This inspection was carried out on 14 July 2016 and was unannounced.

Bowley Court provides nursing care for up to 20 people. It specialises in supporting people who have either, Huntington’s Disease, acquired brain injury or people with mental health needs who also have physical disabilities. At the time of our inspection there were 20 people living at the home.

A registered manager was in post at the time of our inspection. 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.

Staff knew how to recognise and report any concerns about people’s safety. Staff understood risks associated with people’s needs and how to keep them safe. There were enough staff on duty to respond to people’s health needs at the times when they needed support. The provider completed checks to ensure staff were suitable and safe to work at the home.

People were treated with dignity and respect and staff were kind and caring in their approach with people. People had care and support that was centred on them as individuals and their independence and freedom of choice were promoted and supported.

People had end of life care that had been recognised by a national organisation as being of the highest standard with emphasis on people’s wishes and respecting them to the end of their lives.

People’s health needs were responded to effectively with people being supported to access doctors and other health professionals when required. People had daily access to health professionals like neurologists, psychiatrists, doctors, occupational therapists and physiotherapists. People were supported to have their medicines when needed. Medicines were stored and administered appropriately.

People had access to a varied diet of food and drink. People were supported to have their food and drink safely. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon by staff.

Staff understood people’s individual communication styles and were able to communicate effectively with people. People’s permission was sought before any care or support was given. Time was taken to make sure that people could make choices and decisions about the care and support they received.

People were supported by staff that had the knowledge and skills to understand and meet their health needs. Staff had access to additional training to match people’s specific health needs. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance.

People and their relatives found the staff and management approachable, willing to listen to their views and opinions. People knew how to complain and who to complain to. Feedback from the people and their relatives was gathered on a regular basis and any areas identified for action were acted upon. Audits and checks were completed regularly to ensure that good standards were maintained.

Relatives and staff told us the registered manager was approachable and was willing to listen to their views and opinions. Relatives and staff views on the care and support provided was gathered on a regular basis. There had been recent improvements made to how feedback was used to identify any areas for action or improvements to be made. A range of audits and checks were also completed regularly to ensure that good standards were maintained.

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

The people who lived in the home told us they were pleased with the care provided. They felt that their views were respected and listened to.

We saw that staff had received specialist training in the handling of difficult behaviours. This was to protect people’s physical wellbeing as well as their human rights and dignity.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While nobody was currently subject to a DoLS proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the support they received. They told us that the registered manager and the staff had asked them what their needs and wishes were and how they would like them met. One person said, “We talk about what I want”.

Personal records confirmed people’s needs and preferences had been recorded and support had been provided in accordance with their wishes.

People told us they were happy to discuss their support with staff. They said that staff obtained help for them if they were unwell. This meant people were helped to keep in good health, have access to health care services and received ongoing support.

Is the service caring?

People we talked with told us their wishes were respected and they were able to live their lives as they wished. Staff took the time to find out about people’s background. Staff knew people’s needs well and how they needed to be supported. This meant that staff cared about the person as an individual and were concerned about their well-being.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People told us they talked with the registered manager and the staff about what was important to them. They talked about the activities they took part in and their meals. They told us that their support plans had been changed as a result.

Is the service well led?

The registered manager and the staff demonstrated values that promoted involvement, openness, dignity, respect and independence. We talked with staff who showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as much as they were able.