At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

Brough Manor is a residential care home that provides accommodation and support to a maximum of 26 people, some of whom may have a dementia related condition. The home is situated in the town of Brough in East Yorkshire.

People were protected from avoidable harm and abuse. Staff had good knowledge and systems were in place to record safeguarding concerns and action outcomes.

Assessments of risks associated with people’s care and support had been completed to ensure people received safe care and support without undue restrictions being in place.

The provider maintained safe staffing levels and recruitment included pre-employment checks to ensure people were of a suitable character to work in a care home environment.

Systems and processes ensured safe management of medicines and infection control.

People received person centred care and support to meet their individual needs. Staff were supported to access relevant training to build their skills and knowledge and regular supervisions had been completed.

Staff supported people in the least restrictive way to have maximum choice and control of their lives.

People told us they felt staff cared for them and maintained their privacy, dignity and independence.

Policies were in place to support staff in promoting equality and recognising people's diverse needs. Care and support reflected people’s wishes and preferences.

People’s support plans were person-centred. People had a choice of attending both group and one to one activities or events.

Systems were in place and easily accessible for people or their relatives to raise a complaint if they wished to do so.

The provider sought feedback to improve the service and experience for people living at the home. People and their relatives or representatives were involved in the planning and review of their care provision.

Quality assurance systems were in place to support the effectiveness of the service overall and to drive improvements.

Further information is in the detailed findings below.

The inspection of Brough Manor took place on 15 May 2015 and was unannounced. At the previous inspection on 30 July 2013 the regulations we assessed were all being complied with.

Brough Manor provides care and accommodation for up to 26 older people some of whom may be living with dementia. The service offers support with personal care, and provides activities and pastimes to help enable people to remain as independent as possible. Rooms are mainly single occupancy with en-suite toilets but there is provision for shared use as well. There are two lounges, a dining room and a garden courtyard for people to use. There is access to local train and bus transport close by. At the time of our inspection there were 23 people using the service and approximately 10 people were living with dementia.

There was a registered manager in post who had been managing the service for the past three years. 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.

We found that people were protected from the risks of harm or abuse because the provider had effective systems in place to manage issues of a safeguarding nature. Staff were trained in safeguarding adults from abuse and understood their responsibilities.

People that required support with mobility, transferring and postural changes were safely cared for by staff that followed good practice guidelines and were trained in moving and handling techniques and the use of hoists. All safety issues were covered by risk assessments that were regularly reviewed.

We found the premises to be safe and well maintained. Contingency plans and risk assessments were in place for emergency events such as utility failures or inclement weather.

There were sufficient numbers of trained, skilled and competent staff on duty and staff had been safely recruited following effective use of recruitment procedures, which ensured staff were vetted for their suitability to work with vulnerable people.

We found that the management of medicines was safely carried out and while there was a need to improve the infection control equipment in the service, the overall infection control and food hygiene practices were safely carried out and managed.

People told us they were happy with the effectiveness of the service. Staff were appropriately inducted, trained, skilled and supervised to carry out their roles.

Staff use of equipment was seen to be effective, for example, in assisting people to transfer and there was good communication when doing so. The service effectively used the Mental Capacity Act and Deprivation of Liberty Safeguards legislation to ensure people’s rights were adhered to and consent in all things was obtained.

Nutrition and hydration for people was adequately provided and people’s choice/preferences played a part in this. The service was proactive in accessing health care professional’s support.

The environment was suitable for older people, but not entirely suitable for meeting the needs of people living with a diagnosis of dementia.

People we spoke with said the staff were kind, considerate and caring and we observed a caring approach from all staff. Relationships between people and staff were seen to be good. Activities were appropriate to people’s needs and preferences and they made for eventful days.

We were told by people that their privacy and dignity was respected and we saw for ourselves that staff were discreet. People’s physical and emotional well-being was considered and they were supported to achieve good outcomes.

We found that a different approach to supporting people living with dementia at the end of their lives had been discovered and used to ensure their last days were as comfortable and stress free as possible.

We found there were well written care plans in place to reflect people’s needs and to show staff how best to support pole. The complaint system in place showed issues were responded to appropriately and resolved as quickly as possible.

There was a variety of activities provided for everyone. People’s choice and preferences were respected as much as possible.

There was consistency in the running of the service because the registered manager had been registered for the last three years. They were open, transparent, focussed and inclusive in their management style. We found there was a strong and effective system of quality assuring in place: auditing and surveying, which provided feedback to people and their relatives. Records were well maintained throughout the service.

Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People that used the service told us they were satisfied with the care they received. They said, "Everything is done to help me in the way I want to be helped.", "The staff are very good, this is a very good place to live" and "I am quite content." We saw good support for people and care plans contained evidence of this.

We found that there were safe systems in place for the handling and administering of medicines and that everyone received their medication when they needed it.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate recruitment checks had been carried out when following the recruitment and selection procedures.

The provider had an effective system to regularly assess and monitor the quality of service that people received. People took part in a system of surveying and auditing the service performance, and people influenced its future provision.

There were effective systems in place for people that used the service to make complaints. These were listened to and action was taken to resolve them.

We spoke with two people that used the service and with one visiting relative about the service of care provided.

People told us they received the care and support they needed and that the staff were friendly and caring. They said they could make their own decisions, handle their own finances if they wished and could come and go as they pleased.

People told us they felt safe in the home and would talk to one of the staff if they were unhappy about anything.

The relative we spoke with was satisfied with the care their mother received and explained it was nice to visit her and enjoy the relationship they had together.