Brook House Residential Home

We found the following examples of good practice.

The home appeared clean and uncluttered, rooms were being regularly cleaned and an increased cleaning schedule was in place for high touch areas; this was to minimise the chance of cross infection.

The home was allowing visitors in line with guidance and people were also supported to maintain regular contact with loved ones through video calls and telephone calls. Appropriate PPE was being used, and staff, residents and visitors also took part in routine COVID-19 testing. All staff working at the home had received their COVID-19 vaccination.

Staff and people spoke positively about the service and management and had no concerns. One staff member told us, “Oh yes (I feel supported), most definitely. She (the manager) lets us know as soon as something changes.” One person also told us, “I am happy with everything, the staff are nice and help me out when I need it, and they talk to me and are always good to me.”

Brook House is a residential care home providing personal care to 9 people with learning and/or physical disabilities. The service can accommodate 10 people.

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 a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. 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 building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. People told us staff were available when they needed them and they felt safe in their care. The environment was clean and well maintained. People were safely supported to receive their medicines, as prescribed.

People's needs were assessed, and care and support had been planned in partnership with them. People were provided with a nutritious and varied diet. Staff had received regular training and supervision to support them to meet people's needs. 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 told us staff were kind, caring, attentive and treated them with respect. They said staff respected their privacy and dignity and supported them to be as independent as possible.

People received person-centred care which was responsive to their needs. The registered manager managed people's concerns and people told us they felt listened to. The registered manager worked in partnership with a variety of agencies to ensure people received all the support they needed. People were happy with how the service was managed. Staff felt well supported by the registered manager and the director who visited regularly. The registered manager and provider completed regular audits and checks, which ensured appropriate levels of quality and safety were maintained at the home.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 requires improvement (published 7 November 2018) and there was one breach of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Brook House Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided. Both were looked at during this inspection. The care home accommodates up to 10 people living with a learning disability. At the time of the inspection, there were 10 people who received support with personal care as nursing care is not provided at this home.

The care service is aware of 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. We found on this inspection that the service was delivering these values.

The home was managed by a registered manager. 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.

This inspection was the first inspection since the service was registered with the Commission on 23 October 2017. The service was previously registered under a different provider.

During this inspection we found shortfalls in relation to the safe management of medicines and the systems for monitoring the quality of the care delivered. This was because records of people’s medicines had not been effectively managed, and staff did not always have guidance on how to use ‘as and when’ (PRN) medicines and medicine audits were not robust. Action was taken to rectify the shortfalls immediately after our inspection.

We found there was one breach of the Regulations. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.

People and their relatives told us they felt safe living at Brook House Residential Home. Feedback from people regarding the care quality was positive. There was a safeguarding policy and staff had received safeguarding training.

There were systems and processes for monitoring and assessing quality in the home to ensure people's safety and compliance with regulations. However, improvements were required to ensure the audits could identity shortfalls in care provided. Medicines audits had not been effective to identify the shortfalls we found and systems for analysing accidents and incidents were not robust to ensure trends and patterns were identified and lessons were learnt. Internal audit and quality assurance systems required further improvements to ensure they could effectively assess and improve the quality of the service. The registered manager took immediate action to address all the shortfalls immediately after our inspection.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. Additional improvements were required to cover risks associated with use of topical creams and smoking. The registered manager took immediate action to address this after our inspection visit.

The staff who worked in this service made sure that people had choice and control over their lives and supported them in the least restrictive way possible. People’s consent to various aspects of their care was considered and where required, Deprivation of Liberty Safeguards (DoLS) authorisations had been sought from the local authority.

Recruitment checks were carried out to ensure suitable people were employed to work at the home.

Care plans were in place detailing how people wished to be supported. People and their relatives were involved in care planning. People’s independence was promoted.

Visitors and people who lived at the home spoke highly of the registered manager and the owners.

The environment was clean and adaptations and decorations had been adapted to suit the needs of people living at the home. There was an infection control policy however some improvements were required to ensure all toilets had hand washing facilities. The registered manager took action to address this.

Risk associated with fire had been managed and fire prevention equipment serviced in line with related regulations.

The provider had sought people’s opinions on the quality of care provided.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. People’s nutritional needs were met. Risks of malnutrition and dehydration had been assessed and monitored. Comments from people who lived at the home were all positive about the quality of meals provided.

We observed people being encouraged to participate in activities of their choice. People who lived at Brook House Residential Home knew how to raise a concern or to make a complaint. The complaints procedure was available, and people said they were encouraged to raise concerns.

Staff had received induction and training. There was a policy on staff supervision and appraisals and staff had received regular supervision. Staff told us there was a positive culture within the service. Staff we spoke with told us they enjoyed their work and wanted to do their best to enhance the experience of people who lived at the home. The provider had a business plan which showed their visions and future development plans for the service.