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Inspection carried out on 11 July 2018

During a routine inspection

Bruntsfield House is a 'care home'. People in care homes receive accommodation and nursing and personal care as a single package under a contractual agreement with the local authority, health authority or the individual, if privately funded. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered for seven people (residential) and six people were receiving a service when we visited.

Bruntsfield house is also a domiciliary care agency. It provides personal care to people living in one independent supported living, extra care scheme which has two buildings at the same site and is located in Clacton on Sea. There are ten supported living flats overall, seven are located in the main building and 3 were in the adjacent building. It provides a service predominantly to people with learning disabilities and high complex needs and or mental health conditions. The service is also registered for thirteen community placements and ten people were receiving a service on the day we visited.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone using Bruntsfield house receives personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the registered provider was providing support to a total of ten people in the independent living, extra care schemes and six people in the residential service.

Whilst both services were in the same building each had separate entrances and operated independently, however are registered as the same location. The service is situated in a residential area of Little Clacton and is close to amenities and Clacton on Sea. The premises is set out on three floors in the main building with each person using the service having their own individual bedroom or flatlet and adequate communal facilities are available for people to make use of within the service.

At our last inspection on 27 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe using the service. Policies and procedures were in place in relation to safeguarding people from abuse. People's care planning considered risks to people and plans were in place to minimise these risks.

Safe recruitment practices helped ensure that only people suitable to work with vulnerable people were employed by the service.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. We saw that policies and guidance were available to staff in relation to the Mental Capacity Act.

Staff were caring and supportive and people felt listened to. Staff received regular support and training to keep up to date with best practice.

Staff encouraged people and supported them to pursue their hobbies and interests and this was done with the staff team.

A system was in place to manage and monitor complaints and compliments about the service.

People had access to and were aware of the services complaints procedure.

People told us that staff asked them if they were ok and happy with the service. In addition, regular reviews and meetings took place to help ensure that people received the care and support they required.

Information was made accessible to people by being produced in different formats which included the use of photographs, different sized print and pictures.

People were supported with their eating and drinking needs when needed. Specific guidance was available to staff in relation to people's dietary needs.

People told us their privacy and dignity was protected and promoted.

Accidents and incidents were clearly recorded and reviewed by the registered manager to evidence any trends or patterns that may occur.

Systems and audits were in place to regularly check that people were receiving the care and support they required.

The service maintained links with other services within the area to promote change and good practice.

Further information is in the detailed findings below

Inspection carried out on 27 January 2016

During a routine inspection

The inspection took place on 27 January 2016 and was unannounced. Bruntsfield House provides accommodation and personal care and support for up to six people who live with a learning disability or autistic spectrum disorder. It also provides support for a further six people who live independently in the community. The service does not provide nursing care. At the time of our inspection there were five people living in the service with a further five people living in the supported living service. Each service ran as separate units within the same building

The service had a registered manager. 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.

People were safe because staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs. There were enough staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred. The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

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. No-one at the home was subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and empowered to be as independent as possible in all aspects of their lives.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People were involved in the planning and reviewing of their care and support.

People’s health needs were managed appropriately with input from relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs. People were treated with kindness and respect by staff who knew them well.

People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture and staff were supported to provide care that was centred on the individual.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.