Broughton House and College

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was registered for the support of up to 30 people. Twenty nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the design of the buildings. The service was provided over five separate units. One unit accommodated nine people, two units accommodated six people each and two units accommodated four people each. The living spaces were designed to give people space and privacy. The outside space provided large areas for people to safely spend time.

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

People were extremely well supported by an effective management team and staff group at the service. The staff worked in an open and transparent way, using their quality monitoring processes to provide excellent care for people. The communication and collaboration between people, relatives, staff and the supporting multidisciplinary team meant people received outstanding personalised care which had positive impacts on their daily lives. One relative said, “The leadership is outstanding.” They went on to say the team were responsive and empathetic.

Staff had excellent knowledge of the people they supported. They used that knowledge to care for people in a positive and empowering way. People’s independence, social and life skills were enhanced by the knowledge and attitude of staff who supported them. People were actively encouraged to expand their horizons and develop in whatever way they could. All achievements were celebrated and shared with people’s families in an inclusive way.

We found a caring and empathetic staff group who enjoyed working with the people they supported. Relatives told us there was excellent communication from staff about all aspects of their family member’s care. Families were welcomed at the service and felt their relations were treated with care and respect by the staff. Our observations of the interactions between people and staff supported this. Relatives views on their family member’s care were used to provide personalised care, and they were encouraged and welcomed to take part in regular reviews of people’s care.

People’s nutritional needs were well managed, and their different dietary needs were met. People were well supported with all their health needs through established systems of care using the provider’s multidisciplinary health professional team, and the well-established links with the local healthcare team.

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.

People lived in an environment that was regularly cleaned and maintained to meet their needs. They were supported by a staff group who received appropriate training to support them in their roles.

There were robust safeguarding systems in place which were used effectively by staff who showed an excellent knowledge of their roles in protecting the people in their care. The management team had robust processes in place to ensure learning from incidents and events to reduce future risk or reoccurrence. The risks to people’s safety were comprehensively and positively assessed to ensure people were both protected from harm, and could enjoy a full range of life activities safely.

People were supported by a strong staff group who had been through a safe recruitment process, and who received regular monitoring and support from the management team.

People’s medicines were managed safely by a staff group who had received the appropriate training for their role.

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

The last rating for this service was Good (3 January 2018)

Why we inspected

The inspection was prompted in part due to concerns received about a possible safeguarding incident.

This inspection visit took place on 3 Jan 2018 and was unannounced. Broughton House and college is a care service. It 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. The service is registered for 30 people, at the time of the inspection 27 people were using the service.

Broughton College and House is set in small village in the Lincolnshire countryside. The large house is set in its own grounds with parking to the side and rear. The house is divided into five units supporting small groups, each providing communal lounges and dining space. 'Arts and crafts and computers were accessible to people within the communal area

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

People continued to receive safe care. All staff were recruited to ensure that they were safe to work with people. There were sufficient staff to meet individual’s needs. Risk assessments had been used to consider the levels of risks and to provide guidance to reduce the risks. Medicine had been managed safety and provided to people in line with their prescriptions. People were protected from the risk of harm and lessons were learnt when mistakes happened.

The care that people received continued to be effective. They had been 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 support this practice. Staff felt supported by the level of training they received. People had a choice of meals and their dietary needs had been met. The environment had been adapted to suite people’s needs. Health professionals had been involved in the development of peoples care and guidance was provided and followed.

People continued to have positive relationships with the staff who were caring and treated people with respect and kindness. Staff knew people well and were able to balance this knowledge to consider the level of support people required to reflect personal space and dignity in meeting their needs.

The home continued to provide a responsive approach to people’s needs. People were able to access activities which provided stimulation and opportunities to develop their interests and hobbies. There had been no complaints, however information was available and people and relatives felt able to raise any concerns.

The management of the home remains good. The registered manager analysed information about the quality and safety of the service and used it to drive improvements. People’s feedback had been obtained. The registered manager understood their registration and sent us information about the home. They had conspicuously displayed their rating at the home and on their website.

Broughton house specialises in the care of people who have a learning disability. It provides accommodation for up to 30 people who require personal and nursing care. The home is divided into four separate units which are each managed by a unit manager. On the day of our inspection there were 27 people living at the home.

At the time of our inspection there was 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.

On the day of our inspection we found that staff interacted well with people and people were cared for safely. The provider had systems and processes in place to safeguard people and staff knew how to keep people safe. Risk assessments were in place and accidents and incidents were monitored and recorded. Medicines were administered and stored safely.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).If the location is a care home Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to other healthcare professionals such as an occupational therapist and GP. Staff were kind and sensitive to people when they were providing support. Staff had a good understanding of people’s needs. People had access to leisure activities and excursions to local facilities.

People had their privacy and dignity considered. Staff were aware of people’s need for privacy and dignity.

People were supported to eat enough to keep them healthy. People had access to drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were sufficient staff available to care for people appropriately. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs.

Staff felt able to raise concerns and issues with management. We found relatives were clear about the process for raising concerns and were confident that they would be listened to. The provider recorded and monitored complaints.

Audits were carried out on a regular basis and action put in place to address any concerns and issues.

In order to assist us we were accompanied by an expert by experience. Experts by experience have experience in the area of care being inspected and spend time with people to obtain their views.

During our visit we also looked at records and spoke with staff.

During our visit we spoke with three members of staff and the registered manager. We also looked at three records and observed care.

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Information was provided in both pictorial and word formats to assist people to understand it.

When we spoke with staff they told us they had received training to enable them to provide safe and appropriate care to people.

We observed care was planned and delivered in a safe and effective manner. People had access to a range of professionals to support them.

We looked at the management of medicines and saw the provider had safe systems and processes in place to manage medicines.

We saw the provider had processes in place to ensure staff had the skills and experience necessary to be able to respond to people's needs and to support them in their roles.

Staff were supported in their role to provide safe and appropriate care.

As part of our inspection we spoke with two people who used the service. We also spoke with staff and looked at records.

People told us about the activities they were involved in and showed us their bedrooms. We saw the bedrooms were personalised.

One person we spoke with told us about a shop they ran for people at the home. Another person showed us a picture they had chosen for the lounge in their unit.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities. We saw people were treated with dignity and respect and supported to make decisions about their care.

We observed people were cared for in a clean and tidy environment and were protected against the risk of infection.

We saw the home was divided into units and people were cared for in small groups by people who were familiar with their care needs.

When we looked at records we saw consent had been sought for people who had difficulty making some decisions.

People told us they liked living at the home.

We looked at the results of a survey for parents and professionals and saw positive comments. For example, 'I am happy with the level of care my xxx receives' and 'Provide a safe and happy environment to allow our son to develop."