This inspection took place on 8 August 2018 and was announced. At our last inspection in February 2016 we rated the service as Good. At this inspection we found the found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.

Broadview is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It provides care and support for up to four people, and on the day of our inspection there were four people living at Broadview.

We found some environmental risks, such as uncovered radiators and pipework which could pose a scalding risk if people were to fall against them. When we brought this to the attention of the registered manager and provider they immediately arranged to undertake a risk assessment and order radiator covers to prevent people burning themselves.

Infection control procedures needed to be more robust, and we found that some areas of the service required more effective cleaning. The registered manager sent us information that this was being addressed promptly, and new audits were implemented immediately.

Medicine audits were basic, and did not include checks on the quality of recording in medicine administration records. Some documentation, such as medicines which are given 'when required' needed a protocol to describe when these might be needed to provide greater guidance for staff. Action was taken to address these issues promptly following the inspection.

People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

We found systems and processes were in place to keep people safe. Staff understood their responsibilities for safeguarding people they cared for and assessed risks to their health and safety. Measures were in place to reduce these risks and people were supported to stay safe, whilst not unnecessarily restricting their freedom.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

Although most people were unable to fully express themselves verbally, they were seen to be relaxed and happy in the company of staff. Staff had developed caring relationships with people and treated them with kindness and respect. People felt able to express themselves in a safe and supportive environment. Staff had a good understanding of people's preferences and knew them well.

People led full and active lives. They engaged in a wide range of activities based on their personal choices. People were treated equally, without discrimination and information was presented to them in a way they could understand.

The registered manager and provider provided good leadership and support to staff. The provider had put processes in place to support the manager and staff.

Further information is in the detailed findings below.

This inspection took place on 18 November 2015 and was announced.

‘24 hours’ notice of the inspection was given because the service is small and the manager is normally based at one of the provider’s other services. We wanted to make sure that they would be in.

Broadview provides care and support to four people with Learning Disabilities. The home is on two floors with each person having their own bedroom.

There was 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. The manager was also the registered person for another home close to Broadview, which was owned by the same provider.

People were protected from harm by staff who understood the importance of preventing, recognising and reporting potential signs of abuse.

Risks to people in all areas of their lives were identified when they started using the service and were regularly reviewed to ensure that the management of the risk remained appropriate.

People were supported by staff who had undergone appropriate recruitment checks to ensure they were safe to work in health and social care. There were consistently enough staff to meet people’s needs and keep them safe.

People received their medication as prescribed and the service managed medicines safely and appropriately.

Staff received effective support and were well trained and competent. The service also had plans in place to further develop staff’s skills and knowledge.

The Care Quality Commission is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were not being deprived of their liberty unlawfully. Staff understood about people’s capacity to consent to care and had a good understanding of the MCA and DoLS which they put into practice. The service had made appropriate applications to the local authority. DoLS authorisations were in place for some people while others were waiting for theirs to be processed.

People living in the home were supported to have enough to eat and drink. Staff monitored people’s consumption of food and drink. People were supported to make choices about what they ate.

People living in the home were registered with local health services and were supported to attend any necessary health appointments.

People benefited from a staff team who were motivated, worked well as a team and felt supported. Staff were happy in their work and supported people with kindness, compassion and thoughtfulness. Staff had good knowledge of the people they supported and they maintained people’s independence and dignity whilst encouraging choice. Staff supported people in their likes and dislikes and people were fully involved in decisions around the care and support they received.

People’s plans of care were developed around the individual with involvement of those important to them. Care plans gave staff full and clear guidance on how people wished to be supported.

People’s developing needs were regularly assessed and the plans updated accordingly.

The service had an open, supportive and transparent culture and people felt they were listened to. People’s views and feedback was encouraged in order to improve and develop the service. Suggestions were listened to and actioned where appropriate.

Regular audits were completed effectively and contributed to the development of the service.

We spoke with one person in private who used the service and who communicated to us that the service supported their needs. Two care records were reviewed along with the risk assessments for both service users. These two care records showed that identifying and agreeing the service user’s needs and wishes were carried out. We also read ongoing risk assessments that were carried out on a regular basis at Broadview. This would ensure risks were identified and reduced or removed to ensure people were supported safely.

We reviewed staff records and spoke with staff. This told us that staff were supported and valued. Evidence showed that staff were provided with the necessary and ongoing training in order to meet the needs of the organisation, the team and the service users.

One service user demonstrated to us that he was trusted by staff, with supervision, to carry out some small day to day tasks such as making a cup of tea for visitors. We also saw the companionship shared between service users. We saw that people had access to activities such as dancing, horse riding and swimming.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The home was clean, tidy, well presented and comfortable and suitable precautions were in place to keep the service user's safe and free from harm.

We haven't been able to speak to people using the service because during our visit they were at day care. We gathered evidence of people’s experience of the service by reviewing the minutes from their meetings and looking at documentation in their care plans to show their level of happiness and satisfaction with the service. We looked at the complaints log and noted staff supported people to comment or complain about the service as necessary.

We saw that people were involved in the planning of their care, with people’s choices being respected. The provider had the necessary systems in place to plan and review the delivery of care and support.

We saw that the premises and environment were safe and clean. Both individual and communal areas were comfortable and adapted to people’s needs and wishes. We observed health and safety information, and the staff we spoke with could explain how to reduce the risk of infection.

We observed there was sufficient staff on each shift to meet the needs of the people using the service. We saw evidence that staff received appropriate training and one staff member said “I love working here. All the staff support each other and the people living here are cared for really well”.

We looked at the different policies and procedures relating to quality and risk management. This included the reporting of complaints and incidents. We saw that the reports were monitored and audited, with action plans to address any concerns.

Most people living in Broadview did not want to speak to us about what they felt about their home. We listened to the few things people said and also spent time seeing what was happening to find out how comfortable people were with staff and in their home. This showed us that people found staff approachable and that they were relaxed in their home.