This inspection took place on 19 June 2017 and was unannounced. Brindley Court is registered to provide accommodation and personal care and treatment of disorder or injury to 52 adults. At the time of our inspection there were 51 people living at the service. Some people were living with dementia.

A comprehensive inspection of the service took place on 23 November 2016 and was unannounced. We found there were breaches of legal requirements and the overall rating for the service was 'Inadequate'. This meant the service was placed in 'special measures’; services in special measures are kept under review. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Brindley Court on our website at www.cqc.org.uk

At this inspection we found the provider had taken action to make the improvements required.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 received support from staff that understood how to safeguard them from abuse and provide care that minimised risks to their safety. People received support from sufficient amounts of staff. The provider followed safe recruitment practices when employing staff.

People were supported by suitably skilled staff that had regular updates to their training. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were given a choice of food and drink and were supported to meet their needs and preferences for food and fluid intake. People were supported to monitor their health and wellbeing and had access to health professionals as required.

People were supported by staff that cared for them and they had good relationships with staff. People were supported to maintain their independence and were involved in all aspects of their care and support. People were treated with dignity and respect and staff observed their privacy.

People were involved in their assessments and care planning was reviewed regularly. People had access to activities and could follow their individual interests. People understood how to make a complaint and felt confident these would be addressed.

The registered manager was accessible to people, relatives and staff and everyone we spoke with felt the service was well led. People, relatives and staff felt involved in the service and could share examples of how they had been involved in giving feedback and influencing changes. The registered manager had systems in place to support staff and check the quality of the service people received.

We inspected Brindley Court on 23 November 2016 and it was unannounced. It provides accommodation and nursing care for up to 52 people, some of whom are living with dementia. There were 51 people living at the service when we visited. The overall rating for this service is Inadequate which means it will be placed into special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service had a registered manager. 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.

Risks to people’s health and wellbeing were not managed to keep them safe from harm. Some situations which could be harmful to people were not risk assessed and when risk was assessed staff did not always follow the plans put in place to reduce it. Accidents and incidents were not thoroughly reviewed to try to avoid repetition. There were not enough staff available to support people safely as agreed or to respond to their needs in a timely fashion. People did not always receive their medicines as prescribed and the systems in place to manage the risks associated with them were not always followed.

When harm had occurred to people the circumstances around the incidents were not always thoroughly investigated or reported to the local authority to safeguard people from potential abuse. Some people had legally approved restrictions on them to protect them when they didn’t have the capacity to make their own decisions. However, some staff were not aware of these safeguards or what the restrictions were and therefore may not support them as defined.

Staff did not always uphold people’s dignity or treat them with respect. They were often rushed and task focussed and this resulted in not responding to people’s requests or questions. They sometimes spoke about people in front of them and did not always allow them to make choices about their care.

Care was not always provided to meet people’s preferences. Staff were not always aware of people’s changing needs and records were not always amended to reflect the changes and ensure that the care was correct. Audits and quality monitoring systems were not always regularly completed and did not always record all relevant information so they were not effective in drivi

This inspection was unannounced which meant the provider and the staff did not know we were coming. At our last inspection on 25 June 2013 we carried over the compliance action made in April 2013 regarding the management of medicines. This meant the provider had not made sufficient improvements to demonstrate they were fully protecting people using their service in this area.

During this inspection we found that suitable and sufficient improvements had been made where we had identified concerns. We saw the provider had put right what was required. This meant the provider could demonstrate people’s medication was handled safely.

In August 2013 we received information of concern regarding the staffing levels at the home. We asked the provider to send us their staffing rotas and followed this up during this inspection. We found there were suitable and sufficient staff to meet the needs of the people using the service.

We carried out our annual unannounced scheduled inspection on 23 April 2013. During the inspection we made one compliance action regarding the management of medication. This meant the provider had to make improvements in this area to demonstrate they were fully protecting people who used their service.

This inspection was to look at the evidence available following the action plan we received from the provider. We needed to see if improvements had been made in relation to medication management.

We found that some improvements had been made in the areas where we had identified concern, but suitable and sufficient improvements had not been made with auditing medication and ensuring fridge temperatures were taken on a daily basis. This meant the provider was non complaint and had not ensured people using the service received medication that was managed in a suitable and safe way.

On the day of our unannounced inspection we spoke with seven people living at the home, one relative, one visiting professional and five staff. We looked at the care records of seven people. One person told us, “I’m happy here. The staff are nice”. A relative told us, “The carers are brilliant. I am happy to leave X here, I know that staff are looking after X”.

We saw that people experienced care, treatment and support that met their needs. People were cared for by staff who were supported to deliver care to an appropriate standard. We saw that accurate and appropriate records were maintained. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable and nutritious food and drink.

We saw that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

During this inspection we spoke with five people living in the nursing care wing and three people living in the residential care wing. We spoke with six members of staff including the newly appointed manager. We also spoke with six relatives and a visiting district nurse.

We were told by the people using the service that they were happy with the care and support that they received. All of the people said that the staff were kind and looked after them well. One person said 'I only have to ask for something and they do it for me'.

We observed staff carrying out their duties in a kind and respectful way.

People spoken to who were participating in the 'reading the news activity' said they enjoyed it. One person said, 'it gives us something to think about'.

Everyone we spoke to said that they felt safe living in the home and said they would have no problem telling someone if they had a problem or a complaint.

One member of staff told us that since the home had transferred to new ownership they could see that investments were being made to improve the quality of life for people at the home. They told us that a new mini bus had recently been purchased to be able to take people for trips out.