About the service: Briar Hill House is a residential care home that was providing personal care to older people and people with physical disabilities. They were registered to provide care for 36 people and there were 33 living at the home when we visited. The accommodation consists of two floors each of which has large communal areas with kitchenettes.

People’s experience of using this service:

The service met the characteristics of outstanding.

People received extremely caring and kind support from staff who kept their dignity at the centre of all interaction. They were partners in their care and encouraged to make decisions about this. When they were less able to verbalise, staff understood their preferred methods of communication. They embraced family and advocate support and input in this. Staff went the extra mile to ensure people were happy and respected in their home.

People received care which was extremely personalised and reflected their preferences. Staff were dedicated to ensuring their needs were met and their health and wellbeing closely monitored. People were encouraged to meet goals and regain independence when possible. Activities were creative and diverse to meet different people’s interests and needs. There were plans in place which detailed people’s likes and dislikes and these were regularly reviewed. They included end of life care and the provider embedded an open and honest culture around death and dying. People knew how to raise a concern or make a complaint and the registered manager responded to any complaints in line with the provider’s procedure.

People continued to receive safe care. There were enough staff to support them and they were recruited in a safe way to ensure that they were safe to work with people. People were protected from the risk of harm and received their prescribed medicines safely. Lessons were learnt from when mistakes happened.

The care that people received continued to be effective. They 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. Staff received training and support to be able to care for people well. They ensured that people were supported to maintain good health and nutrition; including partnerships with other organisations when needed. The environment was adapted to meet people’s needs.

The registered manager was approachable and there were systems in place which encouraged people to give their feedback. There were quality structures in place which were effective in continually developing the quality of the care that was provided to them.

More information is in the full report.

Rating at last inspection: The service was last inspected on 28 April 2016 and was rated good.

Why we inspected: This was a scheduled inspection based on the date the service was registered.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 28 April 2016 and was unannounced. At our last inspection on 13 August 2013 the provider was meeting all of the legal requirements.

Briar Hill House provides accommodation for up to 36 people who require nursing or personal care. 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.

There were arrangements in place to keep people safe from harm. Staff understood how to recognise potential abuse and the actions they should take in response to their concerns. People’s individual risks associated with their care were identified, assessed and managed to reduce the risk.

People’s medicines were managed to ensure they received their prescribed treatments safely, at the correct dose and time. There were sufficient, suitably recruited staff available to care for people and meet their needs. Staff had access to varied training and support to improve their knowledge of care and enhance their skills to meet people’s needs. People were provided with a choice of nutritious food and plentiful drinks. The support of healthcare professional was sought to ensure people maintained their health and wellbeing.

Staff supported people in a kind and reassuring manner. People enjoyed the company of staff who respected their privacy and promoted their dignity. People were able to maintain their important relationships, as relatives and friends could visit at any time.

People received the care they preferred because staff asked them and their relatives about their likes and dislikes. People and their relatives were able to regularly review their care to ensure it was still appropriate for them. People enjoyed a varied programme of entertainment and support with their hobbies to prevent them from becoming socially isolated. People and relatives felt empowered to discuss any concerns or complaints with staff and the registered manager.

Everyone felt the home was well managed and demonstrated an open and transparent ethos. The registered manager was approachable and keen to listen to the views of others. There were audits in place to identify where any improvements could be made.

We carried out this inspection as part of our scheduled inspections to check on the care and welfare of people using this service. The visit was unannounced, which meant that the registered provider and the staff did not know we were coming.

During the inspection we spoke with six people living in the home. They all told us they felt well cared for and were settled. We looked at how people’s choices were offered, how the staff gained consent from people and how their care and welfare needs were met.

We looked at four sets of care records and recording charts. We reviewed how the staff kept people safe from abuse. One person told us: “I feel like this is home from home. I am very well looked after”.

During the inspection we spoke with staff about how they were supervised at work and looked at their training records.

We talked with the deputy manager about the complaints process and how complaints were dealt with. There were no current complaints at the time of the inspection.

We met and spoke with the manager, deputy manager, nurses and care staff. We spoke with six people that used the service and four relatives whilst on the inspection.

People told us they were very satisfied with the care and attention they received. They told us they would recommend the home to anyone but they were aware that there was rarely a bed available. One person we spoke with told us, “I am very content here, it’s the best”.

We saw staff interacting well with people and their relatives. We observed a music therapy session taking place in a communal lounge. People were singing and joining in on a variety of instruments and they told us they had enjoyed it.

We saw that the home was well maintained and well presented. People told us they felt safe in the home and well respected by the staff. The staffing levels were high to ensure good quality care could be delivered and to ensure people’s needs were met. We looked at the staff training matrix and 100% of staff had completed the mandatory training.

The management ensured high standards of care were maintained by asking the people who used the service and their relatives to complete an annual questionnaire and give feedback about their experience. We saw that positive feedback and a wealth of thank you cards had been received including the following comments. ‘I can’t thank you enough for the care and attention you have shown’. ‘Thank you for the care given and the kindness you have shown us’.

We carried out this review, as our records showed that there had been no recent inspection of this service. Therefore, we visited Briar Hill House in order to up to date the information we held and to establish that people's needs were being met.

There were 28 people living at Briar Hill House when we visited on 6 March 2012. The visit was unannounced which means the provider and the staff did not know we were coming. We were accompanied by an expert by experience (ex by ex) on this visit. The ex by ex took part in the inspection and talked to the people who use the care service. They looked at what happens around the home; observed how everyone got on together and what the home felt like. The ex by ex took some notes and wrote a report about what they have found. These details are included in this inspection report.

We spoke with people that lived in the home and their visiting relatives. One person told us “My care needs are being looked after; they are very good at that, the girls are tremendous they are constantly on the go. I can’t think of anything that could be improved, the care is great.” Another person told us “I feel very safe here, they treat everyone the same, with care and respect”.

One person told the ex by ex “I was encouraged to choose what drinks I like, they keep me supplied all the time. I like fresh juice so they keep coming and offering me more, they are very, very good.”

One relative told the us “I think the place is marvellous, can’t fault it at all. I am always recommending it to people but they very rarely have an empty bed. The staff are very friendly and always take time to have a chat, they are very good at keeping me informed of any changes. They ask me to read the care plan and sign that I agree with the care. It is lovely for us as a family to be able to walk away from the home and we know that she is safe and secure here.”