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Inspection carried out on 12 December 2019

During a routine inspection

About the service

Brownrigg is a care home providing accommodation and personal care for up to six people who are autistic or have a learning disability or mental health need. At the time of our inspection there were six people living at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People told us they enjoyed living at the service.

There were enough staff to keep people safe. Risks relating to people's care and support were assessed and mitigated and people were supported to be as independent as possible. Regular fire drills were held so people knew how to evacuate the service in an emergency. Staff were recruited safely.

People told us that staff were kind and caring. Staff treated people with respect and dignity.

People led active lives and we were shown pictures of the things they enjoyed doing, such as travelling on the bus to the seaside, visiting places in the local community and taking part in sponsored walks.

People were encouraged to access the kitchen whenever they wanted and were able to prepare their own drinks whenever they wished. They were supported to eat and drink safely.

Staff made prompt referrals to healthcare professionals when they needed additional support and advice. People told us they saw a doctor when they were unwell and received their medicines when they needed them.

Staff knew how to recognise and respond to abuse and the registered manager had reported any safeguarding concerns to the local authority.

Small concerns raised by people were documented as complaints and responded to appropriately. People told us they were happy with the support provided.

Staff received appropriate training and were supported by the registered manager to carry out their roles effectively. The registered manager completed a range of checks on the service, including care plan reviews.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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.

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 8 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

Inspection carried out on 10 May 2017

During a routine inspection

The inspection took place on the 10 May 2017 and was announced.

Brownrigg is a care home providing accommodation and personal care for up to six people who have a learning disability or autistic spectrum disorder. On the day of our inspection there were six people living at the service.

At the last inspection on 5 August and 1 September 2014, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt the service was safe. One person told us, “I’m safe, yeah, I like it here”. People remained protected from the risk of abuse because staff understood how to identify and report it.

The provider continued to have arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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 supported this practice. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People felt staff were skilled to meet the needs of people and provide effective care. One person told us, “I think so, yes they are [well trained]”.

People remained encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People said they felt listened to and any concerns or issues they raised were addressed.

Staff continued to support people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs remained met and people reported that they had a good choice of food and drink. One person told us, “The food is wonderful”.

Staff continued to feel fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. One member of staff told us, “There is lots of training available. There is no excuse not to learn”. Another member of staff said, “I get regular supervision. I like to know that I am doing my job well and get feedback”.

The service had a relaxed and homely feel. Everyone we spoke with spoke highly of the caring and respectful attitude of a consistent staff team which we observed throughout the inspection. One person told us, “I like to live here. I like the staff, they are all funny”. Another person said, “I like it here. I like my room and the staff they take a joke”.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People continued to be consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

People and staff told us the management team continued to be approachable and professional. One person told us, “[Registered manager] is alright, I like her”. Another person said, “It’s good. It’s good here”.

Further information is in the detailed findings below.

Inspection carried out on 5 August and 1 September 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection.

Brownrigg is a care home providing accommodation and personal care for up to six people who have a learning disability or autism. There were six people living at the service at the time of our inspection. People have their own bedrooms and access to communal areas in the house, as well as gardens and outside workshops. 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 and has the legal responsibility for meeting the requirements of the law, as does the provider.

People said they felt safe living at Brownrigg and that there were sufficient staff to support them at the home or when they were out in the community. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure that new staff were safe to work with vulnerable adults. One person told us, This is the safest place I’ve been in my life”. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected that abuse was taking place.

People’s mental capacity had been assessed and advocates supported people to make decisions. People were being reassessed for Deprivation of Liberty Safeguards (DoLS) in line with current policy and guidelines, although their freedom was not restricted as they knew the code for the security gate. Medicines were ordered, administered, stored and disposed of in line with good practice and guidelines.

Accidents and incidents were recorded appropriately and steps taken by the service to minimise the risk of similar events occurring in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff. The premises were tidy and clean and everyone took responsibility for cleaning duties. Laundry facilities were available and clinical waste was disposed of safely.

People were encouraged and supported to eat and drink well. One person said, “Oh I like the food here – it’s nice and tasty”. There was a choice of meals and some people were able to prepare their meals independently. People were advised on healthy eating and their weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups and as needed.

People’s rooms were furnished and decorated in line with their personal taste. Bathing facilities were available, although the ground floor shower room was not ideally located to ensure people’s privacy. However, we were told there were plans to re-design the shower room and the rear of the property which was currently used as an office and staff area.

Staff had received all essential training and there were opportunities for additional training specific to the needs of the service. Whilst the majority of staff had received supervisions with their manager every two months, some staff had not had supervisions recently. The manager was aware of this and was taking steps to address this. There were opportunities during the working day for staff to discuss any issues or concerns they had with managers.

People felt well looked after and supported and we witnessed that warm, friendly and genuine relationships had developed between people and staff. A relative said, “The care is genuine, nothing’s put on there”. They added, “It’s developed as a family. Staff have a wonderful way of caring … done with a sense of humour”. Care records described people’s hopes and aspirations for the future and people were encouraged to be as independent as possible. People chose what they wanted to do on a daily basis and were able to access the community, to go shopping or help out on a farm, for example.

Whilst there were no facilities for people to have nursing care, the manager had been trained in end of life care. Some people had made decisions about their future care and this was recorded in their care plans.

People were encouraged to stay in touch with their families and would visit their relatives’ homes. Relatives were asked for their views about the service and the care that was delivered to their family members. Completed surveys showed that families were happy overall and felt that staff were friendly, welcoming and approachable. One relative said, “Staff are always very pleasant”. Residents’ meetings were held regularly and people said they felt listened to and any concerns or issues they raised were addressed. One person said, “We have regular residents’ meetings to chat about things”.

Care records gave detailed information on how people wished to be supported and care plans were reviewed and updated regularly, although there had been a slight delay with the review of some care plans. This had not impacted on the quality of care that people had received.

People were involved in the development of the service and took an active part in interviewing new staff. Staff were asked for their views on the service and whether they were happy in their work. They had received all essential training and felt supported within their roles, describing an ‘open door’ management approach, where management were always available to discuss suggestions and address problems or concerns. Robust systems were in place to ensure that accidents and incidents were reported and dealt with in a timely manner. Quality assurance was undertaken by the provider to measure and monitor the standard of the service. The service worked collaboratively with others such as the local authority and safeguarding teams.

Inspection carried out on 18 September 2013

During a routine inspection

We spoke with four people who told us that they were treated as individuals and that they were given information and choices in relation to their care. One person explained that staff had explained a procedure to them several times so that they could fully understand. People told us that their dignity, independence and privacy was respected. This was confirmed by our review of people's records as well as our observations.

During our observation we saw that staff interacted well with people when they were supporting them and were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence. People explained that staff had helped people to consider each other�s need for quiet time and had helped them agree how to do this. We saw that activities were altered to suit individual needs.

We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These had been developed for each individual and documented their wishes and preferences in relation to how their care was provided and were presented in a form that assisted people to understand what they said. A relative's assistance was sought with this where the person was unable to fully contribute themselves.

Equality and diversity had been considered in the service by looking at each individual's needs. Any equipment or adaptations needed were provided.

Inspection carried out on 31 January 2013

During a routine inspection

We spoke with people who told us that they were treated as individuals and that they were given information and choices in relation to their care. One person said that "we help make decisions��. People told us that their dignity, independence and privacy was respected. This was confirmed by our review of people's records as well as our observations.

During our observation we saw that staff interacted well with people when they were supporting them. We saw that staff were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence. For example staff knocked on people's door before entering and they checked on how people wanted to be supported before doing so. We saw that activities were altered to suit individual needs.

We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These had been developed for each individual and documented their wishes and preferences in relation to how their care was provided. They were presented in a form that assisted people to understand what they said. A relative's assistance was sought with this where the person was unable to fully contribute themselves.

Equality and diversity had been considered in the service by looking at each individual's needs. Any equipment or adaptations needed were provided.

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