Little Bramington Farm provides accommodation and personal care for up to 25 people who are elderly frail. At the time of our inspection 20 people were living at the service and one person was having a short term period of respite at the service.

At the last inspection the service was rated good. At this inspection we found the service remained good.

People told us they felt safe living at the service. A visiting relative also said they felt their relative was kept safe. Individual risks to people were appropriately assessed, identified and managed.

There were enough competent staff to provide people with support when they needed it. Staff had been recruited through a robust recruitment process and had received appropriate training and support to help enable them to carry out their roles effectively.

People received appropriate support to eat and drink sufficient amounts to maintain their health and well-being in relation to nutrition and hydration. Specialist diets were provided and professional input was obtained as required.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice in relation to all aspects of their lives.

People, relatives and staff told us, and we observed that people were treated with kindness by staff who respected their privacy and maintained their dignity.

People and their relatives were given the opportunity to feed back on the service and their views were listened to and acted upon.

People received personalised care that met their individual needs. People were given appropriate support and encouragement to access and participate in meaningful activities and to pursue hobbies and individual interests both within the home and in the community.

People were supported to share their views by giving feedback through residents’ meetings or by recording their dissatisfaction in a comments and complaints book located in reception. People knew how to complain if they were unhappy with any aspect of the service and were confident they would be listened to.

There was an open, transparent and inclusive atmosphere within the service. People and staff had regular meetings to discuss the service and think about future developments and improvements they could make.

There were systems and processes in place to monitor the overall quality and safety of the service and shortfalls identified were promptly acted on to improve the quality of the service. People gave positive feedback on the management of the service.

Further information is in the detailed findings below

We received some safeguarding concerns about people using the service at Little Bramingham Farm Residential Care Home. We carried out a responsive inspection and found that the provider was meeting all the standards that we inspected against and the provider had already acted on the concerns that had been raised.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found.

Is the service safe?

Staff had received training on the safeguarding of vulnerable adults and were able to demonstrate their understanding of the different types of abuse. We saw that the provider acted on any concerns that were raised by people who used the service or staff. People we spoke with told us that they were "looked after well". People’s needs had been assessed and monitored; care documents reflected people’s needs and provided care staff with clear information on how to safely care for people. Risk assessments had been put in place for people and staff were aware of the risks and how to manage them.

Is the service effective?

We saw that people living in the home were free to move around and were happy in their surroundings. People told us that staff were quick to respond to them and 'do the best they can' to assist them quickly. They told us that the care they received was "very good". We observed staff were caring towards people and people we spoke with also told us that the staff were very good. We saw that the care plans were regularly reviewed and contained detailed information about the person and their needs. This meant that staff were aware of people’s needs and were able to provide the correct care and support.

Is the service caring?

People told us that staff were "caring" but at night staff were sometimes 'overworked' and made people feel 'uncomfortable' about asking for support at night. People told us that they were happy with the care being provided by most staff, but that at night it was not always the same because staff were overstretched. We observed that the day staff were attentive towards people and people spoke fondly of the day staff. People said that there were no restrictions on what they did and they especially enjoyed going into the garden area of the home, which was always accessible to them.

Is the service responsive?

Care plans and risk assessments were reviewed and any changes required were made. The provider was quick at responding to any concerns within the home, and we saw that where people had raised safeguarding concerns these had been investigated thoroughly by the provider and families and the local authority were also informed.

Is the service well-led?

The provider had a registered manager in post. People we spoke with told us that the home manager was 'hands on' and worked well with people to ensure the home was running smoothly. We saw that the manager was aware of any issues within the home and was also quick at responding to any concerns.

When we visited Little Bramingham Farm Residential Home on 10 December 2013, we spoke with eight people who used the service and three relatives. We also spoke to eight staff members and the registered manager.

We observed good interactions between people and staff. People looked relaxed and comfortable in the company of staff. We saw staff demonstrating genuine affection, care and concern for people.

We found that people were provided with a choice of suitable and nutritious food and drink in sufficient quantities to meet their needs.

The home had systems in place to reduce the risk and spread of infection. A person who used the service said, “My room is cleaned daily and the sheets get changed as and when needed. It’s like a posh hotel.”

We found that the premises were safe and adequately maintained. The equipment used was also safe and fit for its purpose. This meant that people were not at risk of unsafe premises or equipment.

Suitable arrangements were in place to ensure that the staff were appropriately supported to deliver care safely and effectively. A relative of a person who used the service said, “The staff are good at their job. They are caring which is in their culture.”

When we inspected Little Bramingham Farm Residential Care Home on 17 November 2012, we found people were very satisfied with the care and support they received. They told us they felt safe and the staff were friendly and supportive. One person said "I’m well looked after.”

We observed people were offered support at a level which encouraged independence and assured their individual needs were met. The staff were friendly and courteous in their approach to people and interacted confidently with them. We noted that people were encouraged to express their views about the quality of care in the home. They were also involved in planning their care, making decisions about their support and treatment, and how they spent their time. One person talked about the range of activities available to them and said “I love our days out.” Another person told us “They are very on the ball here.” Within the care files we saw people had been involved with, and agreed with the particular care needs that had been identified for them.

During our visit on 07 November 2011, the people we spoke with told us that they receive good care. They said the staff are wonderful, hardworking and helpful.

One person said to us that although overall the staff answer the call bells in a timely way, ‘we sometimes have to wait a while if they are busy’.

People told us they very much enjoy the days out and especially the kite flying on Dunstable Downs.

People were able to take an active part in resident meeting and were able to have their say and felt they were listened to and action taken if necessary.

This inspection was carried out over two days, on 5 and 8 January 2015. It was an unannounced inspection and was undertaken by one inspector.

Little Bramingham Farm Residential Care Home is a registered care home for a maximum number of 25 elderly and frail people. It does not provide nursing care. The home offers accommodation over two floors. There were 22 people living at the home when we inspected it.

At the time of our inspection, there was a registered manager in place. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected, as DoLS applications were in progress and were being submitted to the authorising agencies.

People were assisted by staff in a way that supported their safety and they were treated with respect. People had care plans in place which took account of their needs and individual choices.

People’s medication was administered by staff who had received training to ensure that the medication was administered safely and in a timely manner.

Staff cared for people in a warm and caring manner. They used appropriate techniques to calm people when they were anxious or angry.

Staff were trained to provide effective and safe care which met people’s individual needs and wishes and were supported by the manager to maintain and develop their skills and knowledge by way of regular supervision, appraisals and training.

People were able to raise any suggestions or concerns they might have with the manager and were listened to as communication with the manager was good.

Arrangements were in place to ensure the quality of the service provided to people was regularly monitored.