Archived: Brookfield House

As part of this inspection we spoke with five people who used the service, the clinical lead and six staff. We also reviewed records relating to the management of the home which included three care records, seven medicine records, four staff personnel files and the training records of five staff.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People we spoke with told us they felt safe and staff treated them well.

Recruitment processes did not meet current legislation and the provider had not completed all the required checks prior to staff starting employment. This meant the provider could not demonstrate that the staff employed to work at Brookfield House were suitable to support the people who used the service. A compliance action has been set for this and the provider must tell us how they plan to improve.

Management of medicines did not fully meet the requirements of law. We found discrepancies in records relating to administration of medicines. This meant the provider could not demonstrate that people were protected against the risks associated with the unsafe use and management of medicines. A compliance action has been set for this and the provider must tell us how they plan to improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No application had needed to be submitted by the provider. Staff had not received training in these Safeguards. When we spoke to staff they had limited understanding of the impact these Safeguards would have on their practice. This meant there was a risk people's human rights may not be respected.

Is the service effective?

People's needs had been assessed before care was provided and a plan of care was in place. When we observed and spoke with staff they showed a good understanding of how to respond to people's support needs.

Care records reflected how people wanted to be supported and described what was important to them. This included details of important people in their lives and their likes and dislikes.

Staff told us they had received training appropriate to their role and felt they had the skills to meet people's needs. This was confirmed when we observed staff supporting people.

Staff told us they were supported in their roles through supervisions and support from senior staff. They told us they had received training that was appropriate to their roles and this ensured they could meet people's needs. However the records we looked at did not reflect what staff told us.

We saw evidence that the provider worked closely with other health professionals to ensure there was a joined up approach to meeting people's care.

Is the service caring?

People we spoke with told us, 'The staff are lovely, I have nothing to complain about'.

We observed staff treated people with respect, dignity and kindness. Staff told us, 'It's like a home from home, not like being at work' and 'I most enjoy the one to one time I can spend with people'.

Is the service responsive?

People took part in activities although one person told us they 'Would like more to do sometimes'. Entertainment was arranged for people which included musicians and singers coming to the home. Most people we spoke with told us they were happiest completing their own activities and when staff sat and talked with them.

Risks to people and the environment were assessed and action taken to reduce these risks. People's needs were regularly reviewed and their plan of care updated when required. This meant staff responded to people's changing needs.

Is the service well led?

Brookfield House had no registered manager in post and we had not received any application for a new registered manager. In this report the name of the registered manager, Alison Edwards appears. They were not in post at the time of our inspection and had not been in post since November 2013. Their name appears because they were still a registered manager on our register at the time of this inspection and they had not submiited an application to remove their name. The CQC are now taking action to remove them from our register.

When we spoke with staff it was unclear who was responsible for the day to day running of the home. There was a clinical lead in post who was responsible for nursing tasks and we were told an operations manager came to the home one to two days a week to assist with managing the home.

The clinical lead had recently started to implement regular audits in the home and we saw evidence that improvements were being made as a result of these.

The provider had no clear systems in place to effectively assess and monitor the quality of service provided. A compliance action has been set for this and the provider must tell us how they plan to improve.