This inspection took place on 4 January 2017 and was unannounced.

Broadmeadow care home is a service which provides care and accommodation for a maximum of 32 people who are older and/or live with dementia. At the time of our visit, 30 people lived in the home.

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.

People at the home were supported by staff who were kind, caring and who understood people’s needs, wants and preferences. People’s privacy and dignity were upheld by staff.

Enough staff were on duty to meet people’s needs. The provider’s recruitment practice provided assurance that all measures had been taken to recruit staff who were safe to work with people. Staff received training and management support to help them effectively meet people’s needs and to keep people safe.

People were supported in line with the principles of the Mental Capacity Act. The manager understood the importance of applying for Deprivation of Liberty Safeguards (DoLS) when there was a need for restrictions to be placed on people’s care to keep them safe.

People enjoyed the food provided and the choice of meals available to them. Timely referrals to the relevant healthcare professional were made when staff had concerns about people’s health. People were also supported to see their GP, dentist and optician when required. People received their medicines as prescribed.

Group and individual activities were provided for people’s enjoyment. People were consulted on the activities provided.

People and relatives knew how to make a complaint if they needed to, although no formal complaints had been made since our last visit. The manager encouraged open communication with people, relatives and staff.

Quality assurance systems were used effectively to keep people safe and to drive improvements in the home. The premises and equipment used were well maintained and safe to use.

This was an unannounced scheduled inspection. This meant the provider did not know we were coming.

During the inspection we spoke with some of the people who used the service and two representatives of people who used the service. We also spoke with the registered manager on duty and the staff who were on duty during the inspection.

We considered our inspection findings to answer the questions we always ask:

Is the service safe?

People who used the service had their needs assessed and risk assessments had been completed to reduce any risks to people's health and well-being.

There were procedures in place to protect people in an emergency.

Staff had been appropriately trained to meet the needs of people who used the service. Further staff training in dementia care would help staff to understand the needs of people a little better.

The provider identified and managed risks to the health and safety of people who used the service, staff who worked there and people who visited.

Is the service effective?

People’s health and social care needs were assessed and plans were in place to provide the support they required. People's needs were reviewed but more regular updates of care plans would ensure that care remained effective.

People were supported to maintain their physical and mental health care needs.

The provider was planning to involve representatives more in the care of their relatives.

Is the service caring?

The staff knew people well and the people who used the service looked relaxed and comfortable in the company of staff. We observed positive interactions between the people who used the service and staff. Staff were patient with people and encouraged them, with support, to take responsibility for their daily living tasks. A person who used the service told us: “I feel safe and well cared for here. The staff are kind and caring".

Is the service responsive?

The home had a complaints procedure. People we spoke with said they would tell the staff if they were worried about anything. A person told us: "You can approach any of the staff about anything. If I had any concerns I would ask the manager and have done in the past".

People living in the home and/or their representatives were enabled to share their opinions with staff, as the provider regularly sought their views and suggestions.

Is the service well led?

Staff who worked at the home felt well supported. One person said: "The manager is very good and I think it is a good company to work for".

There was clear, comprehensive and detailed information to support staff in caring for people and there was guidance for staff when they needed it.

There was a formal staff training and development programme in place. Staff supervision was in place but more frequent supervision would ensure the staff had the opportunity to discuss their own personal development.

There was evidence of quality monitoring having taken place to monitor, audit and improve the services provided.

When we carried out our unannounced inspection we spoke with six people living at the home, one relative and four staff. We reviewed four care records, three staff records and other documents.

People living at the home told us that they were happy and satisfied with the care that they received and that they were treated with dignity and respect. One person told us, “I choose the clothes I want to wear the night before and put them on the chair. The staff help me to put them on in the morning”. Another person told us, “Most staff are always polite”. We saw that people’s needs were assessed and care and treatment was planned to meet their needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We saw evidence that staff had received training to administer medication and an assessment of their knowledge had been done. This meant that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We inspected this service because we had received concerns about the care being provided to people. This was an unannounced inspection so the service did not know we were visiting. We had been told that there were concerns about the care and support people received. At the time of this inspection the local authority was undertaking an investigation into the concerns and the provider had voluntarily suspended placements pending the outcome of that investigation.

People we spoke with told us that they were happy living at Broadmeadow Court. The atmosphere was relaxed and friendly. Staff were polite and respectful when they approached people. We observed that people were asked what they would like and if they wanted to be involved in an activity. One person told us, "The staff arrange things for us to do". "I enjoy the Bingo but I like spending time on my own as well".

Some people did not have capacity to make decisions and were not able to recall what they did with their time other than to say, "I like to be in my room. It's what I prefer". Where people did not have capacity an assessment had been completed.

We saw that people’s health needs were recorded and were being monitored closely and people were supported to receive health services.

There were systems in place to monitor and develop the service to ensure that continually improvements were being made for the benefit of people who used the service.

We visited this service because we had received concerns about the care being provided to people. This was an unannounced visit so the service did not know we were visiting.

People we spoke with said they were happy with the support they received. Comments included: "Good staff" and, "You couldn't get anywhere better".

People were provided with choices about how they lived their lives. They chose when to get up and go to bed, how they spent their day and had choices over what they ate and drank. People were treated with respect.

People had sufficient food and drink of their choice to meet their needs. When people needed special diets these were provided. People's weight was checked and specialist health support provided when needed.

People were kept safe and staff knew how to respond to incidents of potential abuse. Staff were not always aware of issues of the Mental Capacity Act 2005.

There were adequate staff on duty to provide people with care and we noticed positive relationships between staff and the people that live there.

We saw that people's care needs and any risks were being reviewed. We also saw that the service had systems in place to gain the views of people about their care and about how the home was run. The home had a procedure in place to act on any complaints raised.

We visited Broadmeadow Court on 15 March 2012, on the day of our visit we spoke with five people who lived at Broadmeadow Court and two relatives. We also spoke with three members of staff and the registered manager.

People we spoke with during our visit were overall happy with their care. People told us

they were comfortable. People reported staff were caring and they could approach them with a concern. One person commented “staff look after me very well”.

People we spoke with said they were treated with dignity and respect. People told us there were activities they could participate in such as games and walks when the weather was good. People commented they did not have to take participate in activities that they did not like.

People said they enjoyed their meals and they were offered choice, one person told us the food was “very nice". We saw meal times were organised and relaxed. People were

supported into the dining area. Staff ensured people were comfortable and had an adequate meal.

The relatives we spoke with were happy with the care received by their family members. Relatives said they felt involved and staff kept them informed of any changes which occurred.

We saw staff attended to people in a caring, considerate manner and responded

appropriately to their needs. People's likes, dislikes and religious beliefs were known by

staff and included in the delivery of care. For example one person preferred a bath on a particular day we saw evidence this occurred . Records included a section which detailed individual preference to ensure people had their views considered.

Staff we spoke with showed understanding in areas of safeguarding, equality and diversity. Staff were aware of the management of falls and pressure sores. Staff told us they liked working at Broadmeadow Court. One staff we spoke with said there was a “positive attitude”. Staff felt well trained and supported to provide good quality care. Staff understood what constituted abuse and said that they would be able to recognise and report poor practice. This demonstrated people were cared for by appropriately trained staff.

We found systems were in place to ensure the service was improving as a result of

findings. For example as a result of feedback improvements had been made to the garden area.