Broadfield House is operated by Lancashire County Council Older Peoples Services, which is part of Lancashire County Council. Broadfield House is a purpose built two storey building situated in Leyland and close to local amenities. The home has 17 beds for people with dementia, 13 beds for people with physical conditions and 16 community beds or step up, step down beds. These 16 beds from part of Lancashire county Council's Intermediate Care Provision, and are used by people who are not ready to return home following a hospital stay, or by people who require some short term care and support rather than permanent residential care or hospital admission.

The hope is that people who use the "step up, step down" beds would return to their own homes following a stay at Broadfield House. If following an assessment of people's needs, more intensive care and support was found to be required, then appropriate placements would be found for individuals. The accommodation within the home is divided into four separate areas. Each area is self -contained and provides comfortable lounge and dining areas along with bedrooms and bathrooms.

At the last inspection on 29 October 2014 (final report published 31 March 2015), the service was rated Good. At this inspection we found the service remained Good.

At the last inspection, we recommended that separate assessments are always conducted where risks are identified, which outline the strategies implemented to help to protect those who live at the home. We found that risk assessments were undertaken, and the findings built into people’s care plans, so as to ensure that their safety was promoted and protected.

We also recommended that a formal audit of staff files be conducted, so that an organised system be operated, with information being accurately recorded and therefore making details easily accessible. We found that these records were now in an organised format. Recruitment processes included checks so that only suitable staff were employed, and information held by the service was accurate and up to date.

We found that staff knew how to recognise any potential abuse to keep people safe. Potential risks to people were identified and measures were in place to minimise them. People received their medicines as prescribed, however, we recommended that all staff who administer were briefed on and reminded of the home's medicines policy and procedure. There were sufficient numbers of staff to care for people in a safe way. The service was clean and working practices were in place to minimise the spread of any infection.

Where people needed to be deprived of their liberty to live in the home, applications for Deprivation of Liberty Safeguards (DoLS) had been made. Staff were supporting people in line with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People's ability to make decisions about specific aspects of their life were regularly assessed and kept under review. When people could not make decisions for themselves this was done in line with the principles of the MCA.

We found that people’s health care needs were assessed and monitored and advice was sought from healthcare professionals when required. People's dietary needs were met and they had access to food options that promoted their health and wellbeing. People were supported by staff, who had been appropriately trained to understand their needs, and the needs of people living with dementia had been taken into consideration in the design of the environment. We saw that staff communicated effectively with people and treated them with kindness, compassion and respect. People's privacy and dignity was respected by staff. Staff showed concern for people’s well-being in a caring and meaningful way and responded appropriately to their needs.

We found that people and their relatives knew how to raise conce

The home comprised of four units. One unit was for short term rehabilitation for people with dementia. The other three units provided longer term care for older people and people with dementia. We spent time in each of the units at the home.

People using the service told us; “We are well looked after.” And “It’s been good for me, coming here.”

Relatives also spoke favourably about the standard of care provided. Comments included; “I am satisfied she gets the help needed.” And “You only have to ask and they will do their best to help.”

Staff training, written guidance and good practice helped to safeguard people against the risk of abuse.

The good range of communal space meant that people could choose where to spend their time. The home was well maintained and the people we spoke with expressed satisfaction with the accommodation provided.

The staff we spoke with showed a good understanding of the needs of those in their care. The home had a robust recruitment policy and associated procedures in place to help ensure that people employed were of suitable character and had the necessary skills to perform their duties. People living at the home described staff as; “kind” “helpful” and “excellent.”

There were effective systems in place to gain feedback about and monitor the quality of the service provided. Risks within the home were identified, monitored and managed.

People and relatives of those who used the service told us that it was a caring home and a good place to live. They said it was homely and welcoming and that activities regularly take place. Staff told us it was a good place to work and that they felt well supported and trained for their roles.

We inspected a range of documents about the home showing that there were good policies and procedures in place. We saw that care plans were personalised. The plans reported how to manage risk and also the personal strengths and preferences of people using the service.

We observed a range of interactions and activities within the home. We observed that these showed the policies and procedures were being followed. We saw that this was being done in a caring supportive manner and that people using the service were respected as individuals.

Broadfield House is situated in Leyland. The home comprises of four units and can accommodate up to 45 people requiring support with their personal care needs. On the ground floor there is a short stay assessment unit and a ten bedded dementia care unit. The first floor comprises of accommodation for older people and people living with a dementia related illness. The units are linked and can share activities, but each has its own space including bedrooms, dining and lounge areas. A passenger lift is available for access to the upper floor. There is a pleasant garden area and ample parking spaces are available. A wide range of amenities are accessible within the local community. Broadfield House is owned by Lancashire County Council and is regulated and inspected by the Care Quality Commission.

This unannounced inspection was conducted on 29th October 2014 and was carried out by one inspector from the Care Quality Commission, who was accompanied by an Expert by Experience. An Expert by Experience is a person who has experience of the type of service being inspected. Their role is to find out what it is like to use the service. At this inspection this was achieved through discussions with those who lived at the home, their relatives and staff members, as well as observation of the day-to-day activity.

We conducted a Short Observational Framework Inspection (SOFI). This methodology has been introduced, so we can observe a small group of people for short time frames over a selected period of the day. This enabled us to observe and record the day-to-day activity within the home and helped us to look at the interactions between staff and those who lived at Broadfield House. We observed some good practices and positive interactions by staff members.

The manager of the home was on duty when we visited Broadfield House. She had been in post for a short period only and therefore at the time of our inspection had not made application to the Care Quality Commission to manage this location. However, we established the application process had commenced. 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.

At the time of this inspection there were 43 people who lived at Broadfield House. We were not able to converse with some of those who used the service, because they were living with dementia. However, we did manage to speak with others and some of their relatives. We received positive comments from everyone we spoke with. We also spoke with three staff members and the manager of the home. We looked at a wide range of records, including the care files of three people who lived at Broadfield House and the personnel records of two staff members. We observed the activity within the home and looked at how staff interacted with people they supported.

One person told us, “I am very happy here. I am not afraid. I’ve got a good place to live and I don’t want to be anywhere else. These staff would not harm anyone.”

People who used this service were safe. The staff team were well trained and had good support from the management team. They were confident in reporting any concerns about a person’s safety and were competent to deliver the care and support needed by those who lived at the home.

Although relevant checks had been conducted to ensure new staff members were suitable to work with this vulnerable client group, information was not always easy to find. We had difficulty in establishing when some evidence was requested or received. Therefore, a clear audit trail was not always evident.

The premises were safe and maintained to a good standard. Equipment and systems had been serviced in accordance with the manufacturers’ recommendations, to ensure they were safe for use. This helped to protect people from harm.

The planning of people’s care was based on an assessment of their needs, with information being gathered from a variety of sources. However, evidence was not available to demonstrate that people who lived at the home, or their relatives, had been involved in making decisions about the way care and support was being delivered. We made a recommendation that systems be reviewed to ensure the manager could demonstrate people had been enabled to be involved in the planning of their care.

Regular reviews of needs were conducted with any changes in circumstances being recorded well. Areas of risk had been identified within the care planning process and strategies had been recorded. However, assessments had not been conducted within a risk management framework for one person who lived at the home, who had a specific safety need. People were supported to maintain their independence and their dignity was consistently respected. Staff were kind and caring towards those they supported and individual interaction was an important aspect of life at Broadfield House.

Assistance was provided for those who needed help with their meals. This was done in a dignified manner and the dining experience was pleasant. However, we recommend that people who live at the home are consulted about the food and beverage choices, so that more varied options are available.

Staff we spoke with told us they received a broad range of training programmes and provided us with some good examples of modules they had completed. They confirmed that regular supervision sessions were conducted, as well as annual appraisals.

Staff spoken with told us they felt well supported by the manager of the home and although she had been in post for a relatively short period of time, they were confident she would maintain a stable management structure, which would enhance the quality of service provided.