Briarlea Care Home provides accommodation and personal care for up to 26 older people. On the day of our inspection there were 23 people living at the home.

The inspection took place on the 16 November 2016 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

We carried out an unannounced comprehensive inspection of this service on 4 and 9 November 2016 when we found that they required improvement with how they supported people to make decisions. At this inspection we saw there had been improvements made. The registered manager had identified she needed further support and had arranged this with the social work team.

Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. They were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. People told us they were supported in a safe way and had their medicines as prescribed. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them.

People told us staff knew how to support them. Relatives said staff were well trained. Staff had up to date knowledge and training to support people. People had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. They were supported to eat and drink well in a discreet and dignified way. People said they had access to health professionals, and there was a weekly visit from their GP. Relatives were confident their family member had the support they needed.

People said they were happy living at the home and supported by kind and caring staff. Relatives said they had no concerns about the care their family member received. They told us staff were caring and promoted people’s independence. People living at the home were able to see their friends and relatives as they wanted. We saw staff treated people with dignity and respect whilst supporting their needs. They knew people well, and took people’s preferences into account and respected them.

Relatives said they felt included in planning for the care their family member received and were always kept up to date with any concerns. They knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns. The registered manager had arrangements in place to ensure people were listened to and action could be taken if required.

The registered manager promoted an inclusive approach to providing care for people living at the home. For example people were encouraged to attend regular meetings, and to complete questionnaires to share their views about the quality of the service they received. We saw the registered manager to action to use the feedback received to improve the service people received.

The provider and registered manager had systems in place to monitor the quality of care provided.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and 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, 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 we spoke with told us their rooms and other areas were clean. They told us: “They (staff) clean my room regularly” and, “Nice and clean here”. The registered manager regularly checked the cleanliness of the home which ensured the risk of infection was reduced.

People were kept safe as systems had been in place to make sure that the registered manager and staff learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberties Safeguards which applies to care homes. The provider had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. There were no current applications in place. This meant that people would be safeguarded as required.

Is the service effective?

People’s health and care needs were assessed with them, but they were not always involved in writing their care plans due to their conditions. The provider had also considered information and involvement from relatives, other health professionals and staff. One person told us: “They look after me and know the care I need”.

People told us they were involved in their care and staff helped them to remain independent. One person told us: “I have my independence, they give me a choice”. We saw that people’s preferred routines, likes and dislikes had been recorded and staff knew about them. People told us that visitors were able to see them at any time and the home were accommodating and welcoming.

The staff told us told us their training had been kept current and that they had received formal supervisions. This meant the provider demonstrated that staff employed to work at the home had the skills and experience needed to support the people living there.

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. One person told us: “I am comfortable here. Helpful staff and I could not wish to be in a better place”.

Staff we spoke with had a good knowledge of people's individual needs, and knew how to support people so that their needs were met. Staff spoke about people as individuals and we observed that staff listened to people’s views and opinions.

Is the service responsive?

People completed a range of activities regularly and the provider had staff dedicated to arranging and supporting people to attend these activities. One staff member told us: “I change the activities often and it’s their (people who used the service) choice. They told me they liked the Monday activities so they have stayed the same”.

We saw the home had been responsive to people’s changing needs and had responded to professional advice that had been provided. For example, one person had been reviewed as their level of needs increased and professional input had been sought.

Is the service well-led?

The provider had a quality assurance system in place. We saw records that identified shortfalls and the actions that had been taken to address them. The provider listened and responded to people, staff and visitors who had left comments and suggestions.

Staff told us they were clear about their roles and responsibilities. Staff told us that they felt the home reflected people’s care and welfare needs. They told us that the system in place meant they felt supported in their role and where to find information when needed. For example, there was information about each person so staff knew the care and support they needed. Staff also recorded the care and support they provided to each person on a daily basis.

We inspected Briarlea and spoke with four of the people who lived at the home and with three of the staff on duty. We spoke with the registered manager, the deputy manager and the provider. We spent some time in communal areas and observed the interaction between staff and people who used the service.

We looked at care records for three people and other supporting documents for the service. Consent had been obtained from people before care and treatment had been provided. Alternative arrangements had been made to support people who were unable to consent to their treatment or support. Staff told us they: “Always ask people if they are happy with me giving care before I give it”.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff told us they were aware of each person’s needs and how to give care and support to meet those needs. People told us staff were: “Very good here” and that they were: “Very happy with the staff who worked at the home”.

We saw that staff were kind and caring in their approach to people who lived in the home. Recruitment procedures were in place that made sure suitable staff were provided to care for people.

A complaints procedure had been made available to people and their relatives should they wish to make a complaint.

We inspected Briarlea and used a number of different methods to help us understand the experiences of people who lived there. We spent some time with five people who lived at Briarlea, spoke with members of staff and spent some time with the registered manager and the provider.

We saw that people were relaxed and at ease with staff and within their home environment. We saw that staff interacted with people who lived at Briarlea in a friendly, courteous and respectful manner.

We found that people were treated with respect and their dignity and choices had been considered by staff. We saw that people were given choices which supported and enabled them to make their own decisions. When staff spent time with people it was meaningful, personal and offered appropriate encouragement for people to manage their own needs.

People told us that staff “always call me X (persons name) which I prefer” and “I have my breakfast when I want it” and “everyone goes to bed when they want”. They told us that there were things to do and one person we spoke with knew about the record of their care and told us they had been involved in completing it. A relative told us that they were always made to feel welcome at the home and were involved in the care and support of their relative. They told us “I am more than happy to approach the staff about anything”.

We found that people who lived at Briarlea had been involved in making decisions about their care and treatment, and that best interest meetings had been held where people had been unable to express their views.

Staff told us they understood how to meet people’s basic needs and gave the support people needed. Staff confirmed they had received the required training, supervision and appraisal. This made sure that people who lived at Briarlea received an appropriate standard of care to safeguard them from any unacceptable risk of harm.

We found that people who lived at Briarlea were safeguarded from the risk of abuse, because staff had access to up to date local authority safeguarding information. Staff told us that they worked to make sure people felt safe and that they were supported and knew how to complain should they need to.

People who lived at Briarlea were given the opportunity to express their views about the service they received. This was because people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

We carried out this responsive review because we received information that improvements had not taken place regarding the meeting of people’s nutritional needs. This information followed a recent meeting with the provider and the local authority under multi agency safeguarding arrangement.

We undertook two visits to Briarlea. Nobody at the service knew that this responsive review was going to take place. One visit commenced late afternoon in order that we could view the arrangements for tea. The second visit commenced during the morning of the following day and continued until after the mid day meal had taken place.

We spoke with people who use the service and asked them about the food within the home. Most people were quite happy with the food. Some people were less complimentary. One person informed staff that their soup was cold; another person agreed however people within the other dining room were satisfied with its temperature.

One person described the staffing as chaos. During our time in the smaller dining area staff failed to notice certain events such as somebody leaving the table without having had a drink. While people were having their meal staff were busy taking part in a hand over to the next shift.

During both visits there was a degree of confusion within the home regarding what food was available and what people were going to have served. We saw some people getting assistance and one person had a plate guard in place as specified within their care plan. Other people did not receive the attention and support needed to enable them to eat and drink satisfactorily.

Briarlea Care Home provides accommodation and personal care for up to 26 older people. On the day of our inspection there were 23 people living at the home.

The inspection took place on the 4 and 9 November 2015 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 and their relatives said they had no concerns about the care their family member received. They told us staff were caring and promoted people’s independence. People told us they were able to maintain important relationships with family and friends. We saw people had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. They were supported to eat and drink well in a discreet and dignified way. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them. People and their relatives told us they had access to health professionals as soon as they were needed, and there was a weekly visit from their GP.

Relatives said they felt included in planning for the care their relative received and were always kept up to date with any concerns. People living at the home were able to see their friends and relatives as they wanted. They knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns. The registered manager had arrangements in place to ensure people were listened to and action could be taken if required.

Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. They were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. Staff had up to date knowledge and training to support people. We saw staff treated people with dignity and respect whilst supporting their needs. They knew people well, and took people’s preferences into account and respected them.

The registered manager had not assessed people’s ability to make specific decisions about their daily life. For example, if people were able to go outside on their own. We spoke with the registered manager and they had now started the process with support from the mental health team. Therefore we were unable to see if applications to the supervisory body were needed. This was to ensure any decisions to restrict somebody’s liberty were made by people who had suitable authority to do so.

The registered manager promoted an inclusive approach to providing care for people living at the home. People who lived at the home and staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service. The provider and registered manager had systems in place to monitor how the service was provided, to ensure people received quality care.