We inspected the service on 8 February 2017 and the inspection was unannounced.

Broadoak Grange is a care home without nursing and provides care and support for up to 33 older people, people with dementia and physical disability. At the time of the inspection there were 28 people using the service.

There was a registered manager in post. It is a requirement that the service has a registered manager. 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.

Staff understood their responsibilities about protecting people from abuse and avoidable harm. Risk was assessed and management plans were put in place. People's freedom to make informed decisions and take risks was supported.

There were sufficient numbers of staff to meet people's needs. Pre employment checks were carried out so that so far as possible only staff with suitable character and skills were employed.

People's medicines were managed so that they received the right medicine and at the right time.

Staff had received training and knew how to meet people's individual needs. Consent was sought in line with legislation and guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way.

People were supported to eat and drink a varied and nutritious diet. They had access to the healthcare services they required.

Staff were caring, compassionate and treated people with respect. People had their privacy and dignity respected.

Care and support was delivered in the ways that people preferred. People felt comfortable making a complaint and confident they would be listened to.

The culture of the service was open and inclusive. There was a clear organisational structure and staff understood their responsibilities. The quality of the service was monitored and changes were made to continually improve.

This inspection took place on 7 December 2015 and was unannounced.

Broadoak Grange is a care home for older people and is registered to accommodate up to 33 people requiring care because of old age, physical disability or dementia. At the time of our visit there were 31 people using the service.

There should be a registered manager at the service. 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 manager had submitted her application to become the registered manager of the service and it was being processed at the time of our inspection.

People felt safe at the service. People felt able to talk to staff with any concerns. People received their medicines as prescribed. There was not appropriate information available relating to a person's covert medicine. People's privacy and dignity was respected.

There were sufficient staff on duty. Staff received training to enable them to meet people’s needs. Staff had a good understanding of how to the various types of abuse and knew how to report issues internally and externally.

Risks relating to people’s care had been assessed. Where a risk had been identified action had been taken to reduce the associated risk. Risks relating to the environment had not always been identified and assessed.

Where a change to people’s health had been identified referrals to health professionals had been made. There was a risk that a person was not receiving the right professional support for their behaviours.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). Where there was a reasonable doubt that a person lacked capacity to make decisions the service had a mental capacity care plan in place. However, the information relating to the people's mental capacity was not decision specific and therefore did not fully meet the requirements of the MCA legislation. The service had taken appropriate steps where they had identified that people were being deprived of their liberty in any way and they had made referrals to the local authority as is required.

People told us that the staff were kind and caring. Staff interactions with people were task focused and there were only limited times when staff engaged in general conversation with people.

People's needs were assessed and care plans had been put in place. Care plans contained limited information about people’s likes, dislikes and preferences. People did not always receive personalised care that was responsive to their needs.

Staff and the manager shared a vision of the service. Staff were clear about the expectations upon them within their roles. Staff felt valued and listened to and explained how they all worked together as a team.

Monitoring systems that were in place were not always effective at assessing, monitoring and improving the service provision.

We spoke with four people who used the service. They told us they were satisfied with the service and had their needs met. People said they liked the staff and could talk to them. People were given choice and autonomy about their lives. One person said "I have been here for years, they look after you". Another person said "staff do a great job". People told us they liked the food. They told us there was always a choice. One person said "I always clear my plate".

We looked at infection control polices and procedures. The environment was clean and fresh. Staff followed polices and procedures designed to reduce the risk of cross infection. Staff interacted with people who used the service in a positive and respectful way. Staff demonstrated a good understanding of people's individual needs.

We spoke with four people who used the service. People told us they liked the staff. One person said “I love it here, the staff are really kind”. Two people said they sometimes felt bored. We observed staff interacting with people who used the service. Staff were friendly and professional. Staff knew how to communicate with people. We saw the chef talking to people about what they would prefer for lunch. The chef knew about people’s needs and preferences. He asked people about the size of meal they would prefer. He offered people alternatives that were not on the menu.

The provider had made some improvements since our inspection of 13 September 2012. However, the planning and delivery of care did not meet the individual needs of some people. Some people felt they were not asked for feedback about their experience of the care they received. The provider had begun asking for feedback from the relatives of people who used the service. However there were no formal mechanisms for seeking the views of people who used the service.

We spoke with five people who used the service. People told us they liked the staff and found them very helpful. Three people told us they would like more opportunities to participate in social and recreational activities. People felt they had their privacy and dignity respected.

People we met were satisfied with the care and support they received at Broadoak Grange. They found the staff helpful and responsive to their needs. They considered the meals provided to be of good quality with choices provided.