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Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about High Brake House on 9 September 2021. 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 High Brake House, you can give feedback on this service.

Inspection carried out on 20 December 2017

During a routine inspection

This inspection was carried out on 20, 21 and 22 December 2017. The first day of the inspection was unannounced.

High Brake House is a care home which is registered to provide care and accommodation for up to 35 older people, including older people living with a dementia. The service does not provide nursing care. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. High Brake House is an adapted building in a residential area in Clitheroe. At the time of the inspection there were 34 people accommodated at the service.

The service 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.

At our last inspection on the 4 and 5 May 2016 the overall rating of the service was ‘Good’. However there were breaches of the regulations relating to staff recruitment and medicines management. We asked the provider to make improvements on these matters. We received an action plan from the provider on 19 June 2016 indicating how and when they would meet the relevant legal requirements. At this inspection we found sufficient improvements had been made and the service remained Good.

During this inspection we found there were no breaches of the regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. However we found there were some shortfalls with the management of complaints. We have therefore made a recommendation about improving complaints processes.

There was a warm and friendly atmosphere at the service. We found there were good management and leadership arrangements in place to support the day to day running of the service.

Arrangements were in place to promote the safety of the premises, this included maintenance, servicing and checking systems. We found the service to be clean in the areas we looked at.

People were happy with the accommodation. We found there was a good standard of décor and furnishings to provide for people’s comfort and wellbeing. People had personalised their rooms and had been asked for their choice of colour schemes.

People told us they felt safe at the service. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns about people’s wellbeing and safety.

Arrangements were in place to ensure staff were checked before working at the service. We found some checks had not been properly completed. But the registered manager took swift action to make improvements. There were enough staff available to provide care and support. There were systems in place to ensure all staff received regular training and supervision.

People’s needs were being assessed and planned for before they moved into the service. People were supported with their healthcare needs and received appropriate medical attention. Changes in people’s health and well-being were monitored and responded to.

Each person had a care plan, describing their individual needs, preferences and routines. This provided guidance for staff on how to provide support. People’s needs and choices were kept under review.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems at the service support this practice.

There were some good processes in place to manage and store people’s medicines safely. We found some improvements were needed and these were put right during the inspection.

People made positive comments about the caring attitude of staff. During the inspection we observed staff interacting with people in

Inspection carried out on 4 May 2016

During a routine inspection

We carried out an announced inspection of High Brake House on the 4 & 5 May 2016. The first day was unannounced.

High Brake House provides accommodation and personal care for up to 26 older people (including people living with dementia) and also provides personal care and support to people living in their own homes. There were 24 people accommodated in the home and one person receiving care and support in their own home at the time of the inspection.

The home is an extended older type property situated in a residential area of Clitheroe within walking distance to the town centre. Public transport is within easy access of the home. At the time of the inspection work was underway to extend and improve the home.

At the previous inspection on 9 April 2014 we found the service was meeting all the standards that were assessed at the time.

During this inspection visit we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to management of people’s medicines and recruitment processes. You can see what action we told the registered provider to take at the back of the full version of the report.

The service 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.

People told us they did not have any concerns about the way they or their relatives were cared for. They were happy with the care and support provided. People said, “The care staff are very kind and friendly” and “The staff are lovely and there is always someone to help”. Visitors told us, “I feel [my relative] is safe, settled and well looked after” and “The staff are very considerate. [My relative] is safe and happy and has everything they need.”

Staff were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice and had received training on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant they had knowledge of the principles associated with the legislation and people’s rights.

People told us they were given their medicines when they needed them. However, we found areas where improvements were needed to ensure people’s medicines were always managed safely.

The service had clear recruitment and selection policies and procedures although we found a safe and fair process was not always followed. Staff received training and support to give them the necessary skills and knowledge to look after people properly.

People told us there were sufficient numbers of staff to meet their needs in a safe way. People receiving care at home told us they were familiar with all staff and they arrived on time and never missed a visit. Staff were knowledgeable about people’s individual needs, preferences and personalities and people were involved in making choices and decisions about their day.

People made positive comments about the staff. Staff responded to people in a good humoured and considerate manner; we observed good relationships between people.

People told us they enjoyed the meals. We noted the atmosphere was relaxed with chatter and friendly banter throughout the meal. Staff were aware of people’s dietary preferences, the support they needed and any risks associated with their nutritional needs. Appropriate professional advice and support had been sought when needed. Visitors told us they were able to stay and have a meal with their relatives which they appreciated.

People were encouraged to be involved in the running of the home and were kept up to date with any changes. People had no complaints and were aware of how to raise their concerns and were confident they would be listened to.

We found people live

Inspection carried out on 9 April 2014

During a routine inspection

Prior to our inspection we received some concerning information. We considered this information and brought forward our scheduled inspection. Our inspection team was made up of an inspector who addressed our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We considered the evidence we had gathered under the outcomes we inspected. We spoke with four people using the service, one visitor and two members of staff. We also spoke with the local authority (social services).

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

Staff were observed interacting with people in a kind, pleasant and friendly manner and being respectful of people's choices and opinions. People made positive comments about the staff team. They said, �Staff are lovely; they are very kind� and �Staff are nice�.

We found people�s needs were assessed and care, treatment and support was planned and delivered in line with their individual care plan. We found some care records included useful information about people's preferred routines and likes and dislikes, however this was not always clearly recorded. This information was needed to ensure people received the care and support they needed and wanted.

Is the service responsive?

Regular reviews were carried out to respond to any changes in people's needs and to ensure the level of care was appropriate. People who used the service, or their relatives, had been involved in discussions about their care although this was not always clearly recorded.

Staff told us they were able to discuss people's needs at regular 'handovers' which should make sure they were up to date with any changes to people�s needs.

People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with health care professionals to make sure people received prompt, co-ordinated and effective care.

We found there were processes in place to ensure relevant and appropriate information was shared with other providers when people were admitted, transferred or discharged to another service.

People were involved in discussions and decisions about the activities they would prefer and activities were arranged for small groups of people or on a one to one basis.

Is the service safe?

We found there were appropriate arrangements in place to manage people's medicines safely. Staff, who administered medicines, confirmed they had received training to help them to do this safely.

Staff had received induction and ongoing training and the staff team was skilled and experienced. One member of staff said, �We get plenty of training; we are always training�. Staff told us they were supported, kept up to date and encouraged to share their views and opinions at regular meetings. They also told us their work was monitored on a regular basis.

Staff were aware of the procedures for reporting any concerns about poor practice. However, the Care Quality Commission (CQC) had not been notified of two serious injuries relating to people living in the home. The manager gave assurances all incidents would be reported in line with regulation.

Is the service effective?

People told us they were happy with the care and support they received. Comments included, "It is a good place; I have met some nice friends", "I feel I have been welcomed into a new family" and "I am happy to be here; they are very nice people".

People were encouraged to express their views and opinions of the service through regular meetings, reviews and during day to day discussions with staff and management. There was evidence people's views had been used to improve the service.

There were systems in place to assess and monitor how the home was being managed. There was evidence these systems identified any shortfalls and that improvements had been made. This should help to protect people from poor care standards and to identify any areas of non-compliance.

People told us they had no complaints about the service but felt confident they could raise any concerns with the staff or managers. Comments included, "I have no complaints; I am very happy with everything" and "I have not been happy in the past but I was able to discuss my concerns with the managers".

Is the service well led?

There were systems in place to regularly assess and monitor how the home was managed and to monitor the quality of the service. The service had a registered manager responsible for the day to day management of the home. Staff were clear about their responsibilities and were able to raise their views and concerns.

The service worked in partnership with other agencies, including the local authority and safeguarding teams, to ensure people�s safety and well-being.

Inspection carried out on 8 July 2013

During an inspection looking at part of the service

At our last inspection visit in April 2013 we were concerned as it was not clear how people were able to influence how the service was run and the systems to monitor the service and staff practice were not effective. We also found some of the records that were required to be kept to protect the safety and wellbeing of people using the service were not always accurate or up to date, which could result in peoples' needs not being met.

Following our visit we asked the provider to send us information about the action they would take to respond to the shortfalls. We were told action had been taken to respond to the shortfalls.

During this visit we looked at records and spoke with the acting manager. We found people had been encouraged to share their views and opinions about the home and that their suggestions had been acted on. We also found people were more involved in decisions about their care which would help to make sure they received the care they wanted and needed.

We found the systems to monitor the service and to monitor staff practice had been improved. This would help the provider to develop and improve the service.

We found the records that we looked at were accurate, up to date and fit for purpose.

Inspection carried out on 15 April 2013

During a routine inspection

We spoke with four people living in the home who told us they were happy with the care and support they received. Comments included, �It's a lovely place; I'm very comfortable", "I can do what I want to do and can get help if I need to" and �I'm very well looked after; they are lovely girls�.

People told us they enjoyed the food. Comments included, "The food is very good; I've really enjoyed my lunch. It was tasty", "We get plenty to drink through the day with cakes and biscuits" and "I like the food; I can choose what I want".

We looked at how people's medicines were managed. We found some improvements were needed, however a new system had been introduced which would help staff to manage people's medicines safely.

Most of the care staff had achieved a recognised qualification in care, which would help them to look after people properly. Staff were observed interacting with people in a pleasant and friendly manner and being respectful of people's choices and opinions. People told us there were sufficient staff to look after them. People made positive comments about the staff team. One person said, �Staff are lovely; they are very caring and patient�.

We found some of the records that were required to be kept to protect the safety and wellbeing of people using the service were not always accurate or up to date and could result in people's needs not being met.

Inspection carried out on 12 June 2012

During a routine inspection

During our visit we spoke with four people who used the service. All the people who we spoke with told us they were happy with the care and support they received. Comments included, "I'm looked after", "I couldn't ask for anything better" and "They talk to me about the care that I need and how I am feeling".

People who lived at High Brake House told us 'interesting' and 'varied' activities were arranged. We were told, "There is always plenty to do" and "They are always thinking up new ideas to keep us busy".

Everyone we spoke with made positive comments about the recent improvements to the home. They said, "The gardens are beautiful; I can't wait for the warmer weather", "It's a very nice place to stay; I have a lovely room" and "It's like a hotel; so clean and new".

All the people we spoke with made complimentary comments about the staff. Comments included, "They are very kind and caring" and "All the staff are very pleasant".

During our visit we spoke with two members of staff. They told us they were given the training and support they needed to do their jobs properly. Both staff told us they enjoyed working at the home and said, "It's brilliant" and "I like working here".

Inspection carried out on 17 August 2011

During a routine inspection

People who lived in the home told us their opinions were sought and that they were listened to. They told us that staff were very kind and respectful; one person said "they always knock and wait before coming into my room" and another said "staff respect my wishes not to be disturbed at night".

People told us they were happy with the care and support that they received; one person told us "they know what I like". People told us they were looked after properly and that staff treated them well.

People were happy with the staff team; comments included "staff are caring and kind, I am very lucky to live here", "staff are kind", "we are all part of a big family", "I am well looked after" and "I feel safe living here".

People told us that management and staff always asked if they were happy and content.

Staff told us they were part of a good team and that management was "very supportive" and "approachable".

Reports under our old system of regulation (including those from before CQC was created)