Archived: Brookview

Updated 30 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 29 September 2015. The inspection was unannounced and was undertaken by two inspectors.

Due to their complex health conditions and communication difficulties, we were unable to speak with people who used the service. To help us understand people’s experience of the service 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 to us.

We also spoke with three relatives, the interim manager, the team leader, five care staff and a healthcare professional.

We looked at the records of three people who used the service and looked at two staff records, and also reviewed quality monitoring records.

We reviewed information we held about the service, for example, notifications the provider sent to inform us of events which affected the service.

We looked at information received from the local authority commissioners of adult social care services. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority. Prior to our visit we spoke with the local authority. The provider had sent us the Provider Information Return (PIR) and we used this information as part of our inspection planning.

Updated 30 November 2015

This inspection took place on 29 September 2015 and was unannounced.

Brookview is registered to provide personal care for up to eight people with learning disabilities and physical disabilities. At the time of our visit there were eight people living at Brookview.

At our last inspection in June 2014 we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to infection control. The provider sent us an action plan outlining how they would make improvements. At this inspection we found improvements had been made.

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 and associated Regulations about how the service is run. At the time of our inspection a registered manager was not in post although the provider had appointed a manager who started in September 2015. Prior to this, the provider had appointed an interim manager who managed the home.

Staff were not always available at the times that people needed them in order to meet their needs and preferences. The interim manager told us recruitment of staff had been a concern and people were supported by a high number of agency staff which meant people were not always provided with continuity of care by staff who knew them well. To try and ensure continuity the provider would request agency staff who had worked at the home before. The provider had recently recruited new staff and this was on going.

Relatives told us they felt that people were safe at Brookview and staff treated them well.

Staff were kind and caring to people but told us they were not always able to spend time individually with them.

Relatives thought staff were kind, caring and responsive to people’s needs and people’s privacy and dignity was respected.

The interim manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns.

There were risk assessments in place to identify risks to people’s health and wellbeing. Where risks had been identified, there were management plans to minimise these risks, however we found that these were not always followed. We found improvements were required in how the provider analysed incidents, and accidents, which would help protect people from further risks.

People’s care plans were not always up to date or reviewed regularly, however staff had a good understanding of people’s care needs and preferences. Documentation regarding people’s nutritional intake, falls and accidents were not always completed correctly and actions were being taken to address this.

Medicines were stored and administered safely, and people received their medicines as prescribed.

People were supported to attend health care appointments with health care professionals when they needed to and received healthcare that supported them to maintain their wellbeing.

Recruitment procedures made sure staff were of a suitable character to care for people.

Management and staff understood the principles of the Mental Capacity Act 2005 (MCA) and DoLS, and supported people in line with these principles. Correct procedures had been followed regarding referrals to the local authority.

Activities, interests and hobbies were arranged according to people’s individual needs and abilities. However staff were not always available to provide support with these at people’s preferred times.

Staff felt the interim manager and team leader were supportive however the lack of a permanent manager, and reduced staffing levels, meant that staff supervision meetings were not consistently carried out. Staff had regular team meetings and felt their training and induction supported them to meet the needs of people they cared for.

Relatives told us they knew how to make a complaint if they needed to.

There was a provider audit system that identified and improved the quality of service people received. These checks and audits helped ensure actions had been taken that led to improvements.

We found a 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 the report.