We inspected High Broom Care Home on the 16 and 21 March 2017 and the inspection was unannounced. High Broom Care Home provides accommodation for up to 38 older people. On the day of our inspection there were 29 people living at the service. High Broom Care Home is a residential care home that provides support for older people living with dementia and other health related conditions. Accommodation was arranged over three floors with stairs and a lift connecting each level.

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, relatives and staff spoke highly of the service and the management team. One staff member told us, “We are one big family here.” One person told us, “The staff are absolutely lovely and I feel ever so safe living here.”

The management team and staff at all levels were committed to working in a person-centred way, respecting people's wishes and preferences and treating them with kindness and compassion. Visitors valued the relationships they and their loved ones had with the staff team, and told us they always felt welcome. All spoke highly of how caring the staff and managers were. Staff knew people and understood their care needs and preferences. They spent time with people, both during care tasks and at other times.

Staff demonstrated good knowledge and understanding of the Mental Capacity Act (MCA 2005). One staff member told us, “The Mental Capacity Act is about people’s ability to make specific decisions.” Mental capacity assessments were in place but had not considered people’s ability to make a capacitated decision about living at the service when an application for deprivation of liberty safeguard had been made. Improvements were made during the inspection. However, we have made a recommendation about the oversight of mental capacity.

The risks associated with falling were mitigated and actions were in place to prevent people from falling. The provider followed nationally recognised guidance and worked in partnership with external healthcare professionals to promote a safe environment for people. People’s falls risk assessments were reviewed monthly, however, these reviews failed to consider how many falls that person had experienced that month and whether the risk assessments remained effective. We have made a recommendation for improvement.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options had been considered. Staff sought and obtained people's consent before they helped them.

Systems were in place for the safe storage, administration and disposal of medicines. People told us they received their medicines on time and in their preferred manner. We identified a few omissions with the recording of medicines; however, these were addressed during the inspection. We have made a recommendation about the implementation of an overarching medicines audit.

People were protected from the risk of harm and abuse. Staff had received safeguarding adults training and were aware of their responsibility to report any concerns. Policies and procedures were in place to advice staff on what they should do if they had concerns. Safe recruitment practices were followed before new staff were employed to work with people.

The delivery of care met people's individual choice. Care plans gave information on people's likes, dislikes. People's changing health needs, such as changes to eating and drinking were reflected and therefore staff were informed of important changes to care. Information was available on pe