This inspection was unannounced and took place on the 3 April 2017. It was the first inspection following our registration of this provider under the Health and Social Care Act in March 2017.

Brookholme Croft Ltd provides accommodation, nursing and personal care for up to 45 older adults. This may include car for people living with dementia, physical disability or people who are receiving end of life care. At the time of our visit, there were 44 people, including 24 people receiving nursing care at the service. There was a registered manager at this 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.

People were safety supported in a clean, safe and well maintained environment. Any equipment used for people’s care was routinely serviced and maintained up to date. Planning and contingency arrangements helped to ensure people’s safety in the event of a foreseeable emergency.

Arrangements for cleanliness, hygiene and infection prevention and control helped to prevent and reduce any risk to people from an acquired infection through cross contamination.

People’s medicines were safely managed. Known risks to people’s safety from their health condition or environment were assessed before they received care and regularly reviewed. This helped to consistently inform people’s care and related safety requirements, which staff followed.

The provider’s arrangements for staff recruitment and deployment helped to ensure people were protected from the risk of harm and abuse

People’s health and nutritional needs were being met. People were supported to improve and maintain their health and nutrition by staff who sought and followed advice from relevant external health professionals when required.

People’s care was provided in a way that met their assessed need by staff who were qualified, trained and supported to help ensure this.

People were provided with care in line with legislation and guidance in relation to consent. People’s consent or appropriate authorisation was obtained when required for people’s care.

People received care from staff who were kind and caring. Staff treated people with respect and ensured their dignity, comfort, rights and independence in their care.

Staff knew people well; what was important to them for their care and had established positive relationships with people and their relatives.

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People and relatives were mostly well informed and involved to understand and agree people’s care. Management assurance was provided to ensure people’s care plans consistently showed their involvement.

Staff were visible, observant and provided people’s care in timely and individualised way. Staff communicated well with people in a way they understood, which helped to ensure people’s choice and independence.

Staff understood and followed people’s known preferred daily living routines. People were informed and supported to maintain contacts with friend and family who were important to them.

Arrangements for people’s occupation, leisure and spiritual practice were driven by people’s known lifestyle preferences and interests. This was provided in a way that helped to promote people’s social inclusion and their physical and emotional health.

People, relatives and staff were informed and confident to raise any concerns about people’s care or make a complaint if they needed to.

People, relatives and staffs views were regularly sought and used to inform and make improvement to people’s care when required.

The service was well managed and run by a visible, approachable registered manager. People, relatives and staff were confident about this.

Staff understood their roles and responsibilities and they were informed and support