Archived: Brookside House Care Home

Accommodation for up to 25 people is provided in the home on two floors. The service is designed to meet the needs of older people living with or without dementia. There were 15 people using the service at the time of our inspection.

At our last inspection on 17 and 18 October 2016, we served warning notices on the provider in the areas of medicines and good governance. We also asked the provider to take action to make improvements in the areas of statutory notifications, person-centred care, dignity and respect, safe care and treatment, safeguarding people from abuse and improper treatment, premises and equipment, recruitment and display of rating. We received an action plan setting out when the provider would be compliant with the regulations. At this inspection we found that action had been taken to make improvements in all areas. However, while improvements had been made, more work was required in the area of good governance.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

The service had not had a registered manager since January 2017. A manager was in post but had not started the application process to become registered with the CQC. They were available during the 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.

Staff did not always safely manage identified risks to people. Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Sufficient numbers of staff were not always on duty to meet people’s needs during our inspection. Staff were safely recruited. Safe medicines and infection control practices were mostly followed.

Staff did not receive appropriate training, supervision and appraisal. People’s rights were not consistently protected under the Mental Capacity Act 2005. People’s needs were not fully met by the adaptation, design and decoration of the service. People received sufficient amounts to eat and drink and external professionals were involved in people’s care as appropriate.

Staff were kind and knew people well. People and their relatives were not fully involved in decisions about their care. Advocacy information was made available to people. People were treated with dignity and respect and their independence was promoted.

Activities required improvement. People received personalised care that was responsive to their needs. Care records contained information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

There were systems in place to monitor and improve the quality of the service provided, however, they were not effective. Further work was required to ensure that people and their relatives were involved or had opportunities to be involved in the development of the service. The provider was not fully meeting their regulatory requirements.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Accommodation for up to 26 people is provided in the home on two floors. There were 15 people using the service at the time of our inspection. The home provides personal care for older people. At the time of our inspection, the service was not accepting any new admissions.

A registered manager was in post, however, at the time of the inspection they were not working as the manager. An acting manager had been in post for a week and was present during the inspection. However, no application to register a new manager, or cancel the registration of the previous registered manager, had been received by the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

Appropriate action was not taken in response to potential safeguarding issues. Staff did not always safely manage identified risks to people. Sufficient numbers of staff were on duty to meet people’s needs during our inspection, however, systems were not robust to ensure that sufficient staff were on duty at all times.

Safe infection control and medicines practices were not always followed. Staff were not recruited through safe recruitment processes.

People’s needs were not fully met by the adaptation, design and decoration of the service. Staff did not receive appropriate induction, training and appraisal. People’s rights were not always protected under the Mental Capacity Act 2005.

People received sufficient amounts to eat and drink and external professionals were generally involved in people’s care as appropriate.

Staff were kind but did not always respect people’s privacy and dignity. People and their relatives were not fully involved in decisions about their care. Advocacy information was not easily available to people.

People did not always receive personalised care that was responsive to their needs. Activities required improvement. Care records did not always contain information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

There were systems in place to monitor and improve the quality of the service provided, however, they were not effective. People and their relatives were not involved nor had opportunities to be involved in the development of the service. The provider was not meeting their regulatory requirements.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People we spoke with told us they were happy with the care and support they received. One person said, 'I feel like royalty.' Another person said, 'Excellent staff. I am well looked after.'

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We observed there was safeguarding vulnerable adults training in progress on the day of our visit and further training was booked for the same week. We spoke with four people using the service in relation to this outcome. They all told us they felt safe and that staff were kind to them. A relative told us, 'I feel [my relative] is safe here. I have no concerns. The carers are kind.'

We observed staff throughout the day and we saw there were enough staff to meet the needs of people using the service. Staff were attentive and when a person asked for assistance they did not have to wait for it.

People's complaints were fully investigated and resolved, where possible, to their satisfaction. We looked at the complaints records held in the service. We saw concerns and complaints were well documented with a clear audit trail of the concern raised, the investigation and the outcome. This meant that complaints were responded to quickly and action was taken to resolve the matter.

People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members. People had access to health care professionals and the home recorded information appropriately to ensure they worked with other providers.

Staff members had received safeguarding training and confirmed how they would report any possible abuse. People told us they felt safe. An incident was managed by the service; they put most of the actions expected into place.

Action had been taken to redecorate and update areas of the home that were found to require attention at the last inspection. Entrances to the home were secure, although we found that clinical waste bins remained in areas that people could access.

Staff rotas and training information showed that staff were qualified, skilled and experienced, but that there were not always enough staff in the evening and during the night.

There were systems in place to regularly check and monitor the way the service was run.

The service had a policy and procedure to guide people in how to make a complaint but incorrect information about taking complaints further.