The inspection was unannounced and took place on 17 May 2017. We arranged with the registered manager to return on the 19 May 2017 to finish our inspection.

The home is registered to provide accommodation and nursing care for a maximum of 67 people. There were 59 people living at the home on the day of the inspection. The home is split across three floors comprising a nursing unit, a unit for people living with dementia and a residential unit. There was a registered manager in place. 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.’

At the last inspection on 28 April and 3 May 2016 we found that the provider needed to make some improvements to ensure enough staff were in place and organised in the right way to meet people’s needs effectively and people did not always receive support to engage in meaningful activities to meet their personal needs. This inspection found improvements had been made and people were positive about the care and support they received and the service as a whole.

People were safe and well cared for and staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safely supported.

People were cared for by staff who had a good understanding of protecting people from the risk of abuse and harm and who understood how to meet their individual care needs safely. Staff knew their responsibility to report any concerns and were confident that action would be taken.

People needs were met promptly. Both relatives and staff said that there were sufficient staff numbers to meet people’s needs and we saw staff responding to people in a timely way. People’s rights and freedoms were respected by staff. Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them.

People told us they enjoyed meals times where they were joined by staff and were supported to eat and drink enough to stay well. People told us they were happy with choice of food they received. There were good links with health and social care professionals and staff sought and acted upon advice received, so people’s health needs were supported.

People using the service were positive in their feedback about the service and told us staff were caring. Relatives told us the registered manager led staff to provide care that focused on people and took account of their individual needs and preferences. They told us they felt staff were caring and that they knew how to look after the people who lived at the home and that people’s privacy and dignity was respected.

People received care that met their individual needs. People received care that met their individual needs. People were encouraged to join in activities and social events which they enjoyed. People said staff listened to them and they felt confident they could raise any issues should the need arise..

Relatives and staff told the home was well managed and improvements made had improved the care to people. Staff spoke highly of the management team and of the teamwork within the service. Staff were supported through supervisions, team meetings and training to provide care and support in line with people needs and wishes. The quality of service provision and care was monitored and actions taken where required to improve people’s experience of living at the home.

The inspection was unannounced and took place on 28 April and 3 May 2016.

The home is registered to provide accommodation and personal care, and the treatment of disease, disorder or injury for a maximum of 67 people. There were 59 people living at the home on the day of the inspection. The home is split across three floors comprising a nursing unit, a unit for people living with dementia and a residential unit. There was a registered manager in place. 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 cared for by staff who had a good understanding of protecting people from the risk of abuse and harm. Staff knew their responsibility to report any concerns and were confident that action would be taken.

As the occupancy levels had increased at the home people and staff told us people sometimes had to wait for support. The registered manager told us that recent changes had been made to give more support at meal times and that new team leader roles had been introduced to organise and manage staff in a more effective way.

Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were supported.

The assessments of people’s capacity to consent had been completed. People’s rights and freedoms were respected by staff. Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them.

People’s nutritional needs were met. People told us they enjoyed their food and were given a choice of meals and they were supported with drinks throughout the day.

People were supported to access health care professionals and staff were responsive to the advice received in providing care. People and relatives told us people’s privacy and dignity was maintained by caring staff and we made observations that supported this.

People’s access to activities and support varied across the homes three units. We found improvements were needed to support people living with dementia. Relatives said they would like more dementia appropriate activities as there was little for their family members to do and our observations supported this.

Relatives told us communication could be improved. We found communication of people’s changing care needs inconsistent and improvements were needed to ensure action was taken and communicated effectively to all staff.

The management team had systems in place to check the quality of the service provided and actions were planned where improvements were required. Some improvements had been implemented, for example, resident of the day reviews but further action was required to ensure that changes were embedded and also further improvements made in a timely way. Staff said they wanted more structured supervision and staff meetings to support them to provide more effective care.

Brook Court provides accommodation and personal and nursing care for a maximum of 65 people, some of whom may have dementia related illnesses. At the time of our inspection there were 46 people who lived there. At the time of our inspection 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.

People told us that all the staff were caring and that staff were respectful and talked to them calmly. We observed many situations where care staff spoke kindly to people and maintained their dignity when providing assistance. People told us they were supported to remain independent and received assistance when they needed it.

People told us they found the senior management and registered manager approachable and told us they would raise any complaints or concerns should they need to. All the people we spoke with told us that they had never needed to complain or had anything to complain about. Through regular meetings and using an ‘open door’ policy we found that the registered manager promoted a positive culture, in which they invited people to talk with them about any concerns they may have. We found that when concerns were raised to the provider, the provider had acted promptly and appropriately.

We found that people were kept safe by trained staff who knew how to protect people. We found that people were cared for in a supportive way that did not restrict their freedom. The provider of Brook Court had carefully planned and designed the home and garden to ensure it was safe for people who had poor mobility or for those that lived with dementia. Adaptations to the garden ensured it was safe for people to use in a safe way. There were sufficient staff to meet people’s needs.

Brook court opened in September 2013, the registered manager had managed the flow of admissions of people into the home. This meant the registered manager had sufficient time to recruit new staff and ensure induction training was underway. This ensured that safe numbers of suitably qualified staff were on duty. This meant that staff had time to get to know people. Staff knew people’s likes and dislikes and respected their wishes. People we spoke with were complimentary about the food and their dining experience. Relatives spoke about the good support people were offered for those who required assistance. We observed people receiving regular drinks and staff supported those who needed assistance.

We found that the service was responsive towards people’s health needs. People told us they took part in activities that they enjoyed and that they were adapted to their choice.

We found the registered manager had systems in place to ensure that the quality of the care was monitored. Checks in areas such as medication and environment were carried out and completed monthly. Where there were any actions following these checks they were followed up and improvements were made.