The inspection took place on 19 and 20 March 2018. The first day of inspection was unannounced. On the second day of inspection the registered manager, deputy manager, area manager, staff and people knew to expect us. Burleys Wood is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Burleys Wood is situated in Crawley in West Sussex and is one of a group of services owned by a national provider, Shaw Healthcare Limited. Burleys Wood accommodates 60 people across six separate units, each of which have separate bedrooms with en-suite shower facilities, a communal dining room and lounge. There were also gardens for people to access and a hairdressing room. The service provided accommodation for older people, those living with dementia and people who required support with their nursing needs. At the time of the inspection there were 54 people living at the service.

At the previous inspection on 14 October 2015 the service was rated as ‘Good’. Areas in need of improvement were identified. These related to there being no registered manager and a lack of quality assurance audits to ensure that the service continually improved. At this inspection improvements had been made and the service remained 'Good'.

The management team and staff did not always have a good understanding of the Deprivation of Liberty Safeguards (DoLS) and had not always worked in accordance with this. Staff gained people’s consent before supporting them with day-to-day tasks but there was an inconsistent approach to formally gaining consent on people’s behalves when they lacked capacity. This is an area of practice identified as being in need of improvement.

The service was fun, lively, stimulating and inclusive. Staff ensured that all people were provided with access to events and meaningful activities to meet people’s interests. There were adaptations to the type of activities to ensure they were accessible for all. These included garden parties, summer fairs, sports days and pantomimes. People were involved in choosing the events and activities. They were encouraged to become involved in facilitating these. They helped out on stalls at the summer fair and took part in races during the sports day. These events and activities provided people with opportunities for improved socialisation. The registered manager and staff ensured that people led fulfilled lives. People had learnt new skills and were encouraged to participate in activities that they were interested in. One person had got married and people and staff had been involved in the preparations and the wedding itself.

There was a registered manager in place. A registered manager is a ‘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. Comments from people, their relatives and visitors, staff and healthcare professionals were positive about the leadership and management. They recognised that the registered managed ensured that the service people received continually improved. The provider and management team were proactive and involved in projects to monitor people’s health, provide access to integrated healthcare and to develop the service and practices of staff.

The provider had a clear set of values that all staff embraced. These encompassed a person-centred approach and these values were embedded in the culture and the practices of staff. The provider and management team had good quality assurance processes and audits that monitored the practices of staff and the effectiveness of the systems and processes at the home. Action plans were implemented as a result of audits to ensure that any improvements noted were planned for and completed. The provider, management

Burleys Wood is registered to accommodate up to 60 people who require nursing care or support which their personal care. At the time of the inspection there were 55 people using the service. The premises was purpose built and accommodation was provided in six units over two floors. Each unit comprised of 10 en-suite bedrooms, a communal lounge, dining room and kitchenette. There was level access throughout the service and grounds and a shaft lift to the first floor.

This comprehensive inspection was unannounced and took place on the 14 October 2015.

The service did not have 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. The service was being managed on a day to day basis by an acting manager who was being supported by the area manager and senior management team.

The provider had systems in place to assess and monitor the quality of the services provided. However these had not been consistently followed. Therefor shortfalls had not always been identified and rectified. This is an area of practice that needs improvement.

People were positive about the service and were able to see their friends and families as they wanted. All the visitors we saw told us they were made welcome by management and staff. A relative told us “We’ve noticed that they don’t just look after the residents here, but they look after the families and relatives too, everything has always been to our expectations and (person’s name) has been very happy here”.

Everyone we spoke with liked the home cooked food and told us there was a choice of what and where to eat at meal times. One person told us “The food is very good”. Another person told us “I enjoy my meals, the food is excellent, we’re a bit spoilt really”. People who needed help to eat and drink were supported appropriately.

Staff knew the people they were supporting and were aware of their personal preferences, likes and dislikes. Care plans were in place detailing how people wished to be supported and people and / or their representatives were involved in making decisions about their care. Where people lacked the capacity to make specific decisions they were being supported to make decisions in their best interests. They were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.

People and their visitors described staff as being kind, patient and considerate. One person told us “I know they really love me here and they’ll give me a kiss and a cuddle if I want one”. Another person told us “They’re very friendly (the staff), you can always have a laugh and they always seem to work well together”.

It was clear that people enjoyed the group activities on offer and the visits by entertainers. The activity staff spent one to one time with people that did not want to join group activities. A reminiscence area had been initiated on the ground floor referred to as ‘the street’ specifically to help engage and stimulate people living with dementia.

There was enough staff with the right skills and experience to meet people’s needs. One person said “You ring your bell and they’re here like a rocket. Even if you accidentally knock it and it goes off, they don’t make you feel awkward”.

Systems for recruiting new staff included security and identity checks and at least one reference from a previous employer. Staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to the acting manager or senior member of staff.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. They felt supported within their roles, describing an ‘open door’ management approach, where the acting manager and management team were available to discuss suggestions and address problems or concerns.

People were positive about the management of the service. One person told us “Our friends that come couldn’t believe how good it was here and we spoke to (acting manager) to tell her so”. People and relatives alike all said that they had no hesitation in raising concerns or complaints with the management and that they felt they were approachable and would be listened to. One person told us “You only have to mention something and if they can they’ll act upon it”.

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed and emergency procedures were in place in the event of fire.

We spoke with four people who lived at the home and three relatives. They were all happy with the care provided. One person said, "I'm happy here, very happy here." Another said, "They look after me well." One relative said about the staff, "They are really kind, they really are."

We looked at the care records of three people. We saw evidence that their needs were assessed and that care was planned and delivered in line with their needs.We also saw evidence that people's consent was obtained for care and treatment.

We found that appropriate arrangement were in place to obtain and keep people's medicine. We saw that medicines were administered to people safely. We also saw that people were able to look after and take their own medication when they wished and were able to do so.

We spoke with three members of staff. They all said they had received sufficient training to enable them to deliver care safely and to an appropriate standard. They all said they felt well supported by their manager.

We saw that the provider had an effective complaints system in place. We saw evidence that complaints were listened to and acted upon.

Due to people’s complex needs, many people were not able to tell us about their experiences. We used a number of different methods such as observation of care, the Short Observational Framework (SOFI) and reviewing of records to help us understand the experiences of people using the service.

At our inspection visit we spoke with three people living at the service, and two relatives. All were pleased with the care provided. People told us that care and support had been well managed. This included social support, and one person said “I like doing the exercises, I like joining in things. The activities staff are very good.” One person said it had been “the right choice” to admit their relative to Burleys Wood.

People told us that their medicines were being managed well. They told us that care workers were kind and considerate and did their job well.

We observed that people were being cared for well, and that care workers had the right skills to provide the support people needed. We found that the provider had systems in place to monitor the safety and quality of the service, and that action was taken to address any issues identified.