Pollard House is an adapted Victorian building located approximately one mile from Bradford city centre. It provides accommodation and personal care for up to 28 older people, including people living with dementia. There is one double bedroom, the remainder are single bedrooms and some have en-suite toilet facilities. There is a passenger lift to all four floors. The service has a small enclosed garden to the front of the property. At the time of the inspection 21 people were living at the home.

At the last comprehensive inspection in December 2015, the service was rated ‘Good’ overall, with the safe domain rated ‘Required Improvement’ due to concerns with medicines management. We returned to the service in November 2015 and found improvements had been to the medicines management system.

At this inspection we found the improvements had been sustained and rated the service as ‘Good’ overall and in each of the five domains.

Why the service is rated Good:

People told us they felt safe and secure living in the home. Staff understood people well and how to keep them safe. Risk assessments were in place which provided detailed information to staff on how to maintain people’s safety.

Medicines were managed safely and overall, people received their medicines as prescribed. Good checking and auditing systems were in place to highlight any discrepancies with the medicines management system.

There were sufficient staff deployed to ensure people were provided with prompt care and support. Staff responding quickly to people’s requests for assistance. Safe recruitment procedures were in place to ensure staff were of suitable character to work with vulnerable people.

Staff were provided with regular training and support to ensure they were able to care for people effectively. People spoke positively about staff and the support they received. Staff demonstrated a good knowledge of the people and topics we asked them about.

People’s consent was gained before care and support was provided. The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People had access to a range of suitably nutritious food. People’s nutrition was closely monitored and action taken to investigate any weight loss. The service liaised well with external healthcare professionals over people’s healthcare needs.

The service was very caring. People were treated with a high level of dignity and respect by both staff and the management team. Good, caring relationships had been developed and staff and the registered manager knew people well. There was a positive, inclusive and person centred culture within the home.

People’s care needs were assessed and detailed plans of care put in place which were amended when people’s needs changed. People, visitors and healthcare professionals said care needs were met by the service. People had access to a range of activities and opportunities and their social care needs were met by the service.

Staff and the registered manager listened to people and ensured any complaints or concerns were investigated. People and staff spoke positively about the way the service was managed and said the registered manager was friendly and approachable.

A range of audits and checks were undertaken and the service was committed to continuous improvement. People’s feedback was regularly sought and used to make positive changes to the service.

We carried out an unannounced comprehensive inspection of this service on 10 December 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the management of medicines.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (Pollard House) on our website at www.cqc.org.uk

The inspection took place on 8 October 2015 and was unannounced.

Pollard House provides accommodation and personal care for up to 28 older people at any one time.

A registered manager was 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 and associated Regulations about how the service is run.

At the last inspection on 10 December 2014 we found a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We found medicines were not safely managed. Following the inspection the provider sent us an action plan detailing the improvements it would make to ensure it met the regulations.

At this inspection we found improvements had been made. Medication records were fully completed and provided evidence people received their medicines as prescribed. Medicines were administered in a safe and kind way by care workers.

We did not change the rating for this domain as to do so requires evidence of sustained improvement over time.

Pollard House provides accommodation and personal care for up to 28 older people at any one time. On the date of the inspection, 10th December 2014, 23 people were living in the service.

A registered manager was 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 and associated Regulations about how the service is run.

At the last inspection in April 2014, we found breaches of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010; Regulation 10 - Assessing the quality of the service provision and Regulation 13 - Management of medicines. We found improvements had been made to the quality assurance system with robust audit systems in place which were routinely identifying and rectifying issues found. People’s feedback was regularly sought and we saw evidence action was taken based on people’s views and feelings.

Since the last inspection, we found a number of improvements had been made to the medicines management system. However these had not been consistently applied as we found inconsistencies in record keeping and the management of controlled drugs. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we asked the provider to take at the back of the full version of the report.

Staff we spoke with understood their responsibilities under the Mental Capacity Act 2005 (MCA), for example how to ensure the rights of people with limited mental capacity when making decisions were respected. We found the home to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People told us they felt safe in the home and staff had a good understanding of how to manage risks to people in order to protect them from harm.

People and their relatives told us care was good or excellent and they were treated well by staff and the management team. We observed staff were kind and caring and demonstrated a good understanding of people’s individual needs.

Arrangements were in place to assess people’s healthcare needs and care plans were in place for staff to follow to help them meet these needs. There was regular input from a range of health professionals. Health professionals told us the service delivered good care, that staff contacted them if they had any concerns and that staff regularly followed their advice.

Care plans were regularly reviewed to ensure they met people’s individual needs. People and /or their relatives were involved in care plan reviews and it was evident their comments in relation to care and support were recorded and acted on .

People spoke positively about the food. We saw people had a choice and had been involved in the development of the menu. People’s weights were regularly monitored and action was taken where the service had concerns over people’s nutritional intake.

The service was well led. People, staff and visiting health professionals all said the service was well led and the manager was effective in addressing any concerns raised.

Pollard House provides accommodation and personal care for up to 28 elderly people accommodated three floors. On the day of the inspection there were 23 people living at the home. The manager told us 11 people who lived at the home had a diagnosis of a dementia. The service had a registered manager in place. ‘A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.’

People told us they felt safe in the home and nobody raised any concerns with regards to their safety. We found procedures were in place to ensure people were protected from abuse and staff understood how to apply these procedures to keep people safe from abuse.

We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted. CQC monitored the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. We did not observe any restrictions of people’s liberty. The manager had a good understanding of DoLS and was able to give us examples of where they had sought advice from the local authority DoLS team to ensure people’s freedom was not restricted.

Staff we spoke with had a good understanding of the Mental Capacity Act (MCA) and how to ensure the rights of people with limited mental capacity to make decisions were respected.

The medicine management system required improvement. Robust documentation was not in place which meant it could not be evidenced that people’s medication had always been given. Some people had not received their medication on time which meant they may have experienced unnecessary pain. These problems we found breached Regulation 13 (Management of medicines); of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Two healthcare professionals who regularly visited the service told us they thought the service was effective in meeting people’s needs. We found people’s choices and preferences had been sought in the way they wanted their care to be delivered and staff were familiar with people’s needs. Care plans contained information on people’s assessed needs, preferences and choices; although some sections required more detail adding to ensure staff had the necessary information to ensure they delivered effective care.

People were given choices with regards to their daily lives, although the mealtime experience required improvement. People said there was not enough choice of foods and we observed one person’s comments regarding the food were not listened to.

The service worked effectively with healthcare professionals and was pro-active in referring people for treatment and diagnosis. Staff were good at following advice given by health professionals to ensure effective care.

People and their relatives all remarked that the service and its staff were caring and said staff were kind and compassionate. This was confirmed by the caring interactions and positive relationships between staff and people who used the service which we observed on the day of the inspection.

People were able to express their views and opinions in regards to their care through various mechanisms including a confidential comments and suggestions box, regularly resident meetings and resident/relative care plan reviews. We saw evidence people’s views had been recorded and action taken in response.

Regular reviews of people’s care took place and changes were made when people’s needs changed. Staff were aware of people’s ongoing care needs to enable them to deliver responsive and appropriate care.

People who used the service and staff all praised the manager and said they would listen to their concerns. We found an open and honest culture within the organisation with the manager committed to further improvement of the service.

We found risks to people’s health, safety and welfare were identified in three of the five people’s care plans we looked at. However, two people’s care plans were missing risk assessment documentation which meant the service had not assessed the measures needed to keep these people safe.

An incident management system was in place and there was analysis and clear lessons learnt in place for safeguarding incidents. However, accidents such as falls were not analysed for trends although this was something the manager showed us they were in the process of implementing. There was no documentation in place showing the learning from accidents to reduce the likelihood of future harm.

Improvements were required to the provider’s audit systems as the problems we identified with medication were not identified through the medication audit system. Deficiencies in risk assessment documentation were also not identified by the providers internal audit systems.

The above problems we found breached Regulation 10 (Assessing and monitoring the quality of service provision); of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report

People told us they were happy with the service provided by the home. They felt they were given enough information about their care options and were able to ask all the questions they wanted to. They found the staff to be friendly and reported they were treated with respect and their privacy was maintained.

We spoke with a relative of a person who used the service and they said, "We have had a very good service from Pollard House.”

Records we saw confirmed Pollard House had effective recruitment and selection policies in place to ensure staff members were of good character and had the required skills to perform their work.

We saw people had been involved in making decisions about the care and support they received. People had been asked to sign records to consent to the care and support planned.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. We observed staff supporting people who used the service and saw good care being provided. Staff knew the people they were supporting very well. People who used the service seemed comfortable with the members of staff who were supporting them. Staff told us people received very good care and support.

The provider had an effective system to identify, monitor and manage risks to people who used or worked in the service.

We spoke with six people and these are some of the things they told us:

“I like the staff, they are very kind.”

“I like my bedroom it is kept clean and tidy.”

“I can get up and go to bed when I want.”

”I am very happy here the staff understand me.”

“The manager brings my newspaper every morning.”

We saw that people looked well cared for. Staff were attentive and people’s care needs were attended to promptly. There was a nice friendly atmosphere in the home with good interactions between the people living there and staff.

During the visit we had the opportunity to talk to two people living in the home and two visitors. People told us they were happy with care and support provided. They said the staff were kind and caring and treated them well. One person told us staff answered quickly when she used the call bell. People told us the food was good. Visitors told us they were always made welcome, offered a drink and able to visit their relatives in private.