We carried out a review of the data available to us about Bruddel Grove on 6 July 2023. 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 Bruddel Grove, you can give feedback on this service.
Bruddel Grove is a residential care home providing personal care to five people at the time of the inspection. Bruddel Grove can accommodate up to five people in one building.
People’s experience of using this service and what we found
People were positive about living in the home. They felt they had the right amount of support and could seek help from the staff team as and when they needed it.
People were involved in the development and review of their care plans and risk assessments. They could give their views on the level of support they felt they needed, and request help as and when they needed to.
People were encouraged and guided on healthy eating and were supported to access support from external health and social care agencies.
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.
People's medicines were managed safely and effectively. Accidents and incidents were investigated. This included clear processes for investigation and support for staff to learn from mistakes. Complaints were handled and responded to in line with the provider's complaints policy.
Staff were happy in their roles. They were well trained and received regular supervision to enable them to carry out their duties effectively. There were sufficient numbers of staff in place and they understood how to provide people with safe and person-centred care.
There was a clear management and staffing structure in the home. The provider had quality assurance systems in place to monitor the quality and safety of the service.
Rating at last inspection
The last rating for this service was Good (published 14 March 2017)
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bruddel Grove on our website at www.cqc.org.uk.
There was not a registered manager in post. The service had a manager in place who had applied for registration with the Care Quality Commission. 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 the last inspection on the 7 and 8 December 2015 we found that people’s support was not personalised to their individual needs. This was a breach of Regulation 9 Health and Social Care Act (Regulated Activities) Regulations 2014 Person Centred Care.
We also found there were not sufficient numbers of suitably qualified staff to meet the needs of the people in the service. Additionally, staff did not receive support to enable them to carry out their roles and responsibilities. This was a breach of Regulation 18 Health and Social Care Act (Regulated Activities) Regulations 2014.
At this inspection we found the provider had made improvements to address the areas of concern. Support plans had been individualised, these were more person centred. People’s care plans focussed on people’s abilities and gave guidance what was needed to ensure their care was personal to them. Plans were reviewed and evaluated regularly to ensure care was current and up to date. Where it was found that people needed alternative support the service worked with professionals to ensure this happened. Although some activities took place it was acknowledged by the manager that further possibilities needed to be explored to ensure people were able to enjoy interests and activities they chose. Complaints had been dealt with effectively.
There were sufficient staff to meet people’s needs. Staff were trained in safeguarding and had a good understanding of how to respond to safeguarding concerns. Risks to people and the environment were assessed and plans put in place to mitigate any identified risks. Policies and procedures were in place to manage medicines. The registered provider followed safe recruitment procedures. This meant the service was acting appropriately to keep people safe.
Staff responded promptly where people required assistance. Staff had received appropriate training to meet the needs of the people using the service. Staff felt supported and were supervised in their roles. People were encouraged to maintain good nutrition and people had choice and input with planning their menus. 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. People had access to health care when necessary and were supported with health and well-being appointments. This meant the service were effective in meeting people’s health needs.
People were supported by kind and attentive staff who knew them well. The manager and staff had ensured people were reassured, given relevant information and felt cared for when they experienced anxieties. People were supported in a respectful and dignified manner. Staff discussed interventions with people before providing support. People had access to advocacy support when they were unable to express their views clearly. Staff were knowledgeable about people’s abilities and preferences, and were aware about how to communicate with people in a way that met their individual needs. This meant the service was caring.
The service was well led by an experienced manager who provided strong leadership to the team. Staff expressed confidence in the management and felt valued in their roles. There were robust quality assurance processes in place to drive improvement in the service.
We inspected Bruddel Grove on 7 and 8 December 2015. This was an unannounced inspection. Bruddel Grove is a care home run by the National Schizophrenia Fellowship, also known as Rethink Mental Illness, where up to five people who have enduring mental health problems are supported. The aim of the service is to help people move on to more independent accommodation by providing support that meets their changing needs. At the time of inspection there were five people living at the home.
There was a registered manager at the service at the time of our inspection. 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’s needs weren’t always met because of a lack of staff. Staffing levels were not at full capacity and there was not a full time service manager to ensure the day to day management of the service was effectively carried out. There were long delays in recruiting staff. There was a reliance on bank and agency workers and we saw no evidence that agency workers competency had been assessed before managing medicines.
People said they felt safe. Staff had been checked before starting at the service to ensure they were suitable. Staff had an induction when they started at the service which they reported as “good”. Staff had received training on recognising and reporting suspected abuse and the importance of reporting any behaviour from colleagues that may concern them. Regular meetings with their managers had not always taken place as per policy. However staff reported feeling supported.
Staff had not received all appropriate training to care for the changing health needs of people in the service, such as incontinence care and pressure areas.
People were supported to enjoy a balanced and healthy diet and were encouraged to prepare some meals for themselves if able. People had access to health professionals when needed.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. No person at the service had any restrictions.
People felt cared for and their relatives told us the staff were caring. People’s privacy and dignity was maintained when staff accessed their rooms. People were supported to get independent advice from an advocate if required.
People did not always have support that was responsive to their individual needs. There were no structured activities to ensure people were able to enjoy activities they may like to take part in. Staff had attempted to ensure that where people were being considered as ready to move to another service, these were planned. However, communication with other agencies meant these were not always planned effectively and involving all relevant persons.
Improvements were required to ensure the service was well led. Management was not consistent due to responsibilities at other complex services as well as Bruddel Grove.
The service’s aims and objectives did not always relate to the people living in the service or reflect their aspirations. Working in partnership with other relevant professionals had not always been achieved to ensure people were enabled to get the best outcomes.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Below is a summary of what we found. The summary is based on our observations during the inspection, talking with two people using the service, two staff members and the manager. We reviewed the care plans of the five people who lived in the home and other relevant records.
Is the service safe?
Care plans were detailed and instructed staff how to meet people's needs in a way which minimised risk for the individual. They ensured that staff members had all the information necessary to support people in as safe a way as possible.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Training records showed that relevant staff had been trained in the Mental Capacity Act 2005 which incorporated DoLS. The type of care the home provided and the needs of the people who lived there meant that it had never been necessary to deprive people of their liberty.
The home was safely maintained and systems were in place to make sure that the manager and staff continually monitored health and safety within the premises. Health and safety was taken seriously by the home and all the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.
The home made sure that staff were well trained and were generally well supported to enable them to provide safe care to the people who lived there.
Systems were in place to make sure that the manager and staff continually monitored the quality of care offered to people.
Records had been judged as not fit for purpose in October 2013. At this inspection we saw that they were detailed, up-to-date and accurate and helped staff to support people safely.
The people we spoke with told us they felt safe in the home and trusted all the staff.
Is the service effective?
People's health and care needs were assessed with them and they were helped to make informed decisions about their lifestyle and recovery plan. Care plans were detailed and clearly identified people's needs and how they should be met. We saw that staff gave support as described in individual's care plans.
We saw that people signed behavioural agreements as part of their recovery plans and accommodation agreements. We found that if people did not adhere to the agreements they had signed, the appropriate agreed action was taken.
Is the service caring?
People were supported by caring, knowledgeable and patient staff. We saw that care staff were attentive, encouraging and positive. Staff communicated and interacted with people at all times.
People's diversity, values and human rights were respected. Care plans were individualised and person 'centred. We saw that people were treated with respect and dignity by the staff.
People told us that they were treated well and their choices and views were respected.
Is the service responsive?
Care plans were reviewed regularly and amended, as necessary, to meet people's current needs. People were fully involved in making any changes. We noted that staff worked hard to support people to achieve an enjoyable and rewarding life. However, ultimately people made their own choices about their lifestyle and the service was able to identify when they could not meet people's needs. We saw that people were supported and encouraged to access health services in a timely way.
The home had made changes and improvements as a result of ideas and discussions with people who lived in the home.
The home had made the changes required by the Care Quality Commission (CQC) at the last inspection.
The home had received one complaint in 2014. This was being dealt with effectively, at the time of the inspection.
Is the service well led?
Staff members told us that they felt they were generally supported to do their job well although had some concerns that this support had reduced recently. They said that they felt valued and their views were listened to.
The service had a formal quality assurance system. We saw records which showed that the home identified shortfalls and the actions to be taken to address them. Some examples of changes made as a result of the annual quality questionnaires were provided by the manager. As a result, the quality of the service was being maintained or improved.
People who used the service said they felt safe at Bruddel Grove. One person said that they could not think of any changes that they would want to be made to the home. People told us that they liked the staff and that they felt well informed and included in decision making.
We found that people were respected and involved in the planning of their care and the running of the home.
We observed that people were helped to go out and to participate in chosen activities.
The provider had good safeguarding systems in place in order to protect the people who use the service from the risk of abuse or exploitation.
Staff members told us that they had good relationships and support from the management team.
We could see that staff knew the people who live at Bruddel Grove very well and could tell us their needs. We saw that staff tried to help people to be as independent as possible and to achieve their chosen goals.
There were enough staff members on duty in order to meet people's needs and to keep them safe.
The written records of people's individual care plans did not have the necessary level of detail and some risk assessments were absent.
The provider had good systems in place to assess and monitor the quality of its service provision.
People were supported to make decisions about their care and their day-to-day lives. They were also supported to be as independent as possible and to access community facilities.
Medication was stored and managed safely so that people received the right medicines at the right times. Staff had received a range of training and qualifications and they were supervised and supported so that they could meet people's needs.
People were asked their views about the service and these were listened to and acted upon. There was a system to monitor the quality of the service that people received and to make improvements when needed.
People said that they could decide what to do each day. They enjoyed the meals, which they helped to choose and prepare. One person commented (about the weekly menu), 'we say what we want and staff write it down'. Staff members told us that they encouraged people to do things for themselves.
People mostly managed their own personal care, with advice and encouragement from the staff. They received help with making health appointments and staff went with them if needed.
People received support with their medicines, but they could take responsibility themselves if they wished to and could do so safely. Overall, their medicines were being well managed, although the recording of their disposal was not always as clear as it should be.
We observed staff responding to various issues and the questions that people raised. Staff took time to explain things to people. A lot of conversations focused on helping people to feel confident and to be positive about the day ahead.
People had the opportunity to express any concerns, for example when they met with their key worker, and at regular house meetings. One of the staff commented: 'I'd have no problem in whistle blowing if it was needed'.
The people who use the service told us that staff were around to help them when needed. Staff received training so that they were competent and could develop their knowledge. The training was described as 'excellent', and 'light years ahead' of what it had been.
Overall, people were happy living at Bruddel Grove and they felt that the service was meeting their needs.