The Briars is a ‘care home’. People in care homes received accommodation and nursing or personal cars as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Briars accommodates up to 17 people in one adapted building. At the time of our inspection there were 17 people living in the home.

At the last inspection, the service was rated 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 ongoing monitoring that demonstrated serous risk 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.

There was a registered manager 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 2008 and associated regulations about how the service is run.

People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were sufficient numbers of care staff on shift with the correct skills and knowledge to keep people safe.

The administration of people’s medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow. Their competency was checked regularly.

People were supported with maintaining a balanced diet and the people who used the service chose their meals these were provided in line with their preferences.

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

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. People and their relatives were involved in making decisions about their care and support.

Care plans were individual and contained information about how people preferred to communicate and their ability to make decisions.

People were encouraged to take part in activities that they enjoyed, and were supported to keep in contact with family members. When needed, they were supported to see health professionals and referrals were put through to ensure they had the appropriate care and treatment.

Relatives and staff were complimentary about the management of the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

The inspection took place on 13 July and was unannounced. The service provides accommodation and personal care for up to 17 people some of whom are living with dementia. On the day of our inspection 16 people were using the service.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 protected from the risk of abuse as staff had attended training to provide them with knowledge and an understanding of their roles and responsibilities with guidance in how to respond if they suspected abuse was happening. The manager had shared information with the local safeguarding authority when needed and the service had a safeguarding policy and procedure.

People were supported by a sufficient number of experienced and caring staff. The provider had ensured appropriate recruitment checks had been carried out on staff before they commenced work to determine they were suitable to work with the people living at the service. Emphasis was placed providing care and support in ways that people preferred as part of the interview process.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. MCA, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s health needs were managed appropriately with input from relevant health care professionals. People were treated with kindness and respect by staff who knew them well. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health. Staff ensured that people’s health needs were effectively monitored. The staff were aware of individual health needs and responded to people’s concerns and behaviours in an appropriate and compassionate manner.

Positive and caring relationships had been developed between the people and staff. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects of their lives.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People, where able, were involved in the planning and reviewing of their care and support.

People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture and staff were supported to provide care that was centred upon the individual. The manager and deputy were approachable and enabled people who used the service to express their views.

People were supported to report any concerns or complaints and they felt they would be taken seriously. People who used the service, or their representatives, were encouraged to be involved in decisions about the service.

The provider had syst

We spoke with seven people who used the service, looked at four care records and spoke with the manager and three other members of staff. We viewed the staff rotas and quality monitoring systems. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service the manager greeted us and noted our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw the staff rota and dependency levels assessment, which showed that the service assessed people's needs to ensure that there were sufficient numbers of staff to meet their needs.

We reviewed staffing records regarding The Mental Capacity Act (MCA) 2005 in relation to Deprivation of Liberty Safeguards (DoLS) and saw that the manager had undertaken training. We discussed MCA with the manager and they informed us about the two occasions they had used the DoLS. They also informed us that future training was in place for all staff to be trained in MCA. The CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes.

Is the service effective?

There were systems in place to audit care plans which ensured that care was planned effectively.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were reviewed monthly and updated appropriately which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, respectful and professional manner. One person told us: “The meals are lovely.” Another person told us: “I enjoy having my nails done.” We saw members of staff supporting people to choose and apply nail varnish.

Is the service responsive?

The service had an effective complaints procedure in place. We examined the care records of four people who used the service and noted the that risk assessments were reviewed and updated in response to events. This ensured people received safe and appropriate care.

Is the service well-led?

The manager explained to us that they had applied to become the registered manager. The service worked well with representatives of other organisations including Community Psychiatric Nurses and Social Workers to make sure people received their care in a joined up way.

As part of this inspection we spoke with three people who used the service, five care staff, two visitors and a member of the management team. We looked at three people's care records. Other records we reviewed included medication records, staffing records, quality and monitoring records and satisfaction questionnaires completed by the people who used the service. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is the summary of what we found:

Is the service safe?

People told us that they felt safe. The service had appropriate policies and procedures in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards although currently no applications had needed to be submitted.

People were provided with their medication in a safe manner and at the prescribed times. We saw that medication was stored safely.

The service was safe. We saw records which showed regular fire safety checks were carried out which meant that people were protected in the event of a fire.

We saw the staff rota which confirmed that the service ensured there were sufficient numbers of staff to meet people’s needs. People, who used the service, care staff and visitors all told us that they considered staff were available when they needed them. Two people told us that staff always responded to their call bells promptly.

Is the service effective?

People’s health and care needs were assessed in consultation with either the person themselves, relatives or their advocate. People had a plan of care in place that reflected their healthcare needs in conjunction with support from external professionals, where required. Care plans included a method of assessing and monitoring people’s dietary and nutritional needs which ensured that people were protected from malnutrition.

People’s mobility and other needs were taken into account in relation to signage and building adaptation, which enabled people to move around the service freely and safely.

Is the service caring?

People were supported by staff who were kind, caring and respectful. Care workers supported people with patience and genuine affection and assisted people who required additional support in a dignified manner and at their own pace.

People were treated with respect and dignity by the staff.

People commented “All the staff are very kind. It’s like home from home and I don’t even have to do any cooking or cleaning.”

People’s preferences, interests and choices had been recorded and the care and support offered in accordance with people’s wishes.

Is it responsive?

People's care records showed that where concerns about an individual’s wellbeing had been identified, staff had taken appropriate action that ensured people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.

People, who used the service, care staff and visitors all told us that they considered staff were available when they needed them. Two people told us that staff always responded to their call bells promptly.

People who used the service and their relatives involved in the service had completed an annual satisfaction survey and issues raised had been addressed and an action plan completed.

People were involved in participating in a range of activities both within the service and were also offered regular visits from outside entertainers.

People knew how to make a complaint if they were unhappy.

Is the service well led?

The service has a quality assurance system in place and records seen showed us that all areas of the service were monitored or reviewed regularly. This included the monitoring of staff levels provided, the auditing of medication, the auditing of care plans and the auditing of the environment. We found that staff were supervised and trained to carry out their role both safely and effectively.