Brierfield Residential Home provides a residential care service for up to 26 older people. At the time of this unannounced inspection of 19 July 2017 there were 23 people living with dementia using the service.

Our last inspection of 9 February 2015 this service was rated as Good. During this inspection we found that the service had continued to maintain a Good service and was Outstanding in Responsive.

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.

The service was extremely responsive to people's individual needs. People were provided with exceptionally personalised care and support which was planned to meet their individual needs. Care and support was planned proactively and in partnership with people.

The provision of activities was innovative and met people's needs and preferences. Activities and social inclusion were designed to enhance their wellbeing and enable them to live a full life as possible. People were encouraged to share their hopes and aspirations and the service used creative ways of meeting them to ensure they were valued.

People were actively encouraged to give their views about the service. A complaints procedure was in place. People's concerns and complaints were listened to, addressed in a timely manner and used to drive improvements in the service.

The service continued to provide a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse and with their medicines. Staff were available when people needed assistance and the recruitment of staff was done safely.

People continued to be supported by staff who were trained and supported to meet their needs. 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. Systems were in place to assess and meet people’s dietary and health needs.

People who used the service continued to have good relationships with staff. People continued to be involved in making decisions about their care and support.

The service continued to have a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

Brierfield Residential Home provides accommodation and personal care for up to 26 older people who require 24 hour support and care. Most people are living with dementia.

There were 26 people living in the service when we inspected on 9 February 2015. This was an unannounced 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.

There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

There were procedures and processes in place to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how the risks to people were minimised.

There were appropriate arrangements in place to ensure people’s medicines were obtained, stored and administered safely.

There were sufficient numbers of staff who were trained and supported to meet the needs of the people who used the service. Staff were available when people needed assistance, care and support.

People, or their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions. The service was up to date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were protected.

Staff had good relationships with people who used the service and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People’s nutritional needs were being assessed and met. Where concerns were identified about a person’s food intake, or ability to swallow, appropriate referrals had been made for specialist advice and support.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed promptly. As a result the quality of the service continued to improve.

We spoke with three people who were using the service and with four visiting relatives. They all confirmed that they were pleased with the care and support that people received. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. However, we noted a few health and safety issues. We told the registered manager about these concerns and the provider assured us that these would be promptly addressed.

People were protected from the risks of inadequate nutrition and dehydration. Their dietary needs and preferences were catered for and they told us that they enjoyed the food. One person said, “The food is good – always nice and hot”. A visiting family member commented that people's food preferences were respected.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

Effective recruitment and selection processes ensured that people were cared for by suitably qualified, skilled and experienced staff.

The people living in this service were living with dementia and were unable to tell us about the quality of care they received. To enable us to be able to access people’s wellbeing we spent time sitting with them observing the care they received and the level of staff interaction with them.

During our inspection we observed that the staff were attentive to people’s needs. Staff interacted with people using the service in a friendly, respectful and professional manner. We saw that staff sought their agreement before providing any support or assistance.

Most of the people we saw were relaxed, engaged with their surroundings and interacted well with each other. If people became distressed or worried, staff attended to them quickly and acted to distract them or to offer them comfort.

We spent time observing and listening to the care people received to obtain an overview of the quality of care provided by staff, including how they interact, engage and communicate with people living in the home. Our observation of the daily life of people living in the home found that staff responded to people’s needs in a timely and supportive manner. Staff were observed encouraging people to be active, however they could also sit quietly if they chose to do so. People were alert and positively engaged, either in discussion with other residents, visitors or with staff. We observed people sharing sweets, reading and watching TV and moving freely around their home. There was good banter between residents, visitors and staff creating a relaxed and fun atmosphere in the TV lounge.

People we spoke with told us that they are happy with the care they receive and that they are supported to maintain their independence wherever possible. People living in the home, visitors and staff informed us that there always appears to be enough staff. People also told us that there is a consistent staff team who are very kind and sensitive to their needs and respect their privacy and dignity. A person visiting their relative in the home told us one of the things that impressed the family about Brierfields is that the majority of the staff team have worked at the home for a long time.

We were told that the food provided in the home is of a good standard, comments included, “We have a good choice of food” and “There is an alternative choice if you do not like what is on the main menu” and “The food is alright, we have adequate choice”. People we spoke with were complimentary about the refurbishment of the home, they told us that the home is always tidy and comfortable and clean.