The Brambles Care Home provides accommodation and personal care for up to 22 older people who may have care needs associated with living with dementia. There were 18 people living at the home at the time of our inspection. The service does not provide nursing care.

At the last inspection in July 2015 the service was rated Good. At this inspection we found the service remained Good.

The service was safe. The registered provider’s recruitment procedures ensured that only suitable staff were employed. There were enough staff to help keep people safe, meet their needs and protect them from harm and abuse. Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. There were safe systems in place for the management of medicines.

The service was effective. Staff received training to ensure they had the necessary skills and knowledge to care for and support people living at the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough and maintain a balanced diet and to access health and social care services when required.

The service was caring. Staff knew people very well and were kind and sensitive to their needs and ensured their privacy and dignity was respected. People told us they were happy with the care and support they received.

The service was responsive. Where possible people and their families were involved in the planning and review of their care and support; care plans were person centred and were regularly reviewed. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. Staff shared information effectively which meant that any changes in people’s needs were responded to appropriately. There was an effective complaints procedure in place.

The service was well-led. Staff and relatives were extremely complimentary about the registered manager who was committed to providing an excellent person centred service; ensuring people had a good quality of life. There were systems in place to regularly assess and monitor the quality of the service provided and people living and working in the service had the opportunity to say how they felt about the home and the service it provided. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.

Further information is in the detailed findings below.

A single inspector carried out this inspection. Below is a summary of what we found.

The summary is based on our observations during the inspection, from speaking with six people who were using the service, four staff who supported them and with three visiting relatives. We also reviewed records relating to the management of the service and to the support needs of people who were using the service. These included five support plans, daily support records and five staff files.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People were treated with respect and dignity by the staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had detailed policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This was to ensure that people who could not make decisions themselves were protected. Relevant staff had been trained to understand when a DoLS application should be made, and how to submit one. This meant that people were safeguarded as required.

Staff we spoke with said they had been properly recruited and trained. Staff told us that they received good support in their roles.

Is the service effective?

There was an advocacy service available if people needed it. This meant that, when required, people had access to additional support to help them make decisions.

People’s health and care needs were assessed and they were involved in their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A person who used the service we spoke with told us, “The staff are lovely, they spoil me, I’m happy here.” Another person told us, “I like it here, everything is done for me by the staff who are all pretty good.”

A relative said, “We are very pleased that our relative is living in this home, the staff are kind and good at keeping us informed about our relative.” Other comments we received from relatives were, “The staff are approachable and listen to our views, they are also caring and always busy making sure our relative’s needs are being met.”

The responses and views of people who used the service, their relatives and staff involved with the service provision, were recorded at the annual quality monitoring review. Any shortfalls or concerns raised were addressed.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided by staff in accordance with people’s wishes.

Is the service responsive?

People had the opportunity to enjoy a range of activities and, mostly with staff support, were able to get out and about in the local community.

A person who used the service we spoke with told us, “The staff are always around, they ask me if I’m alright, if I tell them if I’m not happy about something they try to sort it out for me.”

Is the service well-led?

The service worked well with other agencies and services to ensure all aspects of people's needs were being met.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the aims of the home and of the standards of care and support that was expected of them.

Regular service monitoring processes were in place. This helped to ensure that people received a good quality service at all times.

A relative we spoke with told us, “I am happy that my relative is in this home, the staff show kindness towards my relative and the managers and staff are good at keeping me updated about my relative’s health.”

We found before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. That service user’s care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Where more than one provider was involved in their care or movement between services people's health, safety and welfare was protected. This was because the provider worked in co-operation with others. We found people were cared for, or supported by, suitably qualified, skilled and experienced staff and that comments and complaints people made were responded to appropriately.

People we spoke to told us that they were happy with the care and support provided. One relative said, “Couldn’t be happier to know they [referring to his relative] is looked after with kindness and thoughtfulness.” The person’s relative also commented on how their relative was spoken to with, “Kindness and laughter.”

We spoke with seven service users and two relatives. They all said that Brambles Care Home was a very nice place to stay and that they were happy with the care provided. They said that they felt respected and were asked about their preferences and given choices.

Two family members of one service user said that they were able to visit the home at any time they wished to see their relative and that they were encouraged to be involved their care.

People with whom we spoke reported that they were happy with their medication and had no problems to report. They said they received it on time.

This inspection took place on 22 and 30 July 2015.

Brambles Care Home is registered to provide accommodation and care for up to 22 people some of whom may be living with dementia. There were 20 people living in the service on the day of our inspection.

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 received their care and support in a way that ensured their safety and welfare. There were sufficient numbers of staff who had been safely recruited, were well trained and supported to meet people’s assessed needs. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made applications appropriately when needed.

Staff had a good understanding of how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely.

People were supported to have sufficient amounts of food and drink to meet their needs. People’s care needs had been assessed and catered for. The care plans provided staff with sufficient information about how to meet people’s individual needs and preferences and how to care for them safely. The service monitored people’s healthcare needs and sought advice and guidance from healthcare professionals when needed.

Staff were kind, caring and compassionate, they knew people well and ensured that their privacy and dignity was maintained at all times. People participated in activities of their choosing and were able to express their views and opinions. Families and friends were made to feel welcome and people were able to receive their visitors at a time of their choosing.

People knew how to raise a concern or complaint and were confident that any concerns would be listened to and acted upon.

There was an effective system in place to assess and monitor the quality of the service and to drive improvements.