We inspected Bramble Cottage Retirement Home on 8 March 2017. Bramble Cottage Retirement Home is a care home registered to provide support for older people who require personal care. The service is registered to support a maximum of 28 people. The service specialises in providing both long and short stays as well as respite breaks for older people. There were 27 people living at the service on the day of our inspection. Bramble Cottage Retirement Home was last inspected in October 2014 and no concerns were identified.

A registered manager was 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 and associated Regulations about how the service is run.

People’s medicines were stored safely and in line with legal regulations and people received their medication on time. However, safe procedures for the administration of the medication were not routinely being followed, which placed people at potential risk of receiving their medicines incorrectly. We have identified this as an area of practice that needs improvement.

We have made a recommendation about the management of medicines.

People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “I feel 100% safe here”. Another said, “There is always a member of staff nearby”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including caring for people with Parkinson’s disease and palliative care (end of life). Staff had received both one to one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place. One member of staff told us, “I get supervisions, it’s useful, but I can speak up on a daily basis”. Another said, “The training is very good and always available. We requested Parkinson’s training and got it”.

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. One person told us, “The food is excellent, very good”. Special dietary requirements were met, and people’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.

People chose how to spend their day and they took part in activities in the service and the community. People told us they enjoyed the activities, which included a popular weekly quiz, gentle exercises, recitals and themed events with external entertainers. One person told us, “I join in with whatever is going on. The quiz in particular is excellent, and we can do crosswords every night”. People were also encouraged to stay in touch with their families and receive visitors.

People felt well looked after and supported. We observed friendly and genuine relationships

The inspection took place on 14 October 2014. Bramble Cottage Retirement Home was last inspected on 30 May 2013 and there were no concerns.

Bramble Cottage Retirement Home located on the outskirts of Brighton. It is registered to accommodate up to 28 people who require support with personal care. They specialise in providing both long and short stay placements, as well as respite breaks for older people. On the day of our inspection, there were 27 people living in 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.

People were happy and relaxed with staff, they said they felt safe living at Bramble Cottage Retirement Home and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. One person told us, “I feel absolutely safe”. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately, including the administration of controlled drugs.

People’s mental capacity had been assessed where required, and they were supported to make decisions. We found staff were up to date with current guidance to support people to make decisions, and would be done in their best interest using appropriate safeguards.

Accidents and incidents were recorded appropriately and steps taken by the service to minimise the risk of similar events occurring in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

People were encouraged and supported to eat and drink well. One person said, “On the whole, the food is very good”. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were advised on healthy eating and special dietary requirement were met. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.

People’s rooms were furnished and decorated in line with their personal taste. People were dressed in their own style and if they needed support, staff helped people to take a pride in their appearance and dress in their personal style.

People could choose how to spend their day and they took part in activities in the home and the community. They were supported to participate in their hobbies and interests, which included painting visiting restaurants. People told us they enjoyed the activities and one person told us, “I enjoy the talks and quizzes”.

Staff had received all basic training and there were opportunities for additional training specific to the needs of the service. Staff had received regular supervision meetings with their manager.

People felt well looked after and supported and we observed friendly and genuine relationships had developed between people and staff. One person said, “Oh yes, they are very caring and treat me very well”. The registered manager told us, “We treat people with respect. The little things are important, and I lead by example”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible. People chose what they wanted to do on a daily basis and were able to access the community, to go shopping for example.

People were encouraged to stay in touch with their families and receive visitors’ to the home. One visiting relative told us, “They look after my relative very well. When we get a bit older, we would definitely come here”. Relatives were asked for their views about the service and the care that was delivered to their family members. Completed surveys showed that families were happy overall and felt that staff were friendly, welcoming and approachable. Residents’ meetings were held and people said they felt listened to and any concerns or issues they raised were addressed. One person said, “Any time I’ve mentioned something, it’s dealt with straight away”.

Care plans gave detailed information on how people wished to be supported and were reviewed and updated regularly.

People were involved in the development of the service and were encouraged to express their views. Staff were asked for their opinions on the service and whether they were happy in their work. They all felt supported within their roles, describing an ‘open door’ management approach, where management were always available to discuss suggestions and address problems or concerns. Quality assurance was undertaken by the provider to measure and monitor the standard of the service.

We observed the care provided and looked at supporting documentation. We talked with two

care staff, the manager, five people who used the service and a relative.

Records showed that people's care needs had been assessed, planned, reviewed and

delivered in line with their individual care plan. People commented, “You have everything you need. You only have to ask and it is done”. “I am very happy with things” and “Everything gets sorted out. You are never neglected”.

People's medication was managed safely and they had access to healthcare support. Recruitment procedures were robust. People who used the service said that staff provided them with all the support and assistance that they needed and wanted.

There were systems in place to identify, assess and manage risks to people who used the service. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. People knew that they had a right to complain and had confidence that their complaints would be addressed.

People expressed their views and were involved in making decisions about their care and treatment. People who lived in the home were consulted with on a daily basis regarding aspects of their day to day living and when choosing both individual and collective social, recreational and leisure activities.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans contained detailed guidance for care workers as to how the care should be provided. Care and support plans we saw were clearly based on people’s preferences.

People we spoke with spoke highly of care workers and the care delivery at the home. They told us that they were treated with dignity and respect and spent their time as they chose.

One person told us “The care has been wonderful” “it has exceeded my expectations.”

Another person told us. “I have no concerns what so ever.” “The staff show remarkable empathy”.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.