Brewster House

Updated 25 May 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors and an inspection manager.

Service and service type

Brewster House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brewster House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, senior care workers and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people's care records, monitoring charts and medicines records. We looked at three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found on inspection and we reviewed training records and quality assurance documentation.

Updated 25 May 2022

About the service

Brewster House is a residential care home providing personal care to up to 71 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 51 people using the service.

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

The provider had implemented a number of improvements since our last inspection. The service had a new registered manager and deputy manager in post who had a strong focus on driving improvements and creating a positive culture for people and staff.

The management of risks to people’s safety had improved. However, the processes in place did not always effectively identify risks or demonstrate what actions had been taken in order to address these. The registered manager was aware of the areas which still required development and was providing staff with additional training and support to ensure processes were improved. There was a service improvement plan in place which the registered manager was continuing to work through to identify what had been achieved and where action was still needed.

The provider completed relevant recruitment checks for new staff; however, some checks had not been fully documented. The registered manager was able to demonstrate how they were making improvements to this process to ensure staff were safely recruited.

There were enough staff available to meet people’s needs and the registered manager had improved how staff were deployed throughout the service to ensure consistency of support. Staff spoke positively about the improvements in the service and the support they received from the management team.

People were protected from the risk of abuse. Staff knew how to identify signs of abuse and felt comfortable raising concerns with the registered manager. People received their medicines as prescribed and the provider ensured staff were trained and competent to administer prior to supporting people. 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.

The managers and staff had developed positive working relationships with other healthcare professionals in order to support people’s changing needs. People’s relatives told us they felt able to feedback and raise any concerns and generally spoke positively about the improved culture of the service and the care people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Inadequate (published 02 August 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 02 August 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 23 June 2021 and 07 July 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the management of risk, safeguarding people from the risk of abuse, staffing and the oversight of the service

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brewster House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.