Background to this inspection
Updated
25 February 2023
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 Care Act 2014.
Inspection team
The inspection was completed by two inspectors.
Service and service type
Bricket Wood Care Limited 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. Bricket Wood Care Limited 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 not a registered manager in post, however the manager was starting to go through the process of registering to become a registered manager. For the purpose of this report they are referred to as the manager.
Notice of inspection
This inspection was unannounced
What we did before inspection
We reviewed information we had received about the service since the last inspection. 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. We spoke with the local authority commissioning team for their feedback about the improvements in the service.
During the inspection
We spoke with three people who used the service and one relative about their experience of the care provided. People were able to verbally talk to us. We spoke with four members of staff including the manager. We reviewed a range of records. This included two people's care and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service. We met with the provider to seek further assurances around improvements they planned to make in relation to governance and oversight.
Updated
25 February 2023
Bricket Wood Care Limited is a residential care home which was providing personal care to four people at the time of the inspection. The service can support up to six people.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People's experience of using this service and what we found
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; although the policies and systems in the service did not wholly support this practice.
Right Support
Staff were aware of people's strengths and what they could do and supported people to make their own choices about their care and support needs. People were being supported by staff to be actively involved and engaged in cooking and completing their own household tasks. People valued these opportunities and they helped to maximise people's independence.
The service had worked hard since the last inspection and improved staff knowledge had supported positive improvement. Staff learned from incidents and how they might be avoided or reduced, although this was not embedded within the day to day management of the service. Staff followed safe practices when wearing personal protective equipment (PPE). Improvements had been made to the environment people lived in to ensure it was clean, supported their needs, was well maintained and appropriate equipment was in place.
Right Care
People experienced an improved quality of care. People and their families told us staff were kind and supported them well. Staff understood how to protect people from poor care and abuse, they had received training on how to recognise and report abuse, and were able to tell us when they would report any concerns. We observed staff interacting with people in a kind and compassionate way and in a way that promoted people’s independence. Staff and people worked together and were continuing to develop positive risk assessing to encourage more positive risk taking and independence.
Right culture
People did not always have risk assessments fully completed to support their support needs. Staff were knowledgeable about the risks to people and were able to mitigate those risks, For example, people at risk of harm People were supported by staff who continued to undergo training to deliver best practice in relation to supporting people with a learning disability. Although further training was required to ensure staff had all the right skills.
The service had a recent change in management which had been positive in bringing about the improvements in the service. People and staff were very positive about the manager. Work had been undertaken to improve the providers quality assurance system, but actions were not always documented, and some audits were not in place. This did not have an impact on people's care. People's opportunity to lead inclusive and empowered lives had improved since the last inspection. This is because staff knowledge and understanding had improved, and management led the development of an open and transparent culture. Managers understood that further work was needed.
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. Report published: 22 June 2022
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection provider was no longer in breach of regulation.
This service has been in Special Measures since 16 May 2022. 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
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 improved to requires improvement.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bricket Wood Care Limited on our website at www.cqc.org.uk.
Follow up
We will work alongside the provider and local authority to monitor progress and will continue to monitor information we receive about the service, which will help inform when we next inspect.