Brookmead

Brookmead is a residential care home registered to provide accommodation and personal care for up to 5 people, who have a learning disability and/or autistic people. There were 5 people living in the home at the time of our inspection. The building had 2 floors and a communal kitchen, dining area and lounge. Each person has their own bathroom. The service is located in a residential area with access to local amenities.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support

People did not have assessments of their sensory needs. This meant potential adaptions to the environment had not been fully considered. Staff were aware informally of some people’s sensory needs and the registered manager had made referrals to request formal sensory assessments to be carried out.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.

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.

Right Care

People's care and support plans did not always fully reflect their range of needs using respectful and empowering language. The registered manager was aware of and addressing shortfalls in written records.

People could take part in activities of their choosing at the service or in the wider local area and pursue their own interests. Staff received training and support to provide care effectively.

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff understood and responded to their individual needs; the service worked with other agencies to do so. Staff and people cooperated to assess risks people might face and staff responsibly encouraged people to take positive risks.

Right Culture

Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. Internal quality assurance systems and processes to maintain and develop the safety and quality of care were not always operating effectively.

People and their relatives told us, they liked living at Brookmead care home and liked the registered manager and staff.

People and staff equality and diversity was respected and promoted at the service and within the provider’s organisation.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 September 2017).

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We have identified a breach in relation to governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brookmead care home on our website at www.cqc.org.uk.

Brookmead is a care home providing accommodation and personal care for up to five people who have a learning disability or autistic spectrum disorder. On the day of our inspection there were four people living at the service.

At the last inspection on 4 November 2014, the service was rated Good. At this inspection we found the service remained Good.

People living at Brookmead were unable to talk with us to discuss their care. However, people’s relatives told us they felt the service was safe. People remained protected from the risk of abuse because staff understood how to identify and report it.

The service had a manager, who had been in post for approximately two months. They were not at the time of our inspection registered with the CQC. 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 provider continued to have arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Relatives felt staff were skilled to meet the needs of people and provide effective care. People and relatives remained encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. Relatives said they felt listened to and any concerns or issues they raised were addressed.

Staff continued to support people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs remained met and there was a good choice of food and drink.

Staff continued to feel fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities.

The service had a relaxed and homely feel. Relatives spoke highly of the caring and respectful attitude of a consistent staff team, which we observed throughout the inspection.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. Relatives continued to be consulted about their care to ensure wishes and preferences were met. Relatives and staff told us the management team continued to be approachable and professional.

Further information is in the detailed findings below.

Relatives told us that staff treated their family members with respect and dignity. We were told people were well supported with their care and treatment. We were told that people were encouraged to do activities they enjoyed. We made observations throughout the visit and saw people being offered choices as to how they wanted to spend their time.

The home's environment was maintained appropriately and maintenance issues were recorded and addressed. We observed that the home was clean and tidy. Rooms we looked at were personalised with people that used the service having their own property and possessions in their rooms. One member of staff told us the home was a, 'good house' and that is was, 'well managed'.

Relatives said that the manager and staff communicated issues with them. One relative that we spoke with said they were, 'very pleased with the care' provided.

At the time of the inspection there was an appointed manager in day to day charge. There was not a registered manager at the home.

One person said, "I can tell that my family member is very happy there, I would know if they were not. When they come home for the weekend and its time to go back to Brookmeads and we tell them they indicate to us that she is happy about this."

Another person said, "We are very pleased with the care at Brookmead, we are always kept informed about what is going on and our family member is very settled and happy there".