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Archived: Brimley Good

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Reports


Inspection carried out on 14 August 2017

During a routine inspection

This comprehensive inspection took place on 14 and 16 August 2017 and was unannounced on the first day.

Brimley provides accommodation and personal care for up to six adults who require personal care. The service specialises in providing care for both younger and older adults with a learning disability and/or autism. The home is a large bungalow in a quiet cul-de-sac in a residential area of the seaside town Exmouth in Devon.

The registered manager had left the service in April 2017 and was in the process of de-registering as the 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 2008 and associated Regulations about how the service is run. After the inspection, the de-registration process of the registered manager was completed.

An area manager in the provider organisation had been overseeing the home and spent several days each week working at Brimley. A recent appointment to the role of manager had been made and this person was in the process of applying for registration as the manager.

The provider organisation Robert Owen Communities has been taken over by another provider, United Response. Senior staff had been in contact with the CQC to arrange to register the service with the new provider.

The service was previously inspected in May 2016 when the service was rated as requiring improvement. At that inspection we found four breaches of regulations and improvements were required as the service was not fully safe, effective, responsive or well-led. The home was the subject of a whole home multiagency safeguarding investigation at the time of our 2016 inspection. These concerns related to staffing, safe care and treatment and records not demonstrating that people’s care and welfare needs were always being met. The local authority, who lead on safeguarding, had monitored the improvements made to the service. They had subsequently closed the safeguarding investigation as they were satisfied with the improvements made.

At this inspection, we found the service had made and sustained improvements and was now meeting all the regulations.

There was a governance system which ensured that the quality and safety of the home was monitored. Where improvements were required, there was a service improvement plan which was updated regularly with actions that had been completed and new actions identified. Checks and audits of the service were routinely carried including audits of medicine administration, fire safety, building maintenance and care records. Senior staff from the provider organisation undertook quality assurance visits on a regular basis.

People were clearly happy and relaxed in the home. Throughout the inspection, we observed people laughing and showing affection towards staff. Comments included “They are very nice, [Manager] is ever so lovely” and “I like it here."

People were encouraged to do activities both outside and in the home. This included going to weekly clubs where people got involved in arts and crafts as well as going out for coffee and lunch. Staff helped people celebrate special occasions by going out to somewhere of the person’s choice. For example, one person who was celebrating their birthday chose to go to the pub with everyone from the home. People were also supported to be involved in day to day living skills such as cooking, shopping, cleaning and personal hygiene.

Staff understood the need to support people to remain as independent as possible. Staff were able to communicate with people using a range of methods both verbal and non-verbal. Some people were able to go out unaccompanied by staff. Care plans showed that this had been risk assessed and systems had been put in place to enable them to contact the home if ne

Inspection carried out on 17 May 2016

During a routine inspection

The inspection took place on 17 and 26 May 2016 and was unannounced. The home had previously been inspected in January 2014 and had met all the regulations inspected.

Brimley provides accommodation with personal care for up to six people who have learning disabilities. When we visited the home, there were five men and women living there, most of whom had been resident for a number of years.

The home is located in a residential area of Exmouth, a seaside town on the south coast of Devon.

It is a large bungalow style building with a parking area at the front and a garden at the rear of the building. The home provides six single bedrooms, a large lounge/diner and a large kitchen. There is also a conservatory attached to the dining area which provided additional seating and dining space.

The home has a manager, who had worked there for a number years and had been registered with the Care Quality Commission since 2014. 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.

The culture at the home reflected some of the provider’s values which included being supportive and caring, treating people with dignity and respect, being passionate about people. However other values of being committed to learning and continuous improvement were not evidenced. Quality monitoring arrangements were in place, but these had not been carried out effectively. Audits had not always been carried out and where they had, there was evidence that they had not identified issues. These included audits of care records, medicines administration and equipment audits. Health and social care professionals said the home did not always implement improvements that were suggested.

Staff worked with healthcare professionals including people’s GP, specialist medical staff and members of the local community mental health team. However some professionals said their advice and guidance was not always acted upon.

Staff supported people to become more independent and develop their skills, both inside and outside the home. This included increasing people’s ability to travel independently and to develop household skills as well as interpersonal and social skills. People were supported to follow activities they were interested in, including meeting people in the community at coffee morning and attending art and craft sessions.

People received their medicines safely and on time. However, storage of medicines was not safe as there was a risk that locked storage cabinets could be removed by unauthorised persons. Staff had a good knowledge of people’s communication, care and health needs. They also had an in-depth knowledge of their mental health and social needs.

People were treated with kindness and dignity. They were involved in and chose their preferences when supported with care. Staff respected people’s rights and helped them to be as independent as possible whilst feeling safe.

Staff encouraged people to eat a well-balanced diet and make healthy eating choices. However, staff had not taken appropriate actions to support people when there were significant changes in their weight.

People’s care records were not well maintained and up-to-date, although the home was in the process of revising all the records. During the inspection new care plans were being developed with each person. However, we did not find evidence that, where appropriate, those close to them, such as relatives, had been involved.

Staff received training when they started working at Brimley. However the training did not fully comply with nationally recognised standards for induction of new care staff.

Staff were supported to refresh and update specific training, such as fire safety and

Inspection carried out on 29 January 2014

During a routine inspection

Five people were living at Brimley at the time of our inspection. During this inspection we observed engagement and interaction between support staff and people who live at the home. We saw that support staff were kind and considerate in their approach to each person and were sensitive to the needs of people.

We found that people's consent had been obtained for care and treatment provided to them by the service. Records we looked at did not show that people had had regular opportunities to be involved in and discuss how they wished to have their care provided or that they had been given information about treatment which they had received.

People's health and social care needs had been assessed and care had been delivered to meet their needs. People had access to community and specialist health services. We saw some risk assessments in place, but there were none relating to nutrition or pressure areas.

People had been protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by suitably qualified, skilled and experienced staff.

People who live at the home were aware of how to make it known to support staff if they were unhappy.

Inspection carried out on 3 January 2013

During a routine inspection

During this inspection we met with all the people who live at Brimley. They told us they were very happy living at Brimley, and said the staff were "the best". We saw that staff were respectful of people's privacy and of their right to be independent and be treated equally. Staff had a good understanding of the mental capacity act and underlying principles, although had not completed records in relation to this.

Records and discussions with staff showed that support for people was focussed on increasing people's skills and independence. People were helped to remain physically healthy by for example seeing their GP and allied healthcare professionals. They were supported to understand and to attend for health checks. People enjoyed their social activities and links with the local community.

Staff received training appropriate to their role, including safeguarding training. Staff demonstrated a good understanding of abuse and of safeguarding. Training had not included how to make a safeguarding alert. Systems were in place to monitor the quality of the service provided.