Bowgreave Rise Home for Older People was inspected on the 30 and 31 January 2019 and the inspection was unannounced on the first day.

Bowgreave Rise Home for Older People can accommodate up to 32 older people, some of whom may have dementia. The home is situated over three floors with a passenger lift providing access to the upper floors. There are 32 single rooms all having a wash hand basin and a call system. There are lounges and dining areas on each floor providing communal space and small sitting areas around the home so people can sit quietly if they wish.

At our last inspection we rated the service 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 serious risks 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.

At this inspection visit we found the service remained good.

Why the service is rated good.

Staffing was arranged to ensure people were supported promptly and people told us they were happy with the staffing arrangements at the home. Staff told us they were sometimes busy and we discussed this with the registered manager.

Prospective employees were subject to recruitment checks to ensure they were suitable to work with people who may be vulnerable.

We saw documentation which showed people were referred to external health professionals if this was required. People told us and we saw they received personalised care in accordance with their needs and wishes.

Training was available to ensure staff were skilled, competent and able to fulfil their role. Staff told us they received supervisions and appraisals to enable them to review their performance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they felt safe living at the home and staff had knowledge of the action to take if they were concerned someone was at risk of harm or abuse.

Technology was used to minimise the risk of falls and staff were aware of the importance of following people’s individual risk assessments so the risk of harm was minimised.

Care plans and risk assessments were written and accessible to staff so they had information on how to support people. These were reviewed and amended as people’s needs changed. People and relatives told us they were involved in care planning.

People, and relatives told us staff were caring and we saw warm and gentle interactions between staff and people who lived at the home. Staff told us they valued people as individuals and would take action to promote and protect their human rights.

People could provide feedback on the service provided through surveys, face to face conversations and group meetings. The registered manager reviewed the feedback and made changes whenever possible.

There was a complaints procedure at the home and people and relatives told us they had no complaints to raise at the time of the inspection.

People and relatives told us the service was well managed and the registered manager was approachable. Staff told us they felt supported and could attend staff meetings to discuss any changes happening at the home.

There was an activities programme for people to enjoy if they wished to do so. People who attended activities told us they enjoyed them.

A series of checks and audits were carried out to ensure areas of good practice were identified and any areas of improvement could be addressed.

Medicines were managed safely. Staff told us they had received training to ensure they were able to administer medicines safely.

Care records contained information regarding people’s end of life wishes and staff told us they would respect these.

The environment was visibly

We inspected this service on 12 May 2016. The inspection was unannounced. The service was last inspected on 15 September 2014, when we found the provider was compliant against the regulations we assessed at that time.

Bowgreave Rise Home for Older People is a purpose built home that can accommodate up to 32 older people, some of whom may have dementia. The home is situated over three floors with a passenger lift providing access to the upper floors. There are 32 single rooms all having a wash hand basin and a call system. There are lounges and dining areas on each floor providing communal space and small sitting areas around the home so people can sit quietly if they wish.

The service is registered to provide accommodation for persons who require nursing or personal care. There is 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.

Safeguarding procedures were in place and we felt reassured by the level of staff understanding regarding abuse and their confidence in reporting concerns.

Staff delivered support effectively and care was provided in a way that intended to promote people's independence and wellbeing, whilst people's safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process.

People told us that they felt that more staff members were needed at times and we have made a recommendation about this.

Staff were kind and respectful towards people ensuring privacy and independence was promoted. Staff understood their roles and people were supported in a person centred way.

People's rights were protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Management applied such measures appropriately and staff understood their responsibilities and how to keep people safe.

People's views had been gathered using effective systems, these included regular resident and staff Meetings.

The service had a registered manager who was available to people who used the service, relatives and staff. People we spoke with told us the manager was approachable.

The provider carried out audits to monitor the quality of the service. However some issues identified on the day had not been picked up prior to our inspection, we have made a recommendation about this.

We found the manager receptive to feedback and keen to improve the service. They worked with us in a positive manner providing all the information we requested.

We have made recommendations around the staff dependency tool and robust quality audits with regards to the environment.

We spoke with seven people who lived at the home and three relatives. All were happy with the care provided at Bowgreave Rise Home for Older People. One person who lived at the home told us: “They (the staff) are all great but sometimes they are busy”. Whilst a relative said: “I couldn’t ask for any more for my mum”.

Care plans we viewed were person centred and included likes and dislikes, allergies and dietary requirements. Plans contained a range of risk assessments and information on people’s specific needs.

At our last inspection on 17 January 2014 we had found concerns regarding communication between care staff and kitchen staff. Specific information regarding people’s individual dietary needs had not been communicated well or recorded. The provider submitted an action plan to tell us how these concerns would be addressed. During this inspection we found this and other systems had improved and measures were now in place to ensure people received nutrition relevant to their needs.

During our last inspection on 17 January 2014 we had concerns about the routine maintenance of the building and the effect on the safety of people who lived at the home. We were told there was not an investment programme for the redecoration or upkeep of the premises. This left the building at risk of falling into a further state of disrepair. The provider submitted an action plan to tell us how these concerns would be addressed. We found during this inspection that some redecoration had taken place and were shown a works improvement action plan from the local authority to improve other areas of the home.

We were shown a number of customer surveys completed by the provider along with a range of audits to check on the quality of the service provided.

Everyone we spoke with had confidence their or their family member’s needs were being met. One person said, “The staff are wonderful, really caring and look after me well.”

Information held included likes and dislikes, allergies and dietary requirements. Information on people’s specific needs was recorded on the kitchen whiteboard to be seen by all kitchen staff. Information on one person’s allergy was missing from the board.

We were told at the time of the inspection the home had allocated finance for the day to day maintenance of the building. There was not an investment programme for the redecoration or any refurbishment to the premises. This left the building at risk of falling into a further state of disrepair.

People we spoke with said the staff were all very nice and worked hard. One person said, “The staff are all really friendly and you can usually find one when you need one.” Another said, “They (the staff) are all great but sometimes they are pushed.”

The home had a business continuity plan that included environmental risk assessments and risk management plans. The home had completed Personal Emergency Evacuation Plans (PEEPs) for every person living in the home.

People told us they were very happy living in Bowgreave Rise and were glad they had moved into the home. Comments included;

I am very happy living here and the staff are very kind. They help me when I ask but encourage me to do things for myself too”.

“I haven’t been here very long but I couldn’t manage any longer living by myself”.

“We look after our friend’s affairs and could not be happier with the care and support the girls give her. She is so much better now and has made a new friend”.

We saw very good standards of care and interaction between the staff and people who lived in the home. Care plans and risk assessments were in place which ensured people were kept safe.

All health care needs were met by visiting professionals and people told us they could see their doctor when they wanted.

Service users are able to visit the home prior to making a decision regarding residency. Day care and short stays are also provided. One person spoke to us about how staff got to know her and asked her about her preferences, likes and dislikes during her first few days at the home.

The service users spoken to made positive comments about the staff team, confirming that staff are polite and respectful. We observed staff responding to service users with kindness and offering choices, such as what to drink and where to sit. The service users we spoke to told us that they enjoyed the meals provided.

In the unit for those with dementia, service users appeared alert and bright and happy to engage with staff. One person likes to wear her dressing gown over her clothes and staff support this decision, recognising that this helps the person to feel relaxed and comfortable.

A number of service users told us that they were happy with their individual bedroom accommodation. We saw that people are able to bring in their own possessions; ornaments etc and so make their room feel more comfortable.

All bedrooms are single and have their own wash basin. Each bedroom has a call system in place. One person told us how the use of the call bell system had been explained to her and how this provided reassurance during the night.