This inspection took place on 19 and 20 November 2018. The first day of inspection was unannounced.

The Brunswick is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The Brunswick provides accommodation and personal care for a maximum of 58 residents. Care needs for people using the service include older people, people with physical disability and people with sensory impairment. The service was registered 12 months ago and this was the first inspection. At the time of the inspection there were 36 people in residence.

A registered manager was in place. 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.

We found management and overall governance was stable. The provider had other locations registered with CQC and was experienced in the care sector. The registered manager was a consistent lead in the home and had been effective in building a positive staff team.

Staffing numbers helped ensure people’s care needs were being consistently met. Feedback from staff, people using the service and visitors was positive in that staffing levels were adequate to ensure safe standards of care. We looked at how staff were recruited and the processes to ensure staff were suitable to work in the home. We saw checks had been made so that staff employed were suitable to work with vulnerable people.

We found medicines were administered safely. People received their medicines consistently. Medication administration records (MARs) were not always clear and this was discussed with reference to future changes in some of the pharmacy arrangements.

People’s nutritional intake was supported appropriately. There had been some negative feedback prior to our inspection and the provider had responded by reviewing the meal arrangements for people. Most people’s comments on the inspection were that the meals had improved. Meal times were seen to be a relaxed and enjoyable experience for people. People’s nutritional intake was monitored.

Staff told us there were very good systems in place to support them in their work such as training and supervision.

Observations and feedback from people and their relatives evidenced people’s dignity was protected and maintained.

The activities programme continued to be developed. A newly employed activities coordinator had made positive improvements to help ensure a more consistent programme of social activities had been developed.

People’s risks regarding their health care were being adequately assessed and monitored. There was good referral and liaison with community health care professionals who worked with the home to help ensure people’s health care needs were met.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported. All staff were clear about the need to report any concerns they had.

Arrangements were in place for checking the environment to ensure it was safe. Planned development / maintenance was assessed and we could see the home was furnished to a high standard.

Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act 2005 were followed and an assessment of the person’s mental capacity was completed and decisions made in the person’s best interest.

There were people being supported on a Deprivation of Liberty [DoLS] authorisation. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes