from the management.

Detailed care plans described the support people needed. These included information from external healthcare professionals. People’s health was well managed and the positive links with professionals promoted wellbeing for them.

Checks and audits were completed by the registered manager and provider to check the quality and safety of the service. We found that some of these checks were missing dates and signatures in some places. These was addressed and rectified by the registered manager.

The service had a robust complaints policy and procedure in place which detailed clearly a log of all complaints received to date. On the day of the inspection we found that one of the complaints was not logged appropriately but this was rectified by the registered manager on the same day. The service had not received many complaints and took pride in learning from feedback including suggestions received from people, staff and relatives .

The service employed an activities co-ordinator who displayed a caring manner towards the people who used the service. The activities co-ordinator explained to us how they researched new activities to ensure innovative and original ideas were used.

The service showed a strong commitment to supporting people with their dementia needs. We observed a staff meeting where discussions took place on how the service could be enhanced further to help meet the wide range of needs of people with dementia. We noted that staff were innovative in trying different methods in engaging people and helping them to get around the service. Staff offered appropriate support which incorporated reflection and consideration of real life practical examples. During our tour of the service we observed sensory walls and aids displayed in the corridors with appropriate signage throughout the service.

More information is in the detailed findings below.

Rating at last inspection: Good (report published 24 February 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained ‘Good’ overall.

Follow up: We will continue to monitor intelligence we receive about the service

We carried out an unannounced inspection of Bradwell Court Residential Care Home on 21 January 2016. We arrived at the home at 10am and left at 6pm. The service had previously met all of the regulations we inspected against at our last inspection on 20 February 2014.

The home provides personal care, support and accommodation for up to 27 older people who may also have dementia. Accommodation is provided on three floors, with lounges available on two floors. A passenger lift and stairs provide access to all floors. The dining area is on the ground floor. Additional quiet seating areas are available around the home. The bedrooms are very spacious and can also accommodate lounge furniture. All bedrooms have their own bathroom with walk in shower. At the time of the inspection there were 25 permanent residents and another permanent resident was in hospital.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Prior to this inspection we received feedback from Healthwatch, the local authority contract monitoring team and a visiting health care professional to seek their views of the service. They did not have any concerns about the care.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions but had not always consistently followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

However, the experiences of people who lived at the home were positive.

People’s needs were assessed and plans were developed to identify what care and support people required to maintain their health and wellbeing and foster their independence where possible.

People were protected from abuse. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s needs and that safe and effective recruitment practices were followed.

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and where shortfalls were identified the manager was using the information to improve the service. This demonstrated that it was a learning organisation.

During our visit we spoke to three people who used the service, one community staff nurse, three members of staff, the registered manager and three relatives. All the relatives and two of the people we spoke to said that they would recommend the care at Bradwell Court, the replies were all positive and one person told us that that they had ‘already done so’.

The service users all commented that the home was clean and they were generally happy living there. All three of the relatives we spoke to told us that they did not have any concerns about the welfare of the service users. We also spoke to one community staff nurse who told us that they did not have any concerns with the home and noted how the staff at the home ‘were always quick to call the community nursing team when required’.

During the inspection, we heard from several credible sources that at times, the home did not always have enough qualified, skilled and experienced staff to meet people’s needs. Though on the day of our inspection we were not able to demonstrate the full impact that this reported shortfall in staff had on people using the service.

We also saw that the home had procedures in place to monitor, improve and protect the welfare of service users. We were shown some examples of service improvement following learning from incidents, external and internal audits.

On the day of our visit we were told there were 26 people resident at the home and we spoke directly with three people who lived there. We also spoke to staff and visitors to the home. People who lived at the home said they were happy with the care and support provided and they were looked after. They told us that staff respected their rights, their privacy and their dignity. One person said: "Staff are wonderful.”

People told us that they liked their room and that they enjoyed the range of activities provided. Family members we spoke to were positive regarding the care people received at the home. Comments included: “Prior to moving here they assessed Mums needs and we meet regularly to discuss her care, they are very supportive”” and: “Excellent care.”

We found that people felt confident to express any concerns. Members of staff had a good understanding of safeguarding procedures and told us they would report any concerns immediately.

We noted that there were procedures in place that were followed to ensure that staff were recruited effectively and records were kept of this process. A comprehensive and documented induction procedure was in place to support newly recruited staff.

We found a complaint system was in place and communicated to family members and people who lived at the home. We saw that the home seeks opinions and comments from people in a variety of ways and these are monitored and responded to in a timely manner.

During our inspection the people we spoke with who use the service told us that staff sit and talk with them about the care they receive. One person told us how ‘the worker who looks after me always asks me how I am doing and if I need anything’. Another person told us how they prefer spending time in their bedroom and that staff often check to see if they needed anything.

We spoke with three relatives who told us the care and treatment their family member was receiving was meeting the person’s needs. They told us they were in regular contact with the home and were kept up to date with any changes to the persons care, support and welfare. They also told us they were consulted about any changes to their family members care as they were able to speak on their relative’s behalf.

One person told us how their quality of life had improved since they moved to the home, they said they ‘couldn’t look after themselves at home since their illness’. Another person told us ‘just having people around if you need them made them feel better’. All the people we spoke with commented on the ‘kind and caring staff’.

The relatives and healthcare professional we spoke with as part of this inspection told us they had no concerns about the safety and welfare of people who use the service. They told us they had regular contact with the home and with the staff and were confident that people who use the service were kept safe and well. They told us staff were always able to answer any questions/concerns they may have about people who use the service. They also told us staff made them very welcome when they were visiting the home.

People who use the service and the relatives spoken with told us they knew what to do if they had any concerns or worries and were confident they would be listened to.

The people we spoke with who use the service were very positive about the staff and the manner in which they were supported with their daily life. One person told us that ‘you can always have a good laugh with the staff’. Another person told us how safe they felt because staff were always there to help them.

One person told us they felt safe living in the home ‘as they were always staff on duty’. A relative told us they were always kept informed if there were any changes to their family members care and treatment.