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Inspection carried out on 1 December 2017

During a routine inspection

95 Bromyard Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 95 Bromyard Road accommodates up to six women in one adapted building, with areas for people to spend time together or more privately as they choose.

Care and accommodation is provided for women with mental health needs. Some people living at the home may also live with learning disabilities.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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

People told us staff talked to them about their safety and that they received care from staff that understood their safety needs. Staff took action to help people to remain as safe as possible. This included when people were developing their independence and trying new things which were important to them. Staff knew what action to take if they had any concerns for people’s physical or emotional well-being and were confident senior staff would put plans in place to protect people if this was required.

There was enough staff available to care for people and to spend time with them doing things people enjoyed, so the risk of people feel anxious or isolated was reduced. People were supported to have the medicines they needed to remain well and free from pain. Action was taken to ensure the risk of people becoming ill through infection was reduced and systems were in place to manage people’s safety.

People had the opportunity to meet staff and visit the home before they decided to move to 95 Bromyard Road. Staff assessed people’s care needs and involved people who knew them, so they could put initial plans in place to meet people’s needs. These processes had recently been further developed, to enhance people’s experience of living at the home.

People and their relatives told us staff knew how to look after them. Staff had undertaken training to develop the skills they needed to care for people living at the home and to meet their needs. People enjoyed preparing their own drinks, snacks and meals and were supported by staff to do this safely, where they wanted this. Staff supported people to access the health services they needed to remain well.

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 supported this practice.

People and their relatives were complementary about staff’s caring approach. People had built trusting relationships with the staff that supported them, and wanted to involve staff in their day to day lives. People showed us they enjoyed spending time with staff. Staff recognised people’s right to independence and varied how they communicated with people so they were able to make informed decisions about the care they wanted. People’s rights to dignity and privacy were understood by staff and their rights were respected.

People’s care had been planned by taking their individual histories, wishes and needs into account. Staff communicated information regularly with other staff, so people’s care would be adapted to meet their changing needs. People and their relatives knew how to raise any concerns or complaints they may have and were confident these would be addressed.

The registered manager encouraged people and staff to make suggestions to develop the home and people’s care further. Staff had been supported to understand how they were to care for people so they there independence and confidence would gro

Inspection carried out on 26 October 2015

During a routine inspection

The inspection took place on 26 October 2015 and was unannounced. 95 Bromyard Road offers accommodation for up to six people with mental health needs. There were four people living at the home at the time of our inspection. We had the opportunity to talk with three people who lived at the home on the day of the inspection. We have therefore not used quotes within this report and the examples we have given are brief because we respect people’s right to confidentiality. People had their own rooms and the use of a number of communal areas, including a kitchen, lounge, conservatory and garden areas.

A new manager had recently been appointed for the home and was seeking advice on becoming the home’s 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.

We saw that people were comfortable with the staff supporting them, and staff offered encouragement and reassurance to people when they wanted it. Staff knew how to support people so they were as independent as possible. Staff supported people to do the things they enjoyed and to keep in touch with friends and family in a safe way.

People’s health needs were understood by staff, and staff arranged for extra support for people when they needed it. Some people liked the independence that looking after their own medicines gave them. Some other people preferred staff to help them with their medicines. We saw that these choices were respected by staff.

People received care and support from staff that knew their individual needs, and recognised when these changed. Staff were supported through regular supervision, and told us if they had any concerns for people’s well-being they were able to get advice from senior staff or the manager. Staff had undertaken a wide range of training so they could support individual people well. People’s consent was appropriately obtained by staff. Staff understood people had the right to make their own decisions and explained how they chatted to people so they were supported to make the best decision for them. Staff worked with other organisations to make sure they were protecting people’s freedom and rights to make decisions themselves.

People were encouraged by staff to choose what they wanted to eat. Some people enjoyed preparing their food independently, and some people liked the company and reassurance of staff when making their meals. Staff knew how to support people if they had any particular dietary needs. Staff made sure people had the opportunity to obtain specialist help with their health. People saw a variety of health professionals so their health needs were met and they remained well.

People liked the staff who supported them and people enjoyed including staff in their daily lives. People’s privacy and dignity were respected and people were supported to make their own choices and increase their independence. People were supported by staff to do the things they enjoyed. Staff acknowledged people’s achievements. People liked the manager. Staff told us they were supported well by the manager and senior staff, so they were able to provide safe and compassionate care.

People’s care was regularly reviewed and checked by the manager and the provider and changes had been made based on suggestions made by people living at the home.

Inspection carried out on 16 May 2013

During a routine inspection

During this inspection we spoke with two people who lived at the home and with four staff. We looked at some people’s care plans which provided information on the needs of each person. We also looked at how staff cared for the people who lived at the home.

We found that people were being supported to make choices and decisions about the care that they received. One person told us: "They (staff) never try to push you into doing anything you don't want to do".

We saw that people appeared relaxed and comfortable. They were being cared for in a way that they preferred. The people we spoke with were positive about their experiences of living at the home. One person told us they: "Really couldn't ask for a better place to live".

We found that medicines were being appropriately stored and administered.

There was a complaints policy in place and people were being supported to raise any concerns.

Inspection carried out on 2 May 2012

During a routine inspection

One person living at the service told us that one of their long term goals was to become as independent as possible. They told us that living at the home was, "a long way forward" towards achieving this goal.

This person told us they were able to be involved in everyday household tasks. They said, "I do washing and hoovering, and I do my own menus. I'm independent."

They told us that they liked living there and said, "I am being looked after well."

We saw that the person who lived at the home was supported to take part in activities which included fitness sessions and college courses as well as trips to the library and markets. The person told us, "I'm on the go all the time."

They told us that if they had a concern, "I would speak to a team leader or the manager." They said they had previously raised minor complaints which had been addressed. The person we spoke with told us they felt safe living at the home.

They told us they were able to raise concerns informally with staff and management, as well as during organised one to one sessions with staff.