This inspection took place on 17 and 19 October 2017 and was unannounced.

Maurice House provides care and support for up to 77 people. Maurice House has 47 bedrooms, large and small communal areas, a dedicated activities room and a well maintained courtyard with step-free access to a large garden with several seating areas. Maurice Lodge is a purpose built dementia care unit set in the grounds of Maurice House in Broadstairs. Maurice Lodge has 30 bedrooms and three themed units; Farm, Beach and Woodland. Each unit has its own dining area, conservatory and enclosed garden. A central ‘hub’ was the hive of activity where people chose to spend much of their time together. Like each of The Royal British Legion services Maurice House is exclusive to ex-Service people and their dependents. At the time of the inspection there were 76 people living at the service, some of whom were living with dementia.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 registered manager was present on the day of the inspection and was supported by a deputy manager.

At the last inspection in November 2015 the service was rated Good and outstanding in the caring domain.

At this inspection we found the service remained Good and good in the caring domain.

Why the service is rated Good

People told us they felt safe living at Maurice House and Maurice Lodge. Risks to people were assessed, managed and reviewed and action was taken by staff to keep people as safe as possible. People were protected from the risks of abuse, discrimination and harm and staff were confident to raise any concerns.

The registered manager followed safe recruitment processes to make sure staff employed were of good character and safe to work with people. There were enough staff on each shift and this was monitored and amended when people’s needs changed. People received effective care from staff who were knowledgeable and trained to carry out their roles.

People’s medicines were managed safely. Changes in people’s needs were identified quickly and staff contacted health care professionals for additional support and guidance when needed. People enjoyed a healthy and balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood the importance of giving people choices and gaining people’s consent.

Staff understood the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called DoLS. Applications had been made in line with guidance.

People were treated with kindness, compassion and respect and their dignity was promoted and maintained by staff. There was a strong, visible culture which centred on people being empowered to live their lives as fully as possible.

People were given the information they needed, when they needed it and in a format that they could understand. Signs around the service were mounted low enough to make sure people could see them. ‘Hearing loops’, large print information and magnifiers were available for people with sensory impairments.

People’s choices for their end of life care were discussed, recorded and reviewed to make

We spoke with people and also observed the interactions between people and staff. There were 45 people using the service at the time of our inspection. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad. Everyone we spoke with expressed that they were very happy living at Maurice House. One person commented, “I’m very well looked after. I get everything I need. I couldn’t ask for more”.

People were asked to give consent and were involved in the decisions about the care and support they received. People told us that they were asked for consent before any care took place and their wishes respected. One person told us, “If I need assistance with something, staff explain what they are going to do and how they will to do it”.

People told us that they received the care and support they needed to remain well and healthy. We saw records to show how people's health needs were supported and that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

We observed that the provider had provided an environment that was suitably designed and adequately maintained. The home was clean and free from offensive odours.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We spoke with people who use the service, relatives, staff members and the Registered Manager. There were 47 people using the service at the time of our visit.

Everyone we spoke with expressed that they were very happy living at Maurice House. We observed interactions between the people and the staff and also people’s reactions to the staff. We observed to see how people were.

People told us that they had the care and support they needed to remain well and healthy. They said they were involved in decisions about their care and support. Everyone we spoke to had positive things about the staff like, “The staff are all great” and “The Manager and Deputy Manager are fantastic.”

People said they liked living at the service and felt safe. One person told us, “I feel safe here.” Another commented, “I wouldn’t want to be anywhere else.”

Staff engaged with people in a warm and positive way and supported people where needed.

This inspection took place on 11 and 12 November 2015 and was unannounced.

Maurice House has 47 bedrooms and is a Royal British Legion care home in Broadstairs. Like each of the Royal British Legion services Maurice House is exclusive to ex-Service people and their dependents. At the time of the inspection there were 45 people living at the service, some of whom were living with dementia.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 registered manager was present on the day of the inspection and was supported by a deputy manager.

People told us that they felt safe living at the service. One person said, "I can get up and go to bed when I like and it feels safe, safer than living at home on my own, where I had a few falls". People looked comfortable with other people, staff and in the environment. Staff understood the importance of keeping people safe. Staff knew how to protect people from the risk of abuse.

Risks to people’s safety were identified, assessed and managed appropriately. People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines. Accidents and incidents were recorded and analysed to reduce the risks of further events. This analysis was reviewed, used as a learning opportunity and discussed with staff.

Recruitment processes were in place to check that staff were of good character. There was a training programme in place to make sure staff had the skills and knowledge to carry out their roles effectively. Refresher training was provided regularly. People were consistently supported by sufficient numbers of staff.

People were provided with a choice of healthy food and drinks which ensured that their nutritional needs were met. People’s health was monitored and people were referred to and supported to see healthcare professionals when they needed to.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People and their relatives were involved with the planning of their care. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Staff knew people well and reacted quickly and calmly to reassure people when they became agitated.

People were supported by staff to keep occupied and there was a range of meaningful social and educational activities available to reduce the risk of social isolation. People, their relatives and health professionals were encouraged to provide feedback to the provider to continuously improve the quality of the service delivered. People knew how to raise any concerns and felt listened to.

Staff had an in-depth appreciation of people’s individual needs around privacy and dignity. Staff were highly motivated to provide kind and compassionate care to people and felt it was very important to also support people’s relatives. Staff told us it was essential for people to be supported to be as independent as possible for as long as they could.

People and their loved ones were involved in the planning, decision making and management of their end of life care. The registered manager and staff made sure that people were supported at the end of their life to have a comfortable, dignified and pain free death. Staff displayed distinctive skills in this area of care and also supported people’s friends and family with empathy and understanding.

The registered manager coached and mentored staff through regular one to one supervision. The registered manager worked with the staff each day to maintain oversight of the service. Staff were clear about what was expected of them and their roles and responsibilities and felt supported by the registered manager and deputy manager.

Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager had submitted notifications to CQC in an appropriate and timely manner in line with CQC guidelines.