About the service:

Dennis Moore Care Ltd known to people as Brideoake Care Home is a residential care home which provides accommodation and personal care for up to 20 people. On the day of the inspection the home had full occupancy.

People’s experience of using this service:

• There a warm and friendly atmosphere when entering the home. There was lots of laughter and respectful conversations heard throughout the day.

• Some people had been at the home for a long time and they told us they were happy with the care they received. Relatives spoke highly of the care and commitment of the staff.

• Information about people’s care and support needs were detailed in a person-centred support plan. Care plan were regularly reviewed and updated to reflect any changes in people’s needs.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• The registered manager and staff worked closely with other healthcare professionals so people’s health and wellbeing was maintained.

• At the time of the inspection the home was undergoing a large amount of building work. Environmental risk assessments had been completed to ensure the safety of people living, working and visiting the home.

• Health and safety certificates were up to date and valid.

• Systems were in place to help ensure the safety and protection of people who used the service. This included the safe management of medicines, effective recruitment and training.

• The home is a family run home with consistent management and oversight by the provider and the registered manager.

• Opportunities were provided for people who used the service, relatives and staff to feedback their views and opinions on the service provided. People spoken with told us they had no complaints about the service. However, they told us if they had any worries they felt the registered manager would address these immediately.

• People engaged with the registered manager and the provider throughout the inspection. People told us that the management team were very approachable and supportive.

Rating at last inspection:

Good and the last inspection report was published on 21 September 2016. For full details, please see the full report which is available on the CQC website at www.cqc.co.uk

At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Why we inspected:

This was a planned inspection based on previous rating for the home.

Follow up:

We will continue to monitor information and intelligence we receive about the home to ensure good quality care continues to be provided. We will reinspect the home in line with our timescales for Good services. However, if we receive any information of concern we may inspect sooner.

This unannounced inspection took place on Thursday 18 August 2016.

Brideoake Care Home provides personal care and support to older people with dementia care needs and is owned by Dennis Moore Care Ltd. The home accommodates up to 20 people and has 17 rooms, three of which are double rooms. The bedrooms are located on two floors and there are two lounges and a dining room downstairs. The home is situated in a residential area of Leigh within walking distance of the local shops and amenities. At the time of the inspection there were 20 people living at the home.

We last inspected Brideoake Care Home on 13 March 2015, when the home was rated as ‘Requires Improvement’ overall and in both the Safe and Well-led key questions. This inspection focussed on any improvements made since then.

People living at the home told us they felt safe living at Brideoake. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

We found that medication was given to people safely, with staff receiving appropriate training. Management also undertook regular audits to ensure there were no shortfalls in practice.

Staff were recruited safely with references from previous employers being sought and DBS (Disclosure Barring Service) checks undertaken.

There were sufficient staff working at the home to meet people’s needs. Feedback from people living at the home, visitors and staff was that staffing levels were sufficient.

Staff received an induction when they started working at the home, as well as receiving appropriate training and supervision to support then in their role.

The home worked within the requirements of the MCA (Mental Capacity Act), with the manager completing appropriate assessments if there were concerns about a person’s capacity. The home also worked within the requirements of DoLS (Deprivation of Liberty Safeguards) and supported people to access outside space, whilst keeping them safe at the same time.

We saw people received enough to eat and drink, with people also making positive comments about the food provided at the home.

All of the people we spoke with during the inspection including people living at the home, visitors and health professionals made positive comments about the care provided.

People told us they felt staff treated them with dignity and respect and promoted their independence where possible.

We observed several caring interactions during the inspection between staff and people living at the home, such as when people became distressed and upset.

The staff at the home had facilities in place to enable people to communicate with their families such as an internet connection and the use of skype. This would be beneficial to people whose family did not live close by and wanted to maintain contact.

People felt the home was responsive to their needs and we saw examples of staff doing this during the inspection.

Each person living at the home had their own care plan, which was person centred and detailed people’s choices and personal preferences.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they received. There were no active complaints at the time of the inspection.

All of the people we spoke with told us they felt the service was well-led and that they felt listened to and could approach management with concerns.

There were systems in place to monitor the quality of service such as audits, resident meetings, staff meetings and accident/incident monitoring.

Staff told us they enjoyed their work and liked working at Brideoake.

We carried out an unannounced inspection of Dennis Moore Care Ltd, also known as Brideoake Care Home on 11 and 13 March 2015. We last inspected Brideoake Care Home on 13 August when we found the home to be meeting the standards in all areas inspected.

Brideoake Care Home provides care and support to older people, including people living with dementia. The home accommodates up to 20 people and has 17 rooms, three of which are double rooms. The bedrooms are located on two floors and there are two lounges and a dining room downstairs. The home is situated in a residential area of Leigh within walking distance of the local shops and amenities.

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 they felt safe living at Brideoake Care Home. We saw that regular checks and maintenance were carried out on the equipment and environment to help ensure it was safe for people living there. However, the service was not able to evidence that they had requested references from previous care employers as is required and to ensure only suitable staff were employed. We have made a recommendation in relation to recruitment procedures.

Medicines were given safely, however some improvements were required to ensure all medicines given were recorded on the administration record (MAR). The service identified how it may do this at the time of the inspection. 

People told us they enjoyed the food on offer and we saw the service took account of people’s dietary needs and preferences. We saw the service had produced a personal menu for one individual with particular preferences. 

The service kept a record of people’s weights in order to monitor their health. There had been a period of four weeks where weights had not been recorded due to the scales having been broken. We did not see evidence that this had resulted in any harm and the service had taken some steps to ensure people's health was monitored during this time.

People told us the staff were kind and caring, and we observed positive interactions between staff and people living at Brideoake Care Home. Staff were patient and communicated effectively with people, including people with limited verbal communication. We saw adaptions had been made to the environment to make it dementia friendly, such as colour themed corridors and pictorial signs to identify bathrooms and other rooms around the home.

There was an activity-coordinator employed at the home who arranged various activities. On the day of our inspection we saw a cake making session and an afternoon tea. People told us they had enough to do, and we saw that people who wanted to help with day to day tasks such as setting the table were encouraged to do so. This would help people retain independence as well as providing occupation.

Staff and visitors to the home, we spoke with, all thought the home was well led. They said the registered manager and director were approachable and that they had confidence that any issues they raised would be dealt with.

We found the registered manager had not been submitting notifications of safeguarding incidents to the CQC as is a requirement. This had been as they had misunderstood when they were required to make such notifications.

We talked with three people who used the service and three relatives. We were told that the quality of the service was good and people’s needs were met in full. People who used the service told us: “Yes I like it here; I think it’s very good. The one thing is you don’t have to do any washing or ironing.” “We’re all right, they’re smashing.”

And: “I absolutely love it here; I’m going to stay here.”

Relatives told us: “All I can say about here is ultimate praise. Everyone is always pleasant, always smiling, I haven’t ever seen anyone lose their patience and staff are gentle and tactile.” This relative also said: “I’m relaxed and relieved that (my relative) is here.”

Another person said: “You get a vibe about a place, it doesn’t have to be beautiful, that’s just cosmetic. They (the staff) treat everyone, residents and relatives, with respect and dignity. I’ve not had a problem here in two the years (my relative has lived here).”

We found systems in place to ensure people who used the service gave the appropriate consent to their care and treatment. People received care, treatment and support that promoted their safety and wellbeing by meeting health, social and emotional needs.

The food and nutrition provided was wholesome and enjoyed by people who used the service. We saw that the premises were safe and promoted people’s independence and staff were employed in sufficient numbers to meet the needs of people who used the service.

We spoke with four people who lived at Brideoake Care Home. All of the people we spoke with told us they were happy living there. We were told “Staff are always helpful, they knock before coming into my room” and “staff ask what I want, they don’t tell me.”

We found that people were given choices about their care and all of the people we asked told us they felt safe at Brideoake Care Home. Staff told us that they felt supported and that they received appropriate training, such as NVQs (National Vocational Qualifications.)

We found that people were well cared for and there were detailed care plans that were updated on a regular basis. On the day of our visit everyone was clean and well dressed with matching clothing. People told us that there was a range of activities available. This included trips to local pubs, the cinema, baking and card making.

There was an effective system to regularly assess and monitor the quality of service that people received but some aspects of this required a few more details to be recorded so that it was clearer.

People told us that they were happy living at Brideoake.

People told us that the staff treated them with dignity and respect.

People told us that there is alot going on and staff take them out.

People told us that they felt safe.

People told us that they liked the food.

People told us the home was always clean and they were happy with their rooms.

People told us that they got on welll with the staff and the manager is very approachable.

People told us that they are able to have a say in the way the home is run.

People told us that their visitors are always made welcome and are able to join in the activities.