We carried out a review of the data available to us about Flexible Support Options Limited (Brilan) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Flexible Support Options Limited (Brilan), you can give feedback on this service.
Flexible Support Options Limited (Brilan) is a residential service providing personal care for up to 4 people with a learning disability or mental health needs. At the time of the inspection there were 4 people living at the service. The service is located on the lower ground floor of a care home operated by a different care provider.
People’s experience of using this service and what we found
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.
Right Support
People were supported to have maximum possible choice, control and independence. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to achieve their aspirations and goals. People were supported safely with medicines. Infection prevention and control practices reflected current guidance. Risk assessments were in place, and it was very evident staff had ensured they fully understood the needs of people. The provider had reviewed the environment and put in place a refurbishment plan, which would lead to the complete redecorating of the home, including installation of a new kitchen and windows. Some of this work had commenced.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. The service worked well with other agencies to do so. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right culture
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff were aware of and were working to best practice guidance for supporting people with a learning disability and/or autistic people.
Recently the provider had worked collaboratively with the owner who operated the care home above them to review potential impacts this might have on this service, in terms of both the structural integrity of the building and how to support the other owner when continuing the operation of their care home if mechanical failures occurred such as a lift breaking down. Any potential impacts were discussed with people and they agreed actions such as hot lock food trolleys being wheeled down the corridor whilst repairs were made could be allowed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 15 August 2018).
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Flexible Support Options Limited (Brilan) on our website at www.cqc.org.uk.
Flexible Support Options Limited (Brilan) known as Brilan is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation for up to four people with a learning, physical disability or mental health condition. On the day of our inspection there were three people using the service.
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.' Registering the Right Support CQC policy.
This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like 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 last inspected the service in February 2016 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.
We found some recording issues in relation to the administration of medicines that had not been found on internal audits. This meant that the medicines audit process was not being completed robustly. People told us they received their medicines in a safe way and when they were due. We saw staff supporting people to take their medicines in a safe and caring way.
People told us they felt safe at Brilan. There were sufficient numbers of staff on duty to keep people safe. There was an effective recruitment and selection procedure in place and relevant vetting checks were carried out. Staff were suitably trained and received regular supervisions and appraisals.
Accidents and incidents were appropriately recorded and risk assessments were in place. Safeguarding procedures had been correctly followed and staff had been trained in safeguarding vulnerable adults.
Health and safety checks were carried out to ensure people were supported to live in a safe environment.
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 were supported with their dietary needs and care records contained evidence of visits to and from external healthcare specialists.
People told us they were assisted by kind and caring staff members. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any support plans and their individual wishes, needs and choices are taken into account.
People were protected from social isolation. People were supported to access activities on site and in the community.
The provider had an effective complaints procedure in place, and people told us they knew how to complain if they wished to.
People who used the service and staff were regularly consulted about the quality of the service via meetings and surveys.
Brilan is a three bed care home that provides care and support to people with learning disabilities and mental health needs. Nursing care is not provided. At the time of the inspection there were two people accommodated there.
The service had a registered manager in post. 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 people living at Brilan appeared comfortable and relaxed. The person we were able to speak with told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults and knew how to deal appropriately with accidents and incidents, which helped to keep people safe.
We observed staff provided care safely. At the time of our inspection, the levels of staff on duty were sufficient to ensure safe, responsive and effective care. New staff were subject to thorough recruitment checks.
Medicines were managed safely with records completed correctly.
As Brilan is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. Staff obtained consent before providing care. Arrangements were in place to assess mental capacity and to identify if decisions needed to be taken on behalf of the person in their best interests.
Staff had completed safety and care-related training relevant for their role. They were well supported by the registered manager and a service manager.
Staff kept clear nutritional and weight records and helped support people’s health needs, working with external professionals where necessary. This ensured people’s medical needs were met promptly.
Activities were arranged in-house, and community based activities were also accessed. We observed staff interacting positively with the people living at Brilan. We saw staff were respectful and ensured privacy and dignity were maintained. Staff understood the needs of the individual and we saw care plans were person centred. Reasonable adjustments had been made to ensure staff had the necessary skills to communicate with people at the service.
People using the service appeared comfortable with, and staff spoke well of, the registered manager. The registered manager was supported by a service manager, responsible for the direct line management of staff at the home. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and their relatives.
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
This is a summary of what we found -
Is the service safe?
People living at the home were supported to maintain their personal safety. Potential risks to their welfare were assessed and managed to ensure care was delivered safely. This included making sure that people were kept safe during help with personal care and when they were taking part in activities outside of the home.
There were appropriate arrangements in place to prevent avoidable harm and abuse and to respond to any allegations of abuse.
New staff were properly checked and vetted to ensure their suitability to work with vulnerable adults.
Is the service effective?
People were provided with extensive care and support that promoted their well-being and met their needs.
A relative told us they were happy with the care and the person's care manager said, 'X's lifestyle has definitely improved'.
Staff were supported in developing their skills and were given training that equipped them to meet the needs of the people they cared for.
Is the service caring?
We found that each person's planned care was tailored to their individual needs and wishes. People were cared for by kind and attentive staff who gave their support in the ways they preferred. Staff interacted well with people and encouraged them to do things at their own pace.
Is the service responsive?
Care was provided according to each person's preferences, interests and diverse needs. People were supported to access activities that were important to them and to be actively involved in the community.
When people's needs changed, their care and care plans were adjusted to make sure their welfare and safety was protected.
Is the service well-led?
The manager and staff had good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were followed to check on standards at the home and get people's views about their service. We received positive feedback from people's representatives and they told us they had no complaints about the service and the care provided.