The inspection took place between 27 October 2017 and 1 November 2017. Our visit to the home on 27 October was unannounced. We arranged to return to the home on 1 November 2017 to look at additional records.

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

Bradbury House is a modern, purpose built home and provides accommodation and personal care for up to 21 people. It is situated in the rural village of Gosforth and is near to all the amenities of the village.

All accommodation is in single, en-suite rooms and the home has a large dining and sitting room and a smaller quiet lounge. The home is owned by the Abbeyfield society, a charity which runs similar homes throughout the country.

At the last inspection of this home in June 2015, the service was rated as good. At this inspection in October and November 2017 we found the service remained good. We judged that the key question, “Is the service responsive” was no longer outstanding. The previous outstanding elements around the provision of activities and care planning were not found at this inspection. Although people told us there were a range of activities provided in the home, some people were not able to enjoy the activities provided due to their health. We also found that, although the care staff knew how to support individuals, the quality of care records varied and some had not been fully completed or reviewed regularly.

Everyone we spoke with told us this was a good home and said people were well cared for. They told us there were enough staff to provide the support people required and the staff treated people in a kind and caring way.

People were safe living in the home. Hazards to people’s safety had been identified and managed. The premises and equipment were checked to ensure they were safe for people to use.

Robust systems were used when new staff were recruited to ensure they were suitable to work in the home.

Medicines were handled safely and people were supported to access appropriate health care services to maintain their health.

The staff were trained to provide people’s support and ensure their safety.

People’s rights were respected. 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.

Where people were not able to agree to aspects of their own care people who knew them well had been included in making decisions in their best interests. We have made a recommendation about improving best interest decision records.

People were provided with meals and drinks they enjoyed. Their visitors were made welcome in the home and people were able to maintain relationships that were important to them.

The staff knew people well and care was planned and provided to meet people’s needs. However we found some records had not been fully completed and some had not been reviewed in line with the provider’s policy.

The provider had a procedure for responding to complaints. People were confident that any concerns they raised would be looked into and resolved.

The service was well managed. People knew the registered manager and how they could speak to her. People were asked for their views about the service they received. The registered manager set high standards and monitored the service to ensure these were met.

The registered manager was supported by a deputy manager. There were arrangements in place to ensure the effective management of the home.

This was an unannounced inspection that took place on 19th June 2015.

Bradbury House is a modern, purpose built care home for up to nineteen older people. It is situated in the rural village of Gosforth and is near to all the amenities of the village. The home has a well-designed garden and a small car park. The home has its own transport.

All accommodation is in single, ensuite rooms and the home has a large dining and sitting room and a smaller quiet lounge.

The home is owned by the Abbeyfield society, a charity which runs similar homes throughout the country.

The home has a registered 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 and associated Regulations about how the service is run.

The registered manager and the staff team understood their responsibilities in safeguarding vulnerable adults. Staff had received training and knew how to make a safeguarding referral.

Accidents and incidents in the home were reported, monitored and suitable changes put into place to lessen risk.

Staffing levels met the needs of the people in the home. The care ratios had been increased to ensure that good levels of care were delivered.

Recruitment and disciplinary procedures were being carried out correctly.

There had been two medication errors and suitable training and checks were in place to lessen the risk of human error. Medicines were in order when we inspected the ordering, administration and disposal of medicines.

The home was clean and orderly with suitable measures in place to prevent cross infection.

We had evidence to show that staff received suitable induction, support and training to develop their skills and knowledge. Staff received supervision and appraisal in a timely fashion.

The staff team understood the legislation around capacity and deprivation of liberty. No one was deprived of their liberty when we inspected. We had evidence to show that people were able to go out when they wished.

There was good quality food provided. People said it was well prepared with lots of choices. They could influence menu planning. Nutritional planning was in place and people were kept well hydrated.

People told us they saw health care professionals when necessary and we saw evidence of regular visits from specialist practitioners.

Bradbury House was a purpose built building and was suitably adapted to meet the needs of older people. The house was well maintained.

We observed staff working with people in a sensitive and polite way that helped to maintain their dignity. People told us they were valued and treated with respect. People had interventions explained to them patiently and appropriately.

We saw evidence to show that people’s privacy was respected. We had a lot of evidence to show that independence was supported.

End of life care was delivered correctly with support from local health care providers. Suitable records were in place about wishes at the end of life.

We saw detailed and up to date assessments and care plans. People told us they were involved in planning their own care.

A wide range of activities and entertainments were on offer. People told us they felt very much part of the life of the local community.

Concerns and complaints were handled appropriately. People told us they felt confident enough to raise any issues with the staff team.

The home had an experienced and suitably qualified manager who imparted the visions and values of the organisation to the staff team. The team worked well with other providers.

Quality monitoring was in place and changes made when people felt that the service needed improvement. Regular internal and external audits were completed.

People in this service told us they were asked formally and informally about consent to care and treatment. The staff team understood their responsibilities under the law.

People in the service told us that they were very satisfied with the way they were cared for and supported.

"I am very happy here and our staff are wonderful. They give us good care."

"I am always asked politely before I am given help."

We checked on the way medicines were managed in the home and we found that there were good systems in place.

People who lived in the home told us that they were happy with their environment. We had evidence to show that the home was secure, clean and well maintained.

The organisation had good systems in place to ensure that high quality standards were maintained. We saw that the team monitored quality, consulted the people in the home and made improvements as necessary.

"I am very comfortable here...a nice bedroom, lovely big lounge, nice garden and views of the fells. What more could I ask for."

The arrangements in place for managing complaints and concerns were in order. People told us:

"Everything here is of a very high standard. I think we get good quality care and services."

We spoke to most of the people who live in Bradbury House and they were extremely positive about the care and services provided:

"It is wonderful here...".

"It couldn't be better...I love it here".

"The staff are really nice...I trust them all".

"The team members are all very efficient...they know their job".

"It is like living in a big family".

"I like my room, the food, the entertainments, days out and the staff are marvelous!".