Brancepeth Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during the inspection.

Brancepeth Court accommodates up to 49 people in one adapted building. People are accommodated in two separate units, each of which had separate adapted facilities. The service provides both nursing and residential care. On the day of our inspection there were 36 people using the service. Rose Cottage accommodated seven people with a learning disability and 29 older people and five younger adults with disabilities lived within the main Brancepeth Court unit.

The inspection took place on 15 January 2018 and was unannounced. This meant staff did not know we were visiting.

We last inspected Brancepeth Court on 19 October 2015 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

The service had a registered manager who was on duty during the course of our visit. The registered manager was also a registered nurse. 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.

Staff and the management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with and their relatives told us they felt very safe at the home. The registered manager shared learning from feedback and safeguarding events with the staff team through recorded meetings.

Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Health and safety checks were completed and procedures were in place to deal with emergency situations.

The home was clean, and we saw staff followed good practice in relation to wearing personal protective equipment when providing people with care and support. The environment was homely, accessible and dementia focussed. For example, the lighting had been replaced throughout the home which increased visibility for everyone and enabled a more pleasant environment.

Medicines were managed safely. We saw medicines being administered to people in a safe and caring way. People confirmed they received their medicines at the correct time and they were always made available to them.

We found there were sufficient care staff deployed to provide people’s care in a timely manner. We saw that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. People told us their needs were attended to promptly.

Staff received the support and training they required. Records confirmed training, supervisions and appraisals were up to date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People gave positive feedback about the meals they were served at the home. People received the support they needed with eating and drinking by the staff team who were trained to support people with nutritional needs.

We saw people’s healthcare needs were well monitored and records in relation to the monitoring of people’s health, nutrition and pressure care were recorded.

People were supported by care staff who were aware of how to protect their privacy and dignity and show them respect at all times. The home had a dignity champion who was committed to the role and had ensured people were involved in the day to day running of the service. End of life care was provided by compassionate and well trained staff.

People’s needs were assessed before they came to live at the ser

During our inspection we asked the provider, staff and people who used the service specific questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

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

Is the service safe?

People told us they were treated with respect and with dignity by the staff.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents.This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The manager told us one application had needed to be submitted and was now waiting for a response from the local authority to address this. We found relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant people were safeguarded as required.

Staff had training on, equality and diversity, and they understood it and knew how to put it into practice.

The service was not well maintained and this compromised people's welfare, privacy choice and dignity. We have asked the provider to make improvements.

The registered manager sets the staff rotas, they told us they took people’s care needs into account when making decisions about the staffing numbers, qualifications, skills and experience required. This helped to ensure that people’s needs were met.

Is the service effective?

People’s health and care needs were assessed with them, and they or their representatives were involved in writing their plans of care. Specialist dietary, social, mobility, equipment and care needs had been identified in care plans where required. Some people said they had been involved in writing them and they reflected their current needs.

We spoke with the chef and looked at the arrangements for specialist diets and discussed how they met people’s preferences. The chef demonstrated a good understanding of people's nutritional needs and showed us the records they kept of individuals food preferences, allergies, special diets and their likes and dislikes.

People confirmed they were able to see visitors in private and that visiting times were flexible.

Is the service caring?

People told us they were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People commented, “I never feel rushed by the staff that help me, they do everything for me and help me to do things for myself”.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised, we saw these had generally been addressed by the provider.

People’s preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The home had its own adapted minibus, which helped to keep people involved with their local community.

Is the service well-led?

The service had a quality assurance system. The records we looked at showed any shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance systems in place. This helped to ensure that people received a good quality service.

We reviewed the minutes of meetings, social activity calendars and, records of visits by or on behalf of the provider where appropriate we saw action plans were in place to make improvements to the service had been recorded. We saw staff supervision and appraisal sessions were regularly happening.

When we visited Brancepeth Court we found a total of 32 people lived there; 24 in the residential and nursing unit, and 8 in Rose Cottage. We spoke with two people who lived at Rose Cottage and six who lived in the residential unit. We also spoke with three visiting relatives. Everybody we spoke with was complimentary of the quality of care provided. One person said, “The staff in here are brilliant.”

People said they were involved in their care, with their preferences being sought and taken into consideration. This included being helped to live their lives independently and joining in with activities if they wished. This meant that people who used the service understood the care and treatment choices available to them.

We saw the home was clean and maintained to an acceptable standard. We found the home had processes in place to monitor and manage arrangements intended to prevent and control infections.

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People told us they were happy with the staff employed by the service and the care they provided, however some people felt there were insufficient staff meaning they sometimes had to wait for assistance. One person said, "They (the staff) are very polite and good at their jobs; there just isn’t enough of them.” People said the staff knew them well and how best to help and support them in their everyday life.

There were arrangements in place to gain additional feedback about services from user satisfaction surveys, relatives and staff questionnaires.

People said they were happy at Brancepeth Court. One person said "They (the staff) made you feel at home straight away." People said they had been given the opportunity to look around the home before deciding to live there. People also said they were involved in their care, with their preferences being sought and taken into consideration.

People said they were happy with the care and treatment they were receiving. One person said "They keep us well and make sure we're ok" and another said "We are being looked after."

People also said if they wanted anything, they would ask the staff who would see to it for them. One person said "They (the staff) don't hesitate" when they have asked for assistance or used their call bell.

People told us they were happy with the staff employed by the service and the care that they provided. One person said "They're very good to me, the staff. I wouldn't be here if it weren't for the staff." Another person told us "The staff are very good" and another added "They're alright."

Everybody we spoke with told us they felt safe at Brancepeth Court and with the care staff employed by the service. People said they knew they could ask the staff at any time if they wanted something. They also said the staff knew them well and how best to help and support them in their everyday life.

People told us they were happy with the service and knew how to raise issues, should they have any. Everyone that we spoke with said they didn't have any complaints or concerns.

This inspection took place on 19 and 20 October 2015 and was unannounced. This meant the registered manager or the registered provider knew we would be inspecting.

At our last inspection in December 2014 we found the provider had not taken appropriate steps to ensure staff were appropriately supported to enable them to safely deliver care and treatment to people. The registered provider had also not protected service users against the risks of unsafe care by not regularly assessing and monitoring the quality of the service provided. Following the inspection the registered manager sent us an action plan to tell us how they intended to improve the service.

Brancepeth Court is part of a complex of care facilities located on one site, called the Willington Care Village. Brancepeth Court is registered to accommodate up to 49 people. The home is split into two separate units; the main nursing and residential unit, and Rose Cottage which accommodates 8 people with learning disabilities. At the time of our inspection there were 23 people living in the residential/nursing unit and eight people living in Rose Cottage.

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. At the time of our inspection there was a registered manager in post.

The registered provider had put in place robust recruitment checks to ensure people were cared for by staff with appropriate background.

We saw people had personal emergency evacuation plans (PEEPs) in place. Each PEEP specified the support required for people to safely evacuate the building.

We found the property was well maintained and actions had been taken which ensured the building was safe. This included weekly fire alarm testing, hot water testing and portable appliance testing (PAT).

We found people’s medicines were safely stored and administered in a caring and patient manner.

We observed people eating their meals and found staff gave people a choice of meals and supported people to eat with dignity and at their own pace.

We found the provider met the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant the provider had sought authorisation from the relevant local authority to keep people safe.

Consent to provide care had been obtained by the registered provider either from the person concerned or their family member in the absence of the person having capacity to understand consent issues.

Since our last inspection the decorating of Brancepeth Court had been completed. We saw the new decoration included using different colours for bedroom doors and having handrails which could be differentiated from the wall by people living with dementia.

During our inspection we observed staff having meaningful conversations with people and listening to what people said. We found the staff approached people in a caring manner and gave them the time to respond.

We found relatives for those people living with dementia had been involved in the care planning of their close family member.

We found people who lived in the home had person centred care plans in place which met their needs. Where people required additional care plans for example regarding falls, the use of a hoist and challenging behaviour these needs had been identified and care plans put in place.

The home could not be clear with us about the information they had sent to hospital when people needed to be admitted.

The service had addressed behaviours which had challenged them and this had ensured people were protected.

During our inspection we discussed ways of working with the registered manager and staff, where we found there were ways to improve the service, for example improving people’s hydration records; we found the registered manager and the staff responded immediately to consider the improvements and put actions in place.

We found the registered provider and the registered manager carried out a number of audits to monitor the quality of the service.

We found the service had worked in partnership with GPs, social workers, optician, dentist, chiropodists and dieticians to meet people’s needs.

We saw there were arrangements in place to enable people who used the service, their representatives, staff and other stakeholders to affect the way the service was delivered. Although these arrangements were in place the registered manager had received a limited response to questionnaires which made it difficult to measure the service.