Broadleas Residential Care Home is a care home for 20 older people of whom some live with dementia. At the time of the inspection 19 people lived in the home. The building had been adapted to meet people’s needs. Accommodation was provided across two floors and a passenger lift allowed access to all floor levels. The outside of the home had been improved to help people access the building and use the garden safely.

At our last inspection on15 and 16 January 2016 we rated the service as overall ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’. There was no evidence or information, from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Improvements had been made to the key question, ‘Is the service effective?’ as this had been rated as Requires Improvement at our previous inspection. The service had made improvements to ensure they could demonstrate that the requirements of the Mental Capacity Act 2005 were fully met when supporting people who lacked mental capacity. People who could not consent to their care, had continued to be supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in accordance with current legislation. The policies and systems in the home supported this practice. Advice had been sought by the provider in relation to this, which enabled the rating for this key question to improve to ‘Good’.

Why the service is rated ‘Good’.

People were kept safe. Risks were identified, managed and reduced. Staff were recruited safely and they were trained and supported to meet people’s needs effectively.

People’s medicines were managed safely and they received these as prescribed. The environment was kept clean and well maintained.

People’s nutritional wellbeing had been maintained and they continued to have access to health care professionals when needed.

People’s needs were assessed and their care planned and delivered in a way which met their needs and preferences. People were treated equally and their differences accepted and celebrated. Relatives were provided with opportunities to speak on behalf of their relative and to visit when they chose to.

Staff were kind, caring and compassionate. There were arrangements in place to help people feel included and to take part in social activities. Staff had the skills and knowledge to support people’s end of life needs.

The home was well managed and managers ensured people’s needs and wishes were the primary focus. Effective and appropriate systems, processes and practices ensured the home ran smoothly and that necessary regulations were met. Complaints could be raised and these were investigated and addressed. All feedback was welcomed and used to improve the service further.

Further information is in the detailed findings below.

The inspection took place on 15 and 16 January 2016 and was unannounced.

Broadleas provides care to predominantly older people. Some live with dementia and others have physical needs which they require support with. It can accommodate 20 people in total and at the time of the inspection 17 people lived there.

A registered manager was in place and they had managed the service since February 2015. They had however worked at Broadleas for eight years. 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 were kept safe, their risks were managed and monitored and there were enough staff to ensure people’s needs were met. The staff were good at recognising people as individuals and tailoring care to suit people’s individual needs. People and their representatives were involved in providing information which helped staff develop very personalised care plans. These gave staff good guidance on how people’s needs were to be met. The code of practice for the Mental Capacity Act 2005 was adhered to and people were supported to make independent day to day choices and decisions. Where more significant decisions had been made and where the person had lacked mental capacity to do this the legislation had been adhered to. Decisions had therefore been made in the person’s best interests by appropriate people. Some improvements were needed to how people’s lack of capacity was reflected in their care planning and, in some cases, further advice was needed with regard to whether people’s liberty had been deprived. Staff ensured people had access to health care professionals and when appropriate that their advice was followed.

Staff were caring and compassionate and the people they looked after mattered to them. They provided reassurance and support to people in moments of distress and patiently built relationships up with people who were confused. People had access to activities and were supported to go out in the local community. Visitors were welcomed at any time.

People were able to raise concerns and complaints because the registered manager was open and approachable. Staff were supported well and any areas of poor competency or practice were addressed. The registered manager was a strong leader and had clear expectations and values which the staff were aware of. She was recognised as a person who was totally committed to the care of those who lived at Broadleas. She said, “The residents come first”. These values were promoted by senior staff and acted on by the staff who worked very much as a team. All staff were committed to providing people with good care and a good quality of life.

Good monitoring systems were in place to ensure the services provided remained safe, compliant and of a good standard. The provider supported the service well and was committed to making improvements which benefitted those who lived at Broadleas.

We recommend that the service seek advice and guidance from a reputable source, about how best to reference consideration of the Mental Capacity Act when planning people’s care.

We also recommend that the service seek advice and guidance as to whether further applications under DoLS are required.