This inspection took place on 19 June 2018 and was unannounced.

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Devonshire Manor is a residential care home for up to six people living with an acquired brain injury. It is situated close to the centre of Nottingham. The home has six bedrooms, with en-suite facilities, over two floors with stairs.

The home has six bedrooms, with en-suite facilities, over two floors with stairs.

At the time of this inspection there were three people using the service.

The service had a registered manager. This 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 home had a welcoming atmosphere. Staff were visible and continually speaking with people they supported. People told us they felt safe at the home and there were enough staff to meet their needs. Staff knew how to minimise risks to people and ensure they had their medicines when they needed them.

Staff were trained, skilled and knowledgeable about how to provide effective care and support.

People were involved in choosing; planning and preparing their own meals and records showed people's nutritional needs were identified and met. Meals were varied. The kitchen was open for people to use in the company of staff.

People's healthcare needs were well-managed at the home.

The premises were homely and comfortable apart from paint damage in two bedrooms.

People said the staff cared about them and encouraged them to be independent. Staff communicated with people in the way people wanted including writing messages and speaking with people.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems at the home supported this practice.

Activities were seen as important to people's quality of life at the home and staff ensured people had the opportunity to take part in one-to-one activities both in the home and the wider community. These included social and leisure activities based on people's preferences.

The home was well-led by the new registered manager. There was a culture of openness at the service and the registered manager was supportive. People and relatives were involved in how the home was run and their views listened to and respected. The results of the annual quality assurance survey showed a high level of satisfaction with the service provided.

Further information is in the detailed findings below.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Devonshire Manor on our website at www.cqc.org.uk

This inspection took place on 10 December 2015 and was unannounced. Devonshire Manor provides accommodation and personal care for up to five people with an acquired brain injury. On the day of our inspection four people were using the service.

Although there was a registered manager they were no longer employed by the provider but they remained on our register at the time of the inspection. A new manager was in post although they had not begun the process of registration. 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.

People felt safe living at the home and were supported by staff who knew how to keep them safe. Risks to people’s health and safety were assessed and steps taken to reduce the risks.

People were supported by a sufficient number of staff and staffing levels were flexible to meet people’s needs. People received their medicines as prescribed and they were safely stored and recorded.

Staff were provided with the knowledge and skills required to care for people effectively and staff felt supported by the manager. People had access to sufficient quantities of food and drink and contributed to the menu choices. People received support from health care professionals when needed.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. We also found staff were aware of the principles within the MCA and how this might affect the care they provided to people.

There were positive relationships between people and staff. People’s views were taken into account when making decisions about their care. People were supported to make day to day choices and staff respected the decisions people made. People were treated with dignity and respect and staff ensured their privacy was respected.

People were provided with care that was responsive to their changing needs and personal preferences and staff encouraged people to be as independent as possible. Whilst people chose not to take part in activities within the home they were able to get out and about regularly. There was a clear complaints procedure in place although no formal complaints had been made.

There was an open and honest culture in the home. There were systems in place to monitor the quality of the service and obtain people’s feedback which resulted in improvements being made.

We spoke with three people who were using the service and asked if they were happy with the care they received. One person said, “I am happy here and they meet my needs. I am involved in my care planning.” We were also told, “I would give them nine out of ten. I go out quite a lot and there are things to do in the home too.”

Each of the people we spoke with indicated that they felt safe. Each person said they would be happy to report anything of concern to a member of staff or the provider.

The staff we spoke with told us they felt there had been an improvement in the standard of cleanliness since our previous inspection. We saw that a new cleaning schedule had been implemented which identified the cleaning tasks required to be completed each day or each week. New carpets had been laid in the lounge area and in some bedrooms. There was a plan in place to redecorate another bedroom.

We looked at the training records that were provided to us. These indicated that staff had undertaken a range of training since our previous inspection covering areas like safeguarding vulnerable adults, first aid and stroke awareness.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. Records were stored securely and could be located promptly when required.

We spoke with three people who were using the service. Everybody confirmed that they were aware of and involved in planning their care.

We spoke with three people who were using the service. Everybody spoke positively about their experience of living in the home. One person said, “Staff are really good, there is respect there, they don’t talk down to you, they understand your condition”. Another person told us, “They help me do what I can for myself. I have a key worker who is really good we get on like a house on fire, they know what I like for instance. I like coffee in the morning, tea later and they know that”. The people using the service we spoke with told us that they became bored at the home because there was not much to do.

On the day of our inspection we noted that there were some cobwebs on the landing. This may indicate that cleaning of this area was not always effective. We also noted some discolouration of paintwork which indicated some areas required a fresh coat of paint.

Appropriate checks were undertaken before staff began work. We looked at the supervision records for all of the staff employed at the service. We saw that only one member of staff had received formal supervision since January 2013.

There was an appropriate complaints procedure available which people using the service were aware of.

We talked with two people who were using the service during our visit. We asked the people we spoke with if staff treated them with dignity and respect. We were told, “Yes staff are much nicer now.” and “Yes.”

During our visit we saw that staff were providing assistance to people as they needed it. The staff we spoke with displayed a good understanding of the needs of different people using the service. On the day of our visit staff were supporting people to carry out daily living activities. Staff also supported some people to access the local community.

Staff had not received appropriate professional development. The majority of training provided was a distance learning package which required staff to read and answer questions. The staff we spoke with indicated they found this method of training was not always suitable and they would prefer more hands on training.

We talked with two people who were using the service during our visit. One person told us they felt they could raise any concerns and it would be listened to, “Yes I think they do listen now.” We saw records to confirm that house meetings had recently been started. This gave people the chance to input into the running of the house and raise any concerns they may have.

People told us they enjoy living at the home and they were happy with the quality of the service provided”.

People told us they feel very safe and secure and felt that the staff are kind, considerate, competent and confident in performing their duties.

People told us that they are asked for their opinions about the quality of service provision through the provision of service user’s questionnaires.

The questionnaires asked people “are you satisfied with the level of care you are receiving” comments included “oh yes definitely, I have good communication with staff which is important and they are helpful” and “I feel that my needs are being met”.

The questionnaire also asked “have you any comments or suggestions you feel could improve the unit” one person commented “nothing springs to my mind, I am happy with the way the unit is run”.