This inspection took place on the 30 November and 5 December 2016 and was unannounced.

The previous inspection was on the 15 January 2014 where all standards inspected were met.

Brookside House is a residential care home providing accommodation and personal care for up to 24 people living with physical disabilities, sensory impairment and learning disabilities. The service is part of Livability a charitable organisation that provides care services nationally.

There is 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.

People told us they were happy living at Brookside House, there was a friendly and welcoming attitude from the registered manager and care staff. There was an ethos that this was people’s homes and that they should be central to any decisions made about what took place there. The registered manager told staff to keep any stresses of running the service in the office and that it should not affect people in their home.

People told us they felt safe at the service and we saw that staff had a good understanding of safeguarding adults and the management team had ensured people understood their rights to a safe and happy life at the service. This had included people living at the service attending safeguarding training and making reporting concerns easier for people to do. Any complaints or concerned raised were responded to and addressed appropriately by the registered manager.

We observed staff to be respectful and proactive they offered support in a caring manner. There were conversations between staff and people whilst undertaking tasks and this promoted a friendly atmosphere in the service.

There were enough staff to meet people’s support needs and there were robust recruitment processes for permanent staff and checks of agency staff documentation before they worked in the service. Staff told us they were well supported by the management team and had received training to support them to undertake their work. Training had included workshops about specific medical conditions that affected some people and they had been invited to attend and share their experiences with other staff to promote greater understanding.

Senior staff were trained to administer medicines and medicine administration records were completed appropriately and were audited to ensure mistakes were not made. People’s care plans described how they showed pain and staff asked people if they required their pain relief to ensure they were pain free. There were no descriptions of the medicines use and side effects in people’s records however we found senior staff were knowledgeable about people’s medicines. The registered manager agreed to ensure medicine information was included in the records as good practice for staff reference.

The registered manager demonstrated they understood their responsibility to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff had received training and obtained people’s consent before supporting them.

There was a variety of meaningful activities for people to attend both inside the service and in the local area. There was a focus on promoting people’s independence and initiatives had taken place utilising assisted technology in a pilot project. People had their own flat with accessible kitchen and bathroom facilities and good support was given by staff to personalise their flats to their own specification.

People told us they were involved with their care planning and that care was provided as they wanted it to be. We saw that care plans were specific to people’s needs, however care plans did not record people’s involvement so we brought this to the manager’s attention who agreed

We spoke with individuals and groups of people. Most people spoke highly of the staff, with one person stating ‘they are very nice to me’. Another said ‘I like it, I haven’t had any problems.’

People felt staff treated them with dignity and respect, and they told us that they were involved in how their care was planned and delivered. One person said ‘I’m treated very well here.’

People's privacy and dignity was respected in the manner staff spoke and interacted with them. We observed staff speaking to people in a caring and calm manner.

We found that care was planned in an individualised way that took account of people’s preferences and that changes in a person’s condition were accommodated in the care planning process. Risk assessments were in place and these ensured people who used the service were cared for safely.

There was a system in place that ensured that all medicines were provided in a way that was safe and adhered to guidance from manufactures and prescribers.

We found that suitably experienced staff were on duty in sufficient numbers to provide safe care to people using the service.

Systems were in place to monitor and to make improvements to the quality of care and support provided to people by the home. Staff said that they felt supported by the service and that they felt able to approach their registered manager with any concerns, knowing they would be acted on.

There were 24 people in residence at the time of our visit and we spent sometime talking to some about the service. We spoke with individual and groups of people. Most spoke highly of staff stating “they’ve been so patient with me,” and “they respect me here, and I respect them.” Most people felt staff treated them with dignity and respect. However, some people told us that staff did not always knock before entering their flat. The manager told us that all staff are aware of the importance of treating people with respect and appeared surprised that this had taken place.

People’s privacy and dignity were respected in the manner staff spoke and interacted with them. We observed staff speaking to people in a caring and calm manner

There were systems in place to ensure that people were protected from abuse and that they received the care they needed. Systems were in place to monitor and to make improvements to the quality of care and support provided to people by the home.

Most staff felt supported by the service and said they felt able to approach their manager with any concerns, knowing this would be acted on.

People were positive about living in the care home and said “I have my own flat. It’s lovely and I’m very happy here”. One person that had only recently moved into the care home told us that “staff have made me feel settled”. People said that they were addressed respectfully and their dignity was maintained. However, although their privacy was respected when personal care was given we were told that carers did not always knock on the door before entering. People knew about their care plan and confirmed that they were involved in the reviews of the plans. They said that they got “enough support” to meet their needs. We asked people whether they were satisfied with the meals service in the home. They told us that “the food is not too bad. We have quite a bit of choice” and “the meals are fantastic”. There were opportunities for people to take part in activities both inside the home and in the community to enable people to have an enjoyable lifestyle.

We asked people if there was someone they could talk with if they had any concerns and people gave us the names of the manager and deputy manager. When asked whether people felt safe and comfortable living in the home and with the people around them and supporting them they agreed that they felt safe. We asked people about the conduct of carers and the manner in which care was provided we were told that “staff get on well with residents”. Most carers were “very thoughtful and understanding” and “kind and caring” although it was remarked that “others need to leave problems behind”. People said that they could discuss any issues relating to staffing with the manager who “wants to know straight away if there is a problem”. They said that they would be listened to and matters would be “put right”. People agreed that the members of staff working in the home were competent and knew what they had to do. Most people told us that there were enough staff on duty to meet the needs of the people using the service and that call alarm bells were answered promptly. When asked about the quality of the care that they received we were told that the caring “deserved ten out of ten” and that “things are very good”.