Archived: Brookvale Lawn

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's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at care plans for three people and found they were clear about people's assessed needs and the support they needed. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Care plans included moving and handling risk assessments as well as identifying people's risk of falling. Care plans identified where people walked with equipment, such as a frame, and staff confirmed this equipment was used. We saw people being supported to walk where necessary to reduce the risk of them falling.

Medicines were handled appropriately and by staff who were trained. Staff who were not trained told us they did not handle medication and were clear about the role of the trained staff. Each person had a Medication Administration Record in place, which was completed after staff had given people their medicine. Records showed people had received their regular medication as well as short term medication such as anti-biotics.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Whilst these safeguards do not currently apply to anyone living at the home, relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People were supported to be able to eat and drink sufficient amounts to meet their needs. People were provided with a choice of suitable and nutritious food and drink. We heard staff asking people if they had had enough food and one person was offered a sandwich as they had not eaten much of their lunch. After lunch, we saw one of the cooks offering people bananas and grapes as an extra snack. We saw people were offered a variety of drinks throughout the day and we spoke with a person who said they always had a drink in their bedroom. A visitor told us drinks were always available to the person they were visiting and staff actively encouraged them to drink. They also said the person was, 'nocturnal' which meant they were up and about during the night, but staff 'accommodated' this, ensuring they had food and drink during the night.

Some people were assessed by healthcare professionals as needing their food pureed and staff confirmed this happened. The food was pureed in the kitchen before being sent to people. This meant people could be assured they were presented with their food in a way they could eat whilst minimising the risk of choking. One person needed all their drinks to be thickened and staff confirmed they did this before giving the drink to the person. A visitor confirmed their relative was given food in ways which met their needs and that fluids were a 'priority'.

Is the service caring?

We found staff treated people with compassion, kindness, dignity and respect. Visitors told us the home was caring and we saw staff interacting with people in a positive way. People's diversity, values and human rights were respected. We found people's privacy and dignity was respected. A person who used the service told us staff ensured the door was shut when assisting with personal care and they chose what clothes they were going to wear that day. A visitor told us staff respected peoples' dignity and gave us an example. They also said staff had 'absolute respect' for people who could present with challenging behaviour.

Is the service responsive?

We found staff liaised with health care professionals when needed. Staff noticed when people were unwell and ensured they contacted the doctor. One person was noted to have difficulty swallowing and staff contacted the doctor to arrange a speech and language therapy assessment. We listened whilst the person in charge of the shift gave a 'handover' to staff whose shift started in the afternoon. The staff member talked about how each person had been and whether any medical issues had been noted, such as a person feeling unwell. This meant staff were aware of people's needs and how they might meet them when they started their shift.

Is the service well-led?

There was an internal quality assurance audit which focused on a different outcome each month which was monitored by the provider. Further, there was a monthly service report which monitored various areas, including, incidents, falls, pressure areas, safeguarding and complaints. Regular audits were undertaken and any necessary actions noted and completed. There was a complaints procedure in place and visitors told us they felt able to use it. The provider also commissioned a regular audit of the whole service by an outside company, who visited and spoke with people. If improvements were suggested, these were addressed. This meant the manager had an overall view of the service and how people's needs were being met.

People were pleased with the care and support they received. They told us the staff were 'very nice', 'helpful', 'lovely', 'kind', 'understanding' and 'cheerful'. One person told us they liked particular staff to assist them with bathing and this was always accommodated. Others confirmed staff undertook personal care tasks in ways they preferred and gave them the support they needed. Staff answered call bells in good time. People told us the home and their bedrooms were kept clean and there was plenty of food.

We saw staff greeted people by their name and were attentive to people's individual needs. Staff spent time talking with people. The provider sought the views of people and made improvements to the service. People received their medication as prescribed but may have been at risk by staff not always following good practice with regard to recording of medication given.

We heard staff offering people a range of choices as well as giving them the time to make an informed decision. We found that people were treated with respect and staff were aware of their individual preferences. Staff were patient and met people's needs as detailed in their care plans.

People had access to health care professionals and staff always sought advice when people were not well. Policies and procedures were in place for safeguarding vulnerable people. Medication was stored and handled appropriately and people received their medication as prescribed.

The manager ensured there were enough staff based on the individual needs of people living in the home. Systems were in place to seek people's views on the service provided and regular auditing was undertaken.