Archived: Brookthorpe Hall Care Centre

Brookthorpe Hall Care Centre is a residential home which provides personal care for up to 32 older people and people living with dementia. The home has a range of communal areas, including lounges, dining room and reception area. At the time of our inspection 19 people were living in Brookthorpe Hall Care Centre

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

The registered manager did not always ensure people’s care plans were current or reflective of their needs. Three people did not have a care plan in place at the start of the inspection, however the registered manager took action during our inspection to start addressing this shortfall. Where the service had received the views of people or their relatives, concerns or complaints, there was not always a documented record of the action the registered manager had taken to respond to these concerns.

People’s risks were known by care staff. Care staff were fully aware of their responsibilities to raise concerns and the registered manager ensured lessons were learnt from any incidents or accidents. There were enough staff deployed to ensure people received the support they required. People received their medicines as prescribed.

People told us care staff were kind, caring and compassionate. Staff were attentive to people’s needs and knew how to promote their wellbeing. When people were anxious, care staff took time to reassure them and promote their wellbeing. People were treated with dignity and respect.

Staff were appropriately trained and had the skills to meet people’s needs. Staff had access to training, support and continued professional development they needed and requested. People received effective care and treatment. The service worked alongside a range of healthcare professionals to ensure people’s health and wellbeing were maintained.

People received care which was personalised to their needs. Where people’s needs changed, or their health deteriorated, care staff took appropriate and effective action to ensure their health and wellbeing were maintained. People enjoyed talking with staff, other people and activities, including games they had played throughout their life.

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.

The registered manager supported staff and ensured they had the information they required to meet people’s needs. Staff were involved in discussing changes in the home. The registered manager had plans to develop the home and provide a high-quality dementia care home. The registered manager sought and acted on the advice of local authority commissioners and healthcare professionals.

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 22 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to good 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 meet with the registered manager and provider to discuss their good governance systems. 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.

This inspection was unannounced and took place on 17 and 18 May 2017. The service was last inspected in September 2016.

There were two breaches of legal requirements at the last inspection in September 2016. At our comprehensive inspection on 17 and 18 May 2017 the provider had followed their action plan with regard to meeting the requirements of the regulations.

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.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. The registered manager had carried out the relevant checks to ensure they were employing suitable people at Brookthorpe Hall.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at Brookthorpe Hall. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained people’s dignity.

The service was responsive to people’s needs. Care plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. Quality checks were in place and where issues had been identified, there was evidence these had been addressed. People, relatives and staff spoke highly of the registered manager. Staff morale was good and reflected the positive support from management. The registered manager had informed CQC of the relevant notifications as required by the law.

This inspection was unannounced and took place on 28 and 29 September 2016.

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.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. The registered manager had carried out the relevant checks to ensure they were employing suitable people at Brookthorpe Hall.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at Brookthorpe Hall. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was not always responsive to people’s needs. Daily records were not completed thoroughly and immediately following care being given. Care plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was not always well-led. Quality checks were in place and the registered manager was planning to ensure these were better used to improve the service provided. However, these audits had not identified shortfalls in areas such as record keeping. The registered manager was well liked and respected.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report. This was a repeated breach from the last inspection. We found at this inspection that there had not been sufficient improvements to meet the requirements of the regulations and the service remained in breach of the regulation.

This inspection was unannounced and took place on 13 and 14 January 2016.

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.

People did not always receive a service that was safe. Risk assessments were not always in place and those that were often lacked sufficient detail to safely provide care. Staffing levels were not regularly reviewed. People did not always receive their medicines as prescribed. The registered manager and staff team understood their role and responsibilities to keep people safe from harm. Staff knew how to raise any concerns regarding people’s safety. Employment checks were carried out on staff before they started work to assess their suitability to work with vulnerable people.

The service did not always provide effective care and support. Some staff had not received training on caring for people living with dementia. The service was not adhering to the principles or requirements of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS).

People seemed to enjoy the food and menus were planned in advance. People did not always have easy access to drinks. Arrangements were made for people to see their GP and other healthcare professionals when they needed to do so. The service had made some adaptations to the environment to meet the needs of people living with dementia.

People did not always receive a caring service. Staff did not always give people the care and attention they wanted or needed. Staff did not always treat people with dignity and respect. People generally spoke positively about the staff caring for them.

The service was not responsive to people’s needs. Care plans were not person centred and lacked the detail required to provide consistent, high quality care and support. Daily records were not completed thoroughly and immediately following care being given. There were not enough activities for people. Comments and complaints from people, relatives and others were not recorded. People’s views and opinions had not always been acted upon.

The service was not consistently well-led. The registered manager had not always submitted notifications to the Care Quality Commission (CQC) as required by law. The registered manager was well liked and respected. Quality checks were in place and the registered manager was planning to ensure these were better used to improve the service provided. However, these audits had not identified shortfalls in areas such as medicines management and record keeping.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of the Care Quality Commission (Registration) Regulations 2009.

You can see what action we told the provider to take at the back of the full version of this report.

We spoke to one person who used the service and saw some of the returned questionnaires in the latest satisfaction survey set out by the provider just before our visit. The comments we heard and saw included "the home is comfortable and the staff are good". "I would not change a thing, I'm very happy". "I am very happy here and the staff look after me very well".

During our visit we saw all the bedrooms and communal areas and all appeared to be clean. We observed that medicines were also given safely and by appropriately trained staff. The home is well staffed with a consistent and stable workforce. The manager also confirmed that they had not received a complaint in over a year because staff do their best to resolve any concerns when they occur.