Brighton and Hove Bethesda Home

People received medicines from trained and competent staff. The service was clean, and staff practised good infection control to help protect people from the risk of infectious diseases. A relative told us, "The home is lovely and clean." Our observations confirmed this.

People's health risks were assessed and managed safely. Where people required equipment to move and position, staff followed care plans to ensure they were supported safely. Detailed guidance was in place for staff to follow, for example, where people required catheter care.

People were supported by enough staff who were trained to meet their needs. Staff were consistent and knew people well. A person told us, "The staff are very good, they are very kind to me." A relative said, "Staff are pretty good. They know what they are doing."

People were treated with dignity and respect. We observed kind interactions throughout the inspection. Staff spoke with people respectfully, addressing them by their preferred name. A person told us, "Staff are good at making sure I have privacy and if my family visit they give us space too."

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We observed, staff frequently asking for consent before supporting people whilst respecting their autonomy. A person said, "I cannot find fault in anything. I am treated well, the way anyone would want to be treated."

People and where required, their relatives were involved in planning their care, this included life stories so staff could understand people. Care was reviewed regularly and updated when people's needs changed. Staff engaged with visiting health and social care professionals to achieve good outcomes for people. A visiting healthcare professional told us, "I am completely confident staff follow our instructions, we put a

care plan in for carers."

People, their relatives and staff told us they we able to make suggestions and raise concerns if needed. A person said, "I haven't had cause to complain but I would feel able to voice my opinions and I feel my concerns would be listened to and dealt with accordingly."

People and their relatives were invited to contribute towards the running of the service, their views were listened to. Staff and management kept relatives up to date with changes to their loved ones, relatives told us they could approach the registered manager at any time.

Quality assurance processes were effective in identifying areas for improvement, shortfalls were addressed at the time or shortly following audits. Management listened to staff feedback, for example, housekeeping staff requested a new format for the cleaning schedule, this was completed following an audit. The provider was in the process of updating audit forms and policies for staff to follow, this was being completed at the time of our inspection, the staggered approach of introducing the documents ensured no disruption to the running of the service.

Staff and the management team worked with health and social care professionals to improve people's care and well-being. Staff spoke of a good working relationship with external agencies and visiting professionals spoke highly of the service. Comments included, "[Registered manager] is absolutely lovely, a good leader, they listen to their staff and community. The residents are fully engaged in decisions, it is seen as their (people's) home, [registered manager] is excellent." And, "They contact us for support if people are acutely unwell. It's very much about partnership working."