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Inspection carried out on 20 November 2017

During a routine inspection

Brooklyn House is a ‘care home’. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premise and the care provided and both were looked at during this inspection. Brooklyn House accommodates up to 17 people in one adapted building. At the time of our inspection 15 people were using the service.

This inspection took place on 20 November 2017. The inspection was unannounced, this meant the staff and provider did not know we would be visiting. At the last inspection on 4 March 2015 the service was rated ‘Good’. At this inspection we found that overall the service remained good. We found some areas for improvement but at the time of the inspection there was no impact to people's safety. Where we have found this we have made a recommendation. Further details can be found in the main body of the report.

Quality assurance systems were in place to identify areas for improvement but people’s views about what improvements needed to be made was not included. We have made a recommendations about how the service ensures that it continuously improves.

The registered manager did not have a way of assessing how many staff were needed, and at the busiest time of the day there was not always enough staff available. We have made a recommendation about staffing levels.

Risk assessments were in place and covered most areas, however when people were at risk of choking or had bed rails in place, the risk assessment did not contain sufficient detail for staff to understand how to care for these people safely. We have made a recommendation about completing comprehensive risk assessments.

Checks were carried out on staff before they started work with people to assess their suitability to care for vulnerable people. Staff understood their role and responsibilities to keep people safe from harm.

Regular staff meetings had taken place, but only one meeting had been held with people to seek their views regarding their care and support. We have made a recommendation about holding regular staff meetings.

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.

Staff received regular supervision and had been trained to meet people’s needs. People were supported to have control of their day to day lives and staff supported them in the least restrictive way possible. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. People had access to the food and drink they chose, when they wanted it.

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and human rights. The care and support people received was individual.

The service did not actively identify the information and communication needs of people with a disability or sensory loss, and no one at the service had been trained in how to do this. We have made a recommendation about staff training and development.

There was a clear management structure in place. The manager and other senior staff were well liked and respected by people and staff.

Inspection carried out on 4th March 2015

During a routine inspection

The inspection took place on 04 March 2015 and was unannounced. Brooklyn House provides accommodation and personal care and support for up to 17 people, some who may have a mental health need. At the time of our inspection there were 14 people who lived in the service.

The home had a registered manager in post. 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.

Health and social care professionals we spoke with were all positive in their comments about the support provided to people at Brooklyn House.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

People’s health care needs were assessed appropriately and care was planned and delivered to meet people’s needs safely and effectively. People were provided with sufficient quantities to eat and drink and their nutritional needs were met. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people’s healthcare needs were well managed. Staff interacted with people in a caring, respectful and professional manner, and were skilled at responding to people’s non-verbal requests promptly and had a detailed understanding of people’s individual care and support needs.

People were supported to follow their own chosen hobbies and interests and encouraged to take part in activities that interested them and were supported to maintain contacts with the local community so that they could enjoy social activities outside the service. There were systems in place to manage concerns and complaints. There was an open culture and the manager and staff provided people with opportunities to express their concerns and did what they were able to reduce people’s anxiety. People understood how to raise a concern and were confident that actions would be taken to address their concerns.

The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits completed by the provider and registered manager and subsequent actions had resulted in improvements in the service. Systems were in place to gain the views of people, their relatives and health or social care professionals. This feedback was used to make improvements and develop the service.