Brandon House is a residential care home providing personal care for up to 35 older people, some of whom are living with dementia. Nursing care is not provided at the home. This is provided by the community nursing service. At the time of our inspection there were 32 people living in Brandon House.

At the last inspection in December 2016 the service was rated Good overall. At this inspection we found the service remained Good.

Why the service is rated Good.

Brandon House had a registered manager who was also the provider. They had oversight of three local homes, including Brandon House. There was a day to day manager who worked in the home and undertook daily monitoring and management tasks. They were in the process of registering with the Care Quality Commission.

The people who lived in Brandon House were provided with high quality; caring support which was person centred and met their individual needs. During our inspection we identified some concerns relating to the management of records but found these issues had been identified by the day to day manager and were being responded to.

We received positive feedback about the staff at the home and the quality of the care provided. Some of this feedback included comments like, “I honestly feel that the residents are well looked after and receive excellent care”, “(Brandon House) has a warm caring atmosphere, nice staff, it’s where I would put my nearest and dearest if they needed looking after” and “The staff are always friendly and professional.”

Staff treated people with respect and kindness. There was a warm and pleasant atmosphere at the home where people and staff shared jokes and laughter. Staff knew people and their preferences well. People were supported to have enough to eat and drink in ways that met their needs and preferences. Meal times were social events and people spoke highly of the food at the home.

People who lived in Brandon House had a variety of needs and were protected from risks relating to their health, mobility, medicines, nutrition and possible abuse. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Staff knew how to recognise possible signs of abuse.

Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Staff supported people to take their medicines safely and staffs’ knowledge relating to the administration of medicines were regularly checked. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the home were sufficient to meet people’s needs. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put this into practice.

People, relatives, staff and healthcare professionals were asked for their feedback and suggestions in order to improve the service. There were systems in place to assess, monitor and improve the quality and safety of the care and support being delivered.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection on 5 and 8 October 2015. The overall rating was 'good'. After that inspection we received concerns in relation to medication management and delays in responding to changes in people's health. As a result we undertook a focused inspection on 22 June 2016 to look into those concerns. We judged that improvements were needed in the security of some medication storage and in the auditing of some medication. We undertook another focused inspection to check that improvements had been made. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Brandon House on our website at www.cqc.org.uk

At this inspection we judged that improvements had been made to the security of some medication storage and in the auditing of some medication.

We carried out an unannounced comprehensive inspection on 5 and 8 October 2015. The overall rating was ‘good’. After that inspection we received concerns in relation to medication management and delays in responding to changes in people’s health. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those/this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Brandon House on our website at www.cqc.org.uk

We judged that improvements were needed in the security of some medication storage and in the auditing of some medication. However, other medication records were well completed and records showed people were supported with their pain relief in the way prescribed for them. We spoke with two people, who told us they were happy with the way they received their medicines and that they were given them at regular times.

Records showed staff recognised changes in people’s health and well-being and people had access to healthcare professionals.

There were 34 people living at Brandon house at the time of our inspection. We spoke with five people who lived at the home and two relatives of people who lived there. We also spoke with three care workers, the manager, the cook and a health professional.

People told us that they were treated respectfully by care workers. People told us that they were involved in discussions about their care and that they had choices about they spent their time. One person said "There's plenty of choice of things to do."

People and relatives were very positive about the care delivered. Comments included “It’s a good home, I am well looked after.”

People's needs had been assessed and their care had been planned and delivered in line with those assessments. Care plans had been regularly reviewed and updated.

People told us that they enjoyed a range of different activities including yoga, quizzes, arts and crafts.

We saw evidence that background checks had been completed on care workers at the home prior to employment.

We saw evidence that the provider conducted regular audits and that there were effective systems were in place to monitor the quality of care delivered.

There were 33 people living at Brandon house at the time of our inspection. We spoke with eight people who lived at the home and three relatives of people who lived there. People told us that they felt safe and were treated respectfully by care workers. People were involved in discussions about their care as much as they wished to be. Where people did not have the capacity to make significant decisions about their care appropriate procedures were used to protect their rights.

People and relatives were very positive about the care delivered. Comments included, "I am very well looked after." and "Since [our relative] has been living here we have been very happy and feel that we now have some peace of mind.” People's needs had been assessed and their care had been planned and delivered in line with those assessments. Care plans had been regularly reviewed and updated.

People enjoyed each other's company and a range of activities were available. Staff had time to talk with people as well as to complete tasks. Care workers had received training which supported them to meet people's needs and there were sufficient staff on duty to respond in a timely way.

Effective systems were in place to safeguard people and to assure the quality of the service.

An unannounced inspection took place on 5 and 8 October 2015. It was carried out by two inspectors. Brandon House provides accommodation for up to 35 people and 34 people were living at the home during our visit. The service provides care for older people; some people are living with dementia.

A registered manager was 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.

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection, no applications had been made to the local authority in relation to people who lived at the service as the registered manager had judged that currently there were no people who required this safeguard.

Improvements were needed to the monitoring of infection control practice in the laundry. Medication was generally well managed but some improvements were needed to make practice safer. The registered manager had implemented changes to address inconsistencies in the management of supervision and training.

People looked confident as they moved around the home and people told us they felt safe. For example, "The carers here are wonderful... X (registered manager) chooses good staff.” Staff knew to report poor or abusive practice.

Accident and incident records were analysed and action taken. Risk assessments were in place for people’s physical and health needs. Care records were personalised. People had access to health services.

Staff treated people as individuals and checked how they wished to be supported. Staff understood the importance of gaining consent. People benefited from a staff group that were trained and worked as a team.

Staffing levels met people’s care needs. The atmosphere was welcoming and friendly. Staff were calm and unhurried in their approach when they supported people. People commented favourably about staffing levels and told us, “If you want something they’re there straight away”; "Always responded to promptly” and "They respond fairly quickly.” Staff had the skills and compassion to provide quality end of life care.

People complimented staff on their friendliness and kindness. People said “Everybody’s nice and staff are helpful” and “The girls are so kind and such fun.” Another person said there was “Fantastic care” and a fourth person commented, “It's lovely, everybody so helpful to me.”

The service was well run by a committed manager, who people said was approachable. Safety checks were up to date and the home was well maintained. The home was clean and there were no unpleasant odours.