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Inspection Summary


Overall summary & rating

Good

Updated 9 August 2017

This inspection took place on 4 April 2017 and was announced. At our last inspection in December 2015, we found the provider was not meeting a number of regulations. We therefore asked the provider to take action in relation to upkeep of the environment, staff training and support, quality assurance systems, notification of reportable events and record keeping. Following the inspection, the provider sent us an action plan which set out the action they were taking to meet the regulations.

Brigstock House is a care home registered for eight adults with a learning disability, autism or mental health needs. There were six people using the service at the time of our inspection. Two people used the service for short stay breaks from time to time.

The registered manager in post at the time of our previous inspection left employment shortly afterwards and a replacement manager was appointed in April 2016. This manager left and another new manager was appointed in October 2016. They were in process of applying to register and were already registered for a second location owned by the registered provider. 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.

Since our last inspection essential repairs and redecoration to the environment had been carried out. The home was clean, comfortably furnished and bedrooms were personalised according to people’s needs and interests.

Staff had undertaken further training to support them in their role and meet people’s individual needs. The manager had improved the arrangements for staff supervision and to check and monitor that staff had the skills to support people effectively.

We previously found that incidents and accidents were not always reviewed or investigated and those which were reportable to CQC had not been shared. We found improvements at this inspection.

Further quality assurance arrangements had been introduced to check that people were well cared for and safe. New audits and checks were in place although further work was required to embed and sustain consistent practice. We have not changed the rating for the well led question from requires improvement because to do so requires consistent good practice over time.

There were adequate numbers of staff who had been safely recruited. Staff were available to provide people with one to one support when needed.

People felt safe and the staff took action to assess and minimise risks to people’s health and well-being. Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse.

People spoke positively about the home and the staff team. Staff understood the needs of the people who used the service and how they liked to be supported. We found that staff communicated well with people and with each other.

Staff respected people’s privacy and treated individuals with kindness and patience. Staff made sure people’s dignity was upheld and their rights protected. 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 support this practice.

Care and support was planned in partnership with people so their plans reflected their views and wishes. Care plans were reviewed on a regular basis to ensure people were getting the right support.

People maintained relationships with those who were important to them. Staff worked flexibly to support people with their preferred interests, activities and hobbies.

People were involved in the planning and preparation of their meals which met their dietary needs and choices. People received the support and care they needed to maintain thei

Inspection areas

Safe

Good

Updated 9 August 2017

The service improved to Good. We found that action had been taken to improve the environment and cleanliness of the home.

People lived in a home that was safely maintained. People were protected from the risk of infection because appropriate guidance had been followed.

Risks to people's safety were identified and planned for. Steps were taken to minimise these and keep people safe.

People were supported by sufficient numbers of staff and the provider followed the correct recruitment process.

People received their medicines as prescribed and medicines were stored and managed safely.

Effective

Good

Updated 9 August 2017

The service improved to Good. We found that action had been taken to strengthen the arrangements for staff supervision and training.

Consent to care and treatment was sought in line with the Mental Capacity Act 2005 and staff understood the requirements of this to protect people’s rights.

People were encouraged and supported to make meal choices that met their preferences. Individuals received the assistance they needed with eating and drinking and staff were aware of people’s dietary needs.

People received the support and care they needed to maintain their health and wellbeing. They had access to appropriate health care professionals when required.

Caring

Good

Updated 9 August 2017

The service was caring. People were comfortable and relaxed in the company of the staff supporting them.

There were positive relationships between people who lived at the home and staff. Staff knew people well and what was important to them.

People were supported to maintain meaningful relationships with those close to them.

Staff treated people with dignity, respect and kindness.

Responsive

Good

Updated 9 August 2017

The service was responsive. People’s needs were regularly assessed, monitored and reviewed. Their care plans were personalised to reflect individual needs and preferences and staff responded to changes in people's needs or circumstances.

People took part in a variety of activities that reflected their interests and choices.

Arrangements were in place for dealing with complaints and responding to people’s comments and feedback.

Well-led

Requires improvement

Updated 9 August 2017

Some aspects of the service were not well-led. The changes in management had resulted in some inconsistency although the new manager knew what was required to develop the service.

New systems and processes to check the quality of care had been introduced although these had not been effectively established to ensure consistent and sustainable governance at the home.

Records about people’s care were fit for purpose and reflected their needs and preferences. The manager was taking action to personalise people’s care plans further.

The new manager demonstrated effective leadership and values, which were person focused. There was open communication and staff felt supported in their roles.