This unannounced comprehensive inspection took place on 4 and 5 July 2018.

Broughton House Residential Home is a ‘care home’ located in South Liverpool, near to Sefton Park. The home has access to local amenities such as cafes, restaurants, shops and public transport links. The home accommodates up to 30 people over three floors in one large building and has a garden to the rear of the property. At the time of our inspection 28 people were living at the home.

People living 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.

The home had an experienced manager who was registered with the Care Quality Commission and had worked at the home for over 20 years. 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.

When we completed our previous inspection in April 2016 we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as the provider had not ensured that the premises were safe to use. We also found a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as the provider had not ensured service users were only being deprived of their liberty with lawful authority. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve in our key question areas of Safe and Effective.

During this inspection we found that all the completed improvements recorded in the action plan had indeed been completed and this had led to improvements in our key question areas of Safe and Effective. Overall, we found that the home had made sufficient improvements and was no longer in breach of the Regulations.

We found that some of the window restrictors in people’s bedrooms were ineffective and allowed the windows to open wider than they should which posed a potential risk to people’s health and safety. We also saw that part of a glass roof to the side of the building had broken and left broken glass on the floor. This external area was not usually accessed by anyone but the broken glass was a potential hazard if anyone did access this area. The registered manager and the registered provider promptly addressed these issues after we had highlighted them. We found no other concerns with the environment during this inspection.

The activities on offer to people at the home were limited and people had very little to do with their time, with the main options being daytime television, reading papers and completing crosswords. This was also reflected in the feedback we gathered from various people we spoke with. We discussed this with the registered manager and highlighted that this was an area that required improvement.

We saw that there were policies and procedures in place to guide staff in relation to safeguarding vulnerable adults and whistleblowing. Staff had received training on this and information about how to raise safeguarding concerns was readily available in various places throughout the home. People living at the home and their relatives told us that they felt safe there.

We saw that medication was safely administered, stored and recorded.

During our last inspection we found that staff had been safely recruited and the home had a robust recruitment process to ensure people employed were suitable to work with vulnerable people. No new staff had been recruited since our last inspection.

Staff were supported in their roles through induction, appraisal and regular training.

The registered manager understood the requirements of

This inspection was carried out on15th and 19th April 2016. The first day of the inspection was unannounced.

Broughton House residential Home is registered to provide accommodation and support for up to 30 people. At the time of our inspection 30 people were living there.

The home had 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 2008 and associated Regulations about how the service is run.

During the inspection we met a number of the people living at Broughton House and spoke in depth with six of them. We also looked around the premises and spoke with five members of staff and two visiting health care professionals. We examined a variety of records relating to people living at the home and the staff team. We also looked at systems for checking the quality and safety of the service.

At this inspection we found breaches of two regulations. These were because parts of the premises were not safe and people’s legal rights had not always been protected

You can see what action we told the provider to take at the back of the full version of the report.

Medication was managed well and people received their medication as prescribed. Support was provided to people with their health and personal care.

People told us that they felt safe living at Broughton House and their visitors said they thought it was a safe place for people to live. Policies and training were in place to help staff identify and deal with potential safeguarding issues that may arise.

Staff were aware of the actions they should take in the event of an emergency occurring.

There were enough staff working at the home to meet people’s support needs. People liked and trusted the staff team. Staff had received the training and support they needed to carry out their roles effectively and to support people safely.

Staff knew people well and knew how to support people based on their individual choices and needs.

Suitable systems were in place for recruiting, training and supporting staff, this helped to ensure they were suitable to work with people who may be vulnerable.

People were confident to raise any concerns or suggestions they had with the staff team but said they had nothing to complain about.

The people living and working in the home had confidence in the registered manager who knew them well. They described her as “very supportive”.

Systems were in place for checking the quality of the service in relation to medication, care plans, complaints and accidents and incidents. These systems worked well. Systems for checking and improving the safety of the environment were not effective.

The views of people living at the home and their relatives had been obtained and generally acted upon.

During our inspection we spoke with six of the people living at Broughton House Residential Home and with four of their visitors. We also spoke with four members of staff who held different roles within the home.

People were treated with dignity and respect. We observed that staff took time to consult with people and to provide support in an unrushed manner. Care records confirmed the people living at the home and their relatives had been involved in planning the care they had received and in planning their future care as their needs changed.

People told us that their care and welfare needs had been met whilst living at the home. This was confirmed in the care records that we read.

People told us they liked the staff team and had confidence in them. A visitor commented, “The care is fantastic I have recommended it.” One of the people living there told us, “They are very good to you.”

The home was clean, warm and comfortable with an ongoing programme in place to upgrade the environment.

Systems were in place for dealing with any concerns or complaints that may arise. People told us that they would have feel comfortable and confident raising any issues with senior staff.

During our visit to Broughton House Residential Home we spoke with seven of the people who lived there and five of their visitors. We also spoke to seven members of staff who held different roles within the home. We spent time observing the day to day support provided, looked at a cross section of records and toured the premises.

People told us they were involved in planning the care they received. They said they were happy with the care and support provided. Everyone we spoke with told us they liked the staff team with one person commenting, “They would do anything for you”. Relatives and the people living there told us they felt it was a safe place to live and they had felt confident to raise any concerns they may have had.

The environment received comments such as “It’s a bit tired” and "it could do with a lick of paint. However one person commented “I wouldn’t go anywhere else.”