• Care Home
  • Care home

Archived: The Brake Manor

Overall: Inadequate read more about inspection ratings

97 Bodmin Road, St Austell, Cornwall, PL25 5AG (01726) 61518

Provided and run by:
Morleigh Limited

Important: We are carrying out a review of quality at The Brake Manor. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

24 November 2016

During a routine inspection

We carried out this unannounced comprehensive inspection of The Brake Manor on 24 November 2016. At the previous comprehensive inspection on 3 November 2014 the service was meeting the requirements of regulations. Following concerns raised with the commission in March 2015 we carried out a focused inspection. The concerns related to people not having a choice as to when they got up and went to bed, a lack of access to snacks in the evening, male residents not being supported to shave and people’ not receiving adequate support with other aspects of personal care. The inspection found the allegations were unfounded.

We undertook this comprehensive inspection of the service as we had received concerns in respect of the care and welfare of people using the service. The concerns raised were that staff did not know what a person’s needs were when ambulance staff requested the information. Also, that where people were at risk from skin damage, staff were not supporting them as instructed in their care plan to minimise this risk.

The provider for this location is registered under the legal entity of Morleigh Limited which is responsible for a group of nursing and residential care homes.

The Brake Manor is a care home which provides accommodation for up to 26 people who require residential care. At the time of the inspection 25 people were living at the service. Some people were living with dementia. The Brake Manor is a three story house set in an elevated position in its own grounds. The service had a range of aids and adaptation in place to meet the needs of people living there.

The service is required to 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 Brake Manor had two registered managers in post until September 2016 when one left. The current registered manager had been managing the service on a part time basis three days a week. The registered manager was not available throughout the inspection although they had been made aware of our presence in the service and did visit the service on the day. At the time of this inspection a newly recruited full time manager had been in post for eight days.

Systems and processes to ensure good governance were not being effectively operated. Records relating to managing the health and care needs for people were not always being updated or completed by staff. People’s fluid intake was not being recorded as instructed in the care plan. There were gaps in records to demonstrate people had been repositioned regularly to prevent pressure sores.

Medicines were not being managed safely. There had been no audit of the medicines system since July 2016. The medicines trolley was dirty and disorganised. There was no evidence of stock rotation. Medicines were being used when the use by date had expired. There were gaps in the records of when creams had been applied and they were not consistently signed as given. Medicines were not being returned to the pharmacist as required. Medicines requiring stricter control were not being managed safely. The level of stock of these medicines did not reconcile with the records. We found one person was not receiving their medicine as prescribed. There were regular errors in recording medicines which required stricter controls.

Records to show when people had been repositioned due to the risk of pressure damage to their skin, were not always taking place or being recorded. One person who had been identified as requiring repositioning and had no record to show this had occurred throughout the day of the inspection. This person’s care records had not been updated since May 2016 and therefore staff did not have the accurate information to enable them to deliver safe and effective care. Staff were relying on daily information from the manager. Another person required regular re-positioning. The associated records were not clear. They did not record the time or frequency of change. They did not show what position the person had been in prior to the change and what position they were in when the staff had completed the change. This meant the information could not be relied upon and we were unable to establish if people were receiving the care and support required to protect them from identified risk.

Records relating to managing the health and care needs for people were not always being updated or completed by staff. People’s fluid intake was not being recorded as instructed in the care plan. One person’s health had been deteriorating for some time and a professional told us they had only recently been made aware of this person’s needs in order to carry out a health assessment. The person had experienced a weight loss of 10kgs in the period August 2016 to October 2016. A record of the person’s food and fluid had been put in place to allow staff to monitor if they were getting enough to eat and drink. Fluid records did not show the minimum daily amounts the person should be consuming. This meant staff would be unaware if the person’s intake was enough to maintain their well-being. Daily fluids recorded were not totalled or reviewed. Where people were at risk of losing weight due to a poor appetite or being unable to eat independently they had their weight recorded. However, these weight records were not being reviewed regularly to ensure that any loss of weight was identified and action was taken to address the concern. This meant care and support was not being monitored effectively.

Information in care plans was not always accurate because they had not been reviewed or updated. For example a person had recently been discharged from hospital back to the service and their needs had changed. Staff told us they had been updated about the person’s needs verbally by the manager. However the person’s care plan was last reviewed in May 2016 and did not reflect their current needs.

The service did not have robust recruitment procedures in place. We found staff were starting work in the service before the organisation had received satisfactory Disclose and Barring Service (DBS) checks. In one instance an employee had no record of the date they started working in the service or whether a satisfactory Disclosure and Barring Service (DBS) check was in place at the time the staff member started work. These are used to help ensure staff are suitable to work in the care sector. In two other instances recruitment files showed one person had started working at the service ten days before a completed DBS check had been received and another twenty-one days before a satisfactory DBS check had been received. The failure to complete necessary checks before allowing staff to provide care exposed people to unnecessary risk.

The environment was not being suitably maintained and there was a general air of neglect. There was evidence of some water damage to the ceiling of a bedroom on the third floor. This room also had the top drawer missing from a chest of drawers. A room on the first floor had been a bathroom. The bath had been removed although the toilet was still operational in this room. There was no floor covering for this room. Two hoists were also being stored in this room and there was a sliding door with no lock. The dignity of people using this toilet was therefore not maintained.

There was a lack of signage which would support people to move around the service independently and recognise bathroom, lounge and dining areas as well as their own rooms. This did not support the needs of people who were living with dementia, and needed prompts to help them to recognise their surroundings.

Systems for recording daily records were not robust. This was because staff removed all care plans from the office and completed the daily logs in the lounge area. However, there were occasions when staff needed to respond to call bells etc. This meant staff sometimes had limited time to complete the daily logs. In some instances staff told us they verbally passed on information to their colleagues about an event and relied on the staff member to record this.

Staff were not always being regularly supported in their role. Staff told us that, due to recent changes in managers, supervision had lapsed. Two staff files did not have any supervision records in place. Staff files were loose leaf resulting in information being difficult to find. There was a supervision matrix in place. It showed the previous manager and four of the care staff had not received supervision at all during 2016. This meant not all staff were receiving the level of support they needed to help them carry out their role and develop their learning.

Staff were caring but were not always available to people in lounge areas for any length of time to provide meaningful support. For example, two people without mobility in reclining lounge chairs spent most of the morning sleeping. They remained in the chairs when being supported with their lunch. There was little interaction seen between them and the staff members on duty. Staff were respectful and sensitive when speaking with them but there were periods of time when they were on their own without any environmental stimulation other than music playing or television. Neither seemed particularly interested in these pastimes.

People had mixed views about meals provided by the service. Some people told us they liked the food and others said it could be improved. In general we found that the quality of food was adequate though not of a high quality. Comments included, “It’s not been as good as usual today” and “I have changed my mind and had the alternative.” Other people told us they were not happy with the food in general. Comments included, “It’s

16 March 2016

During an inspection looking at part of the service

We carried out this focused inspection in response to concerns raised about the environment and the care provided to people at the Brake Manor. The concerns were about people not having a choice about when to get up and go to bed and lack of choice about some elements of their personal care. There were concerns that people did not have access to snacks in the evening and during the night. Some people were not supplied with the appropriate moving and handing equipment to meet their needs. There were unpleasant odours in the building and some sinks did not have hot water. Staff did not have access to suitable protective gloves and hand sanitiser to help prevent and control the risk of infection.

This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Brake Manor on our website at www.cqc.org.uk. The service was last inspected in November 2014; we had no concerns at that time.

The Brake Manor is a care home which is registered to provide personal care for up to a maximum of 26 older people, some of whom had a diagnosis of dementia. On the day of the inspection there were 23 people living in the service.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

At this inspection we did not find any evidence to substantiate the concerns raised. When we arrived at 9.30am in the morning most people were up, eating their breakfast and staff were assisting other people to get up. There was an unrushed, relaxed atmosphere and staff were working with people at their pace. It was clear from speaking with people and staff that people had chosen when they got up and went to bed.

People’s individual care plans recorded their preferred choices and routines. We observed staff asking people for their consent before delivering care. People were involved in making choices about how they wanted to live their life and spend their time.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Staff supported people with their personal care needs and people looked clean and well cared for.

The building was clean, well maintained and free from any unpleasant odours. There was hot water, set to the correct temperature, in the sinks in people’s rooms and in shared bathrooms. The registered manager advised us that a few weeks prior to our visit the rooms on the top floor had been without hot water for two days due to a fault with the boiler. Once the fault was repaired hot water was restored to these rooms.

Staff told us there were plentiful supplies of suitable gloves for them to use and they had access to hand sanitiser. This meant people were protected from the risk of infection because there were systems in place to prevent and control infection.

We found people had access to appropriate moving and handing equipment. The registered manager sought advice from healthcare professionals, such as community nurses and occupational therapists, to ensure people were assessed for the right equipment.

Staff supported people to maintain a balanced diet appropriate to their dietary needs and preferences. People were able to choose where they wanted to eat their meals, in either one of the lounges, dining room or in their bedroom. People had a choice of meals and had access to snacks throughout the day, evening and during the night. One person told us, “Yes the meals are very, very good. I like a hot drink before I go to bed and a biscuit or something.”

People who were able to express a view of the service told us they felt safe living there. Comments included, “Not sure how long I have been here, but I like it” and “I am very happy here, this is my home.” We observed people were relaxed and at ease with staff, and when they needed help or support they turned to staff without hesitation.

People had a good relationship with staff and staff interacted with people in a caring and respectful manner. One person told us, “You can always talk to staff and they will stop and listen to you. I can’t fault them.”

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.

3 and 4 November 2014

During a routine inspection

This was an unannounced inspection which took place on 3 and 4 November 2014.

The Brake Manor is a care home which is registered to provide personal care for up to a maximum of 26 older people. Many people living in the home have some form of dementia.

There was a registered manager in post who was responsible for the day-to-day running of the home. 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.

At this visit we looked at what action the provider had taken in relation to concerns raised at our last inspection on 16 September 2014. These concerns related to the lack of clear guidance for staff to follow when providing care to meet people’s individual needs and a lack of robust care plan auditing systems. At this inspection we found improvements had been made in these areas and the provider had met the relevant legal requirements.

On the day of the inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a friendly and respectful way. People were encouraged and supported to maintain their independence. They made choices about their day to day lives which were respected by staff.

The registered manager had implemented an effective quality assurance system to make sure that any areas for improvement were identified and addressed. However, there was no system in place for the quality of the service provided to be monitored at the provider level by an auditing process external to the home. There were systems in place to seek people’s and their families views about the running of the home.

People told us they felt safe living at the home and with the staff who supported them. Visitors also said they felt the home was a safe place for people to live. A visitor said, “As care homes go this is good compared with others I have visited.” One person said, “I feel very fortunate to be here. Care is good and there is nothing untoward here.”

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns. The staff were confident that any allegations made would be fully investigated to help ensure people were protected from abuse and neglect.

People and their families were given information about how to complain. People told us if they had a concern or complaint they would speak to the registered manager. People told us they saw the registered manager every day when she was on duty as she administered the medication and described her as a, “very hands on person”.

People were well cared for and were involved in planning and reviewing their care. There were regular reviews of people’s health and staff responded promptly to people’s changing needs. Staff had good knowledge of people including their needs and preferences. Staff were well trained and there were good opportunities for on-going training and support and development..

People’s privacy was respected. Staff ensured people kept in touch with family and friends. Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors in communal areas or in private.

There were activities on offer such as; quizzes, craft work, pamper sessions, singing sessions and board games. External activities were arranged such as people who visited with owls and PAT (pets as therapy) dogs. A local clergyman visited once a month and people had the opportunity to take holy communion should they wish. One person said, “I enjoy quizzes, letter box, the visit of the owl man and snakes & ladders”.

There was a management structure in the home which provided clear lines of responsibility and accountability. People told us the registered manager and deputy manager were very approachable and regularly asked them for their views of living in the home. A regular visitor said, “There is generally a good atmosphere here”.

There was a positive culture within the staff team with an emphasis on putting the people who lived in the home first. Staff consistently interacted with people in a friendly and reassuring manner as they worked with people. Staff felt supported and enjoyed their work. They told us the managers were, “lovely” and “you can talk to them”.

16 September 2014

During an inspection looking at part of the service

This inspection was carried out by two inspectors in one day. We carried out the inspection to check what action the provider had taken in relation to the concerns raised at our inspection on 17 June 2014.

We gathered evidence against the outcomes we inspected to help answer our five key questions: is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Overall we found The Brake Manor to be safe.

During this inspection we spoke with four people living in the home, two visiting relatives, one visiting health worker and four of the care staff on duty.

We saw that people were treated with dignity and respect by the staff. People we spoke with told us 'can't fault it [the home]' and 'I like it here '.

At our inspection on 17 June 2014 we found people's needs were not always met because care records did not accurately reflect their current needs. Vital information for staff to follow was not recorded in care records, which meant staff did not always have sufficient information to meet people's needs. At this inspection we found improvements had been made to people's care plans and these had been updated to mostly reflect people's needs.

At our inspection on 17 June 2014 we found there were not always enough staff on duty to meet people's needs. At this inspection we spent time in the communal areas and observed interaction with people to check if there were enough staff to safely meet people's needs. We found there were adequate numbers of qualified, skilled and experienced staff to meet people's needs.

Is the service effective?

Overall we did not find The Brake Manor to be effective.

People's health and care needs were assessed and specialist dietary, mobility and equipment needs had been identified in care plans where required. Staff we spoke with showed they understood people's needs.

At our inspection on 17 June 2014 we found where people lacked capacity, assessments of their ability to make specific decisions about their care had not been completed. At this inspection we found people's capacity to make daily decisions had been assessed. Care plans detailed the daily decisions people could make and how staff could support them to make their own decisions. This meant staff understood how to support people to make decisions about their care because areas where they could make decisions were identified.

At our inspection on 17 June 2014 we found care plans did not give staff sufficient information for them to effectively meet the needs of people who had complex behavioural needs. At this inspection we found where people could display challenging behaviour care plans had not been updated to give staff guidance about how to respond to people when their behaviour became challenging.

Is the service caring?

Overall we found The Brake Manor to be caring.

We observed people in the main lounge and dining room area throughout the six hours of the inspection. We saw staff interaction with people was caring and considerate.

People we spoke with told us staff were kind and caring. Relatives we spoke with also told us staff were attentive to people's needs and they were confident people living in the home were well cared for.

Is the service responsive?

Overall we found The Brake Manor to be responsive.

The Brake Manor gave clear information to people about how to complain. The home had not received any complaints since our last visit in June 2014. Relatives we spoke with told us whenever they raised any concerns these were listened to and dealt with promptly. This meant that any concerns were dealt with quickly and resolved without the need to formally complain.

We spoke with a visiting health worker who told us the home responded well to people's changing needs and reported any health concerns to them in an appropriate and timely manner.

The home had an activities co-ordinator who arranged group activities such as arts and crafts, singing sessions and quizzes as well as individual one-to-one activities with some people.

Is the service well-led?

Overall we did not find The Brake Manor to be well-led.

At our inspection on 17 June we found care plans were not robustly reviewed and did not give staff clear guidance to ensure people's needs were met safely and effectively. This was particularly in relation to people who had complex communication or mobility needs.

At this inspection we found care plans had been reviewed and in most areas gave staff guidance about how to provide care that met people's needs. However, we found staff were still not given clear guidance and direction about how to manage and understand people who had complex behavioural needs.

We found the provider had not always sought guidance from appropriate professionals to assess people's behavioural needs and provide knowledge based advice for staff about how to meet those needs in practice.

17 June 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions: is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Overall we did not find The Brake Manor to be safe.

During our inspection we spoke with eight people living in the home and two visiting relatives. People told us they felt safe and their privacy and dignity was respected. Comments from people included, 'you couldn't find a better home', 'I feel safe here', 'It's lovely here, couldn't be better, I'm happy' and 'they {staff} always knock on my door before entering'.

However, people's needs were not always met because care records did not accurately reflect their current needs. Vital information for staff to follow was not recorded in care records, which meant staff did always have sufficient information to met people's needs.

There were not enough staff on duty to meet the needs of the people living at the home. We have asked the provider to tell us what actions they intend to take to meet the requirements of the law in relation to people's care and staffing levels.

Is the service effective?

Overall we did not find The Brake Manor to be effective.

During our inspection we observed staff caring for people. It was clear from our

observations and from speaking with people that staff had an understanding of people's needs.

We found the service had obtained consent from people, or their representatives, and acted in accordance with their wishes. However, we found the provider was not meeting the requirements of the Mental Capacity Act (MCA). This was because where people lacked capacity, assessments of their ability to be involved in and to make specific decisions about their care had not been completed. We have asked the provider to tell us what actions they intend to take to meet the requirements of the law in relation to MCA.

People's health and care needs were assessed. However, assessments of people's mobility and equipment needs had not been updated and did not accurately reflect the care being provided.

We identified during this inspection that the low levels of staff on duty impacted on the ability of staff to meet people's needs effectively.

Is the service caring?

Overall we found The Brake Manor to be caring.

During our inspection we spoke with eight people living in the home and observed staff interaction with people. People we spoke with told us staff were caring and attentive to their needs. We observed staff responded to people in a kind and caring manner.

Comments from people about staff included, 'staff are really wonderful' and 'you can't fault the carers'.

Is the service responsive?

Overall we found The Brake Manor to be responsive.

People told us the home had responded when they became unwell and taken appropriate action. One person told us, 'Recently I had heart problems in the middle of the night, it was dealt with quickly, paramedics came and took me to Treliske'.

The home provided group activities such as arts and crafts, singing sessions and quizzes as well as individual one-to-one activities with some people. Most people we spoke with did not express a view about the activities on offer.

Is the service well-led?

Overall we did not find The Brake Manor to be well-led.

The home worked with external health professionals to ensure people's health needs were met. Care files we looked at showed evidence of the home working with GPs, community nurses, community mental health nurses and dieticians.

The provider asked people who used the service, their families and professionals for their views about their care and treatment and used any feedback to improve the service.

However, the provider did not have an effective quality assurance process to monitor how they provided care. The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.

Care plans were not robustly reviewed and did not give staff clear guidance to ensure people's needs were met safely and effectively. This was particularly in relation to people who had complex communication or mobility needs. The provider had not carried out a needs analysis and risk assessment of people's needs as the basis for deciding on sufficient staffing levels to meet people's needs.

27, 28, 29 January 2014

During an inspection in response to concerns

None of the people who lived at The Brake Manor told us they were unhappy there, but there were some negative comments about their lives there and the care from the staff. We saw little evidence of people consenting to their care or being involved in their care. We saw evidence of care that was task driven rather than personalised to the individual.

We were shown that there was a robust system in place to order, store and dispense people's prescribed medicines.

People who used the service, and the staff, told us there were not enough staff on duty to meet people's needs.

22 May 2013

During a routine inspection

People who lived at The Brake Manor told us staff were kind and helpful. One person said 'it's a nice home, they do good food' and they 'are a nice lot of girls'. Another person told us 'I made a choice to move in here, I can't find any fault, I love it here'. We saw there were a range of activities available that included quizzes, movie afternoons and outside entertainers.

The care records reflected people's care and support needs and associated risk assessments.

We were shown that there was a robust system in place to order, store and dispense people's prescribed medicines.

People who used the service and staff told us there were enough people on duty to meet people's needs. We looked at three staff files and found they included all the required information.

The training records showed that staff had undertook a variety of training including fire safety, dementia care, safeguarding and medicines management.

11 May 2012

During an inspection in response to concerns

Some of the people that used the service at The Brake Manor had dementia and therefore not everyone was able to tell us about their experiences. To help us to understand people's experiences, we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allowed us to spend time watching what was going on and helped us record how people spent their time, the type of support they got and whether they had positive experiences.

We spent 45 minutes observing life for people in one of the sitting rooms. There were 12 people in the room during that time. For the first 30 minutes there was no activity other than the television. After 30 minutes one person began to sing and other people joined in. Three people began to reminisce about music memories. The staff member used this as an opportunity to ask if everyone would like some music on for a sing a long. The staff member switched off the television, without asking people if they had finished watching it, and began to ask people about music choice. During this time, the staff member had to leave the lounge to answer a call bell. They returned within 5 minutes and put some music on. During the time that the staff member was absent, there was no stimulation for people in the lounge.

Throughout the 45 minutes, we observed interactions that were mainly task orientated. Such as assisting people to sit down and placing blankets over people's legs. We saw people being spoken to in child like manner; one comment included 'put your slippers on please', 'don't put that on there please' and 'let me get you some tissues'.

We found that for some people a lack of stimulation meant that they slept or watched each other or staff. One person looked withdrawn and gazed out into the middle distance. People, who were not able to communicate with the majority, were asleep or withdrawn.

During our observation we noticed one person in particular. To begin with we noticed that this person was sitting in a chair gazing into the middle distance. Within 5 minutes this person began to cry. A member of staff comforted the person and re-assured her and held her hand. This demonstrated good interaction, and showed that the staff member had genuine affection, care and concern for the person.

During our 45 minute observation we observed that this person attempted to get up and out of a chair four times. Each time this person tried to get up and walk away from the lounge area, comments from staff included, 'just stay there a minute', 'X where are you going' and 'no please stay there'. This interaction was disempowering to the person, and did not allow the person to participate in what they chose to do. The person was never allowed to leave the lounge during our observational time.

On one occasion the person started to cry again. A comment from a member of staff included 'what's the matter now X'. One person who lived in the home noticed that this person was crying and attracted the staff's attention; a comment from one staff member included 'I know that she is crying; there isn't anything I can do'.

We noticed that this person had a bruise to the left side of her face, we spoke to the manager, looked at this persons care records and looked in the accident book, all of which confirmed that this person had had some recent falls. We saw that this person was undergoing tests in relation to the falls. The care plan was not updated to reflect how the person now needed to be managed

We observed a staff member discussing this person with a colleague. They told their colleague, 'I don't know where to put her, she won't sit down'. The advice given was 'why don't you go and sit with her'. The advice that was given demonstrated that this staff member understood how important providing reassurance and comfort was for a person.

We spoke to one person who was in their bedroom. We observed that there was no radio or TV in this person's room and that they were sitting in silence. We asked the person if they would enjoy having a radio or TV in their bedroom. We were told by the person that 'you have to pay extra'. We asked this person if they had enough to do during the day, they replied and told us that they 'get bored'. We spoke to the manager about this person, they confirmed that it was no extra money to have a TV or radio in people's bedrooms and that the person we spoke to usually enjoyed spending time with others in the lounge and not in her bedroom.

Overall the atmosphere in the home during our visit was relaxed and we saw that there was a positive rapport between the people who lived in the home and the staff.

One person told us 'all the staff are absolutely marvellous. I have no complaints', 'cook is wonderful'.

Many people that we met were not able to comment specifically on the staffing levels and staff skills at the home, but we observed that some staff were more attentive than others.

We saw people living at the home appeared relaxed and at ease with the staff. However, there were times during the 45 minute observation that staff behaviour was not person centred and was task oriented.

2 December 2011

During an inspection in response to concerns

We carried out a site visit on 5 October 2011. The people we spoke to said they were very happy living in the home and with the care and support they receive. One person said they 'could not fault the staff'. People were very positive about the staff support they received. We saw people's privacy and dignity being respected and staff being helpful and there were no issues raised by people using the service or staff.

We saw that the routines being observed during the site visit that people are able to get up when they want and have choices about where they spend their time.

People told us that they liked watching the old movies that are put on regularly and were going to join in the quiz that was on during the afternoon of our site visit.

We saw that a number of people were able to move around the home independently and that the staff were offering appropriate support and guidance. We saw that calls for assistance were responded to quickly and appropriately.

People told us that the staff are kind and helpful and they felt safe in the home. Those that could tell us said there would be no problem voicing concerns to staff or the manager if the need arose.

Staff told us they enjoy working in the home and they felt that they work well as a team.

People using the service told us that the staff are very kind and caring and they are well cared for. They added that they 'only have to ask' when they need anything. They thought the staff were busy but helpful.