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Inspection carried out on 14 August 2018

During a routine inspection

Brightwater is registered both as a care home but also to provide a personal care service to people living in their own home. Throughout the report we refer to the registered provider by their trading name of In Chorus. The registered care home provided accommodation and personal care for up to five people living with autistic spectrum disorder and/ or other mental health needs. People in care homes receive accommodation and their care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. At the time of our inspection there were four people living in the care home.

At the time of the inspection, Brightwater was providing a personal care service to one person who was living in their own home. When people live in their own home, CQC do not regulate the premises within which they live, only the ‘personal care’ element of support being provided.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

At our last inspection in April 2016, we rated the service as overall good. At this inspection, we found the evidence continued to support an overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Some elements of the service were outstanding.

People were very much at the heart of the service and staff, the registered manager and providers demonstrated a real commitment to provide outstanding person-centred care which achieved the best possible outcomes for people and help them reach their potential.

The feedback from relatives about the person-centred care and support being provided at Brightwater was exceptional.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance.

People had very personalised support plans that contained clear guidance for staff on how best to support them.

Staff had taken steps to provide information to people in a way in which they could understand allowing them to be as involved as possible in decisions about how their care was provided. This supported the requirements of the Accessible Information Standard.

All the relatives we spoke with were confident that they could approach staff or the registered manager with any concerns and that these would be dealt with.

Other areas were good.

Staff understood how to recognise and respond to abuse and had a good understanding of risks to people’s health and wellbeing. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

The home was clean, safe recruitment practices were followed and medicines were managed safely.

Staff received an effective induction, training and ongoing development.

Staff supported people with their dietary needs.

There were systems in place to support effective joint working with other professionals and agencies and to ensure that people’s healthcare needs were met.

Staff supported people to maintain relationships that were important to them. People were encouraged to access the community and be engaged in meaningful activity.

People's choices were respected and staff consistently supported people in a way that maintained their independence. People were cared for with dignity and respect.

People, their relatives and staff were positive about the registered manager an

Inspection carried out on 27 April 2016

During a routine inspection

We inspected Brightwater on 27 April 2016, the inspection was unannounced. The service was last inspected in July 2013; we had no concerns at that time.

Brightwater is a care home owned by In Chorus and provides accommodation and personal care for up to five younger adults with a learning disability or with autistic spectrum disorder. The service has two separate units and also provides care to one person in their own home. Brightwater is located in two adjoining houses located in a residential area, approximately four miles from the centre of Eastleigh.

Relatives of people who lived at the service told us, “We are very satisfied with the quality of the care and support provided by the service.”

The service is required to have a registered manager and there was one 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.

Not everyone who used the service could tell us their views due to their health needs. We spoke to two people who lived at Brightwater and observed support provided. People told us they felt safe at the service and with the staff who supported them. People told us, “I feel safe,” and “Yes, staff are nice to me.” A relative told us, “Staff are very caring people and support [person’s name] very well.”

People told us they received their medicines on time. The completion of medicine administration records was thorough and accurate. Medicines were stored appropriately and staff who administered medicines received suitable training.

There were adequate numbers of staff available to support people. Relatives of people who lived at the service told us, “There are enough staff and what is really good is how flexibly they work to make sure things happen to suit [person’s name] needs. They will do what needs to be done to get the best out of each situation for [person’s name].”

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately. Staff training was delivered to a good standard, and staff received updates at regular intervals.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist and optician when required. People said they received enough support from these professionals and this was evidenced by detailed records kept by the service.

The service had a personalised social and activity programme for each person. This reflected things each person liked to do. For example, one person enjoyed active pursuits and swimming and these activities were scheduled and completed each week.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, such as the Mental Capacity Act (2005).

People were very happy with their meals and wherever possible, took an active role in cooking for themselves and others each week. People said they had enough to eat and drink and a good variety of choice. Comments received about the meals included, “The food is very good,” and “The meals are chosen by the people who live here, so it is what they want.”

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They

Inspection carried out on 15 July 2013

During a routine inspection

People�s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed the care records in relation to two people who used the service. The care plans included profiles of each person detailing their likes and dislikes, a record of healthcare, and information in respect of diet, behaviour, communication and support needs.

During our inspection we spoke with one person who used the service who told us �I like it here.� We spoke with a relative who was positive about the care provided. They said �I think (their relative) is extremely happy, I�ve never had any worries.�

The home was well maintained both inside and out and looked clean and comfortable. There were security arrangements in place. Throughout the home we noted smoke detectors, carbon monoxide detectors, heat sensors, first aid boxes, fire extinguishers, fire blankets and signs denoting the fire exits.

People who use the service had weekly meetings with their keyworker where they were able to discuss plans for the week and discuss any worries or concerns. The keyworker documented what was discussed. There were weekly meetings held every Sunday for people who use the service. This enabled them to discuss the activities of the previous week and put forward suggestions. Choices for the following week were made in terms of menu and activities.

Inspection carried out on 4 February 2013

During a routine inspection

People told us that staff checked with them before providing any support or care to make sure they were happy with what was planned. One person confirmed that at certain times they had said that they didn�t want care or support, and staff had respected this.

During our visit we reviewed the care plans for two people who used the service. We saw that the records contained person centred care plans. One relative, when asked what the service did well, replied "Caring, caring, caring." One person told us "It's nice here, the staff are nice, they look after me well."

Medicines were administered appropriately and safely. We reviewed the medication and administration policy. We spoke with a member of staff who told us how she administered medicine and this matched the policy. All the staff we spoke to confirmed they had received medication administration training and were only permitted to administer medication after they had completed the training and also received 'on the job' training from management.

Appropriate checks were undertaken before staff began work. We saw records and spoke with staff who confirmed this.

People were made aware of the complaints system in a format which met their needs. This included a picture board in the main living room.

Inspection carried out on 29 March 2012

During a routine inspection

There were five people living at the home when we visited. On this occasion we did not seek the views of people who use the service. Our information is based on our observations of the interaction between the staff and people using the service, our talks with staff and the records.

We spoke with several staff during our visit including the manager. Staff said that they liked working at Brightwater �the job is varied and can change from day to day depending how people are feeling�. They told us that they had good support form the senior staff and that there was an on call system available for out of office hours.

We observed how staff interacted with people in a friendly and respectful manner and ensured choice with daily events. The atmosphere was calm and relaxed.

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