The inspection took place on 29 July and 9 August 2016. Both visits were unannounced.

EABF (known and referred to in this report as Brinsworth House) provides accommodation and nursing care for up to 36 older people, some of whom may be living with dementia. The home is a Victorian listed building with extensions at the rear of the property. Accommodation is arranged over two floors and there is a passenger lift to assist people to get to the upper floor. There were 33 people living at the home at the time of our inspection.

The last inspection of Brinsworth House took place in November 2014 when we found two breaches of regulations relating to consent to care and treatment and management of medicines. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements.

At this inspection we found the provider had followed their action plan and improvements had been made in the required areas.

The home had 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.

People and their relatives were positive about the care and support provided. Staff knew people well and treated them in a kind and dignified manner. We observed positive relationships between staff and people at the service throughout our visits. A wide range of activities were provided for people to participate in both in and outside of the home.

Staff told us they received the support and training to care effectively for people and meet their needs. They had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern. They were confident that any concerns raised would be taken seriously by the registered manager and acted upon.

People were protected against the risks associated with the unsafe use and management of medicines. Improved arrangements were in place for the recording, safekeeping and administration of medicines.

We also found improvements had been made so that the service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Where people no longer had the capacity to consent to aspects of their care, we saw the registered manager and staff worked in people’s best interests. Assessments were completed to document the decision making process involving family and medical professionals as appropriate.

Healthwatch Richmond visited in June 2016 reporting that Brinsworth House was a well-run home with good systems in place to care for the residents and that these worked to a high standard. They observed good practice throughout their visit commenting there was a welcoming atmosphere with good interaction between the staff and residents.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience. These are people who have experience of using services and who can provide that perspective.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Overall people made positive comments about the home and the care and support they received. Comments included ‘I’ve been living in the home for a year. It has a very friendly atmosphere’, ‘very comfortable’ and ‘the people here are willing to do things to help you’.

One person said ‘I always tell people that it is rather like a boarding house at St Anne’s-on-Sea but with medical attention’.

People living at Brinsworth House are members of the entertainment industry or their dependents. We met some of the people living at the home, visitors and staff. Everyone we spoke to was very positive about their experiences. People living at the home told us that the staff were kind and caring and that their needs were met. They told us that they liked the environment, food and activities. The staff said that they were appropriately supported and that they enjoyed working at the home. Visitors were well informed and said that they were always made welcome.

This was an unannounced inspection, carried out over two days on 5 and 6 November 2014.

EABF (also known as Brinsworth House) provides accommodation and nursing care for up to 36 older people, some of whom may be living with dementia. The home is a Victorian listed building with extensions at the rear of the property. Accommodation is arranged over two floors and there is a passenger lift to assist people to get to the upper floor. There were 28 people living at the home at the time of our inspection.

We last inspected EABF in August 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

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 and associated Regulations about how the service is run.

People using the service told us they liked living at EABF and felt safe there. They said that there were enough staff on duty who were caring, respectful and upheld their individual privacy and dignity.

Improvements had been made around activity and occupation since our previous inspection with a full time co-ordinator now in post. We saw that a structured programme of activities had been introduced and work was on-going to personalise this to each person living at EABF.

Care staff provided appropriate support to help people eat and drink. People receiving assistance were given information about what they were eating and staff checked with individuals if they had enough to eat. Feedback was however mixed about the quality of food provided. The registered manager was already aware of the issues raised and had taken action to start making improvements.

New staff completed induction training when they first came to work at EABF. Further training was then made available to them to make sure their skills and knowledge were kept up to date. Staff we spoke with were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of a person using the service and were confident in being able to report these to senior staff.

Medicines were stored securely and safely however safe practice was not being followed consistently when giving them to people and keeping up to date accurate administration records.  You can see what action we told the provider to take at the back of the full version of this report .

We found that further work was required to ensure that the provider consistently acted in accordance with the requirements of the Mental Capacity Act 2005. The assessments of capacity seen showed a lack of understanding and application of the Act in protecting people who may not be able to make decisions for themselves. You can see what action we told the provider to take at the back of the full version of this report.

There were processes in place to gather the views of people using the service, staff and visiting professionals about the quality of service provided. A review carried out in mid-2014 had resulted in changes to staff contracts, shift rotas and senior management structures. We saw that this had impacted on everyone in the home with new systems and staff roles being introduced at EABF.