The inspection was carried out on the 26 July 2016 and was unannounced.

Bowercroft Care Limited is a care home providing accommodation and care for up to 18 older people who may be living with dementia. At the time of the inspection 15 people lived at the service.

We last inspected the service on the 23 and 25 June 2015, when we made recommendations for improvement in relation to administration of medicines, updating policies and procedures, quality assurance auditing and enhancing the environment for people living with dementia. At this inspection we found that the provider had taken action and improvements had been made.

There was a registered manager employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Management understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

The registered manager and staff had received training about the Mental Capacity Act 2005 and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care.

People said they felt safe and relatives told us that they knew their relatives were safe. People were protected against the risk of abuse. Staff had had training and recognised the signs of abuse or neglect and what to look out for. Management and staff understood their role and responsibilities to report any concerns and were confident in doing so. Staff told us they knew what to do if they needed to whistle blow, and there was a whistleblowing policy available.

People had varied needs, and some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy by showing warmth to the provider, registered manager and staff who were supporting them. Staff were attentive and interacted with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Gaps in applicants employment history had been followed up and DBS checks had been updated as appropriate. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments were being updated and were individual for each person. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice, such as doctors, speech and language therapist (SALT) and dieticians.

People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the home cooked food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.

People were given individual

We carried out this inspection on the 23 and 25 June 2015, it was unannounced.

Bowercroft Care Limited is a care home providing accommodation and support for up to 18 older people who may be living with dementia. It is situated in a residential area near to the centre of Maidstone. At the time of the inspection 16 people lived at the service.

The service was purchased by the new provider of the service six weeks before our inspection. One of the previous registered providers who was also the registered manager was going to continue as the registered manager. However, they left shortly after the handover of the business. This meant that there was no registered manager of the service, and the provider had in the interim promoted a senior member of staff as acting manager. 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.

Not all medicines were stored, administered and disposed of safely. Some medicines had not been returned to the pharmacy, and some records had not been signed appropriately when medicine had been given. We have made a recommendation about this.

The provider had not adapted the environment for people living with dementia. Doors were all the same colour, and toilets and bathrooms were not always clearly identified to aid and support independence of people living with dementia. We have made a recommendation about this.

People demonstrated that they were happy at the service by showing open affection to the provider and staff who were supporting them. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff interacted well with people, and supported them when they needed it.

People were given individual support to take part in their preferred hobbies and interests. However, the provider needs to support people by providing an increased range of activities for people living with dementia.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; and daily contact with the provider and staff.

The provider investigated and responded to people’s complaints. People knew how to raise any concerns and relatives were confident that the registered manager dealt with them appropriately and resolved them where possible. People and relatives told us they had no concerns.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Applications were being completed in relation to DoLS, the provider understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

Staff had been trained in how to protect people, and they knew the action to take in the event of any suspicion of abuse towards people. Staff understood the whistle blowing policy. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. The provider and staff contacted other health professionals for support and advice.

People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the home cooked food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.

Staff were recruited using procedures designed to protect people from unsuitable staff. Staff were trained to meet people’s needs and they discussed their performance during one to one meetings and annual appraisal so they were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place, and these systems were being reviewed, to review accidents and incidents and make any relevant improvements as a result.