Brambles Residential Care Home is registered to provide care and accommodation to up to 64 older people. At the time of our inspection 57 people were living there.

The inspection took place on 29 April and 10 May 2016 and was unannounced.

At the time of our inspection 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 2008 and associated Regulations about how the service is run.

People told us they felt safe living at the home. People told us and we saw staff to be kind and considerate and treated people with respect and dignity. People’s privacy was respected.

Staff were able to describe the actions they would take to keep people safe. People felt sufficient staff were on duty to meet their care and support needs. The registered manager was able to review staffing levels in line with people’s needs and increase staffing if needed. Systems to ensure safe recruitment processes were in place.

Staff were supported by the management and received training to ensure they had the skills and knowledge necessary to care for people. Staff were able to attended meetings where they were able to voice their opinions. People’s care needs were well known by the staff we spoke to including people’s likes and dislikes.

Care plans and risk assessments were in place. Although these were not always up dated to reflect people’s changing care needs staff were aware of how to care and support people.

People were asked for their permission prior to receiving care and support so people were able to give their consent. Where people were not able to give their consent decisions were made in their best interests. People who lived at the home and their relatives told us staff were kind and considerate.

People’s healthcare needs were monitored and health professionals were consulted in order to maintain people’s well-being. People told us they liked the food available and confirmed a choice was available to them.

People were satisfied with the care provided and were supported in a way they wanted. People had care plans in place describing their needs and risks associated with their care.

Staff told us they enjoyed their work and liked the management team. People and their relatives were confident any complaints made would be listened to and responded to.

Systems were in place to monitor the service provided for people as a means to improve the quality of care and support people received.

There were 60 people living at the Brambles when we carried out our inspection. We looked at how care was provided to people with dementia. We asked staff how many people had a diagnosed dementia. The registered manager told us that 24 people had dementia although not always diagnosed. The majority of people living with dementia lived on the top floor of the building.

During our inspection we found that many of the people were not able to tell us about their experience of living at the home. However, we spoke briefly with some people living with dementia and with three relatives.

We left comment cards at the home for people to complete. These were collected seven days after our inspection. We received a total of 25 comment cards. Comments received were positive and included: “Staff cope extremely well. They are very caring and treat him with dignity and respect” and: “The care she has received has been excellent in a safe and motivating environment. All the staff have been sympathetic".

We observed that there were good relationships between the staff and the people with dementia. Staff were friendly and respectful when they spoke with people. We saw that staff offered people assistance with their personal care discreetly throughout the day. Staff offered people choices during the day and these included how they wanted to spend their time.

We saw that health and social care professionals were consulted with. We found that staff worked with other providers and professionals to ensure that people received the right care at the right time.

Effective systems were in place to enable the quality of care provided to be assessed, monitored and improved.

Sixty four people were living at the home when we visited. We talked with four of them and three relatives about their experiences of living there. We spoke with the manager and the deputy manager and six staff. We also looked at the care records for five people who lived at the home to see how their needs should be met.

Each person had their own room and people and relatives told us that staff knocked on their door if they wanted to come in.

People who lived at the home told us they were happy with the care and support they received. One relative shared with us that they had been involved in all of the care planning and had listened to their relations preferences so that they received the right support in the right way.

People who lived at the home and relatives told us that staff were friendly and approachable so if they had any concerns they would feel comfortable in raising these. There were also regular meetings for people to attend and a book where people could write any comments they wished to make. This helped the manager to regularly assess and monitor the quality of the service people received at Brambles making sure people’s experiences were acted upon.