26 July 2023
During an inspection looking at part of the service
Edge Brook is a small ‘care home’ providing accommodation to up to 6 people who require nursing or personal care. The service provides support to young people with an eating disorder. At the time of our inspection there were 4 people using the service.
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.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
Right Support: People were supported by staff who had a strong understanding of how to promote people’s independence. Staff supported people to work towards achieving their goals by working in accordance with robust care plans. People told us they felt support relating to 1 to 1 support and engagement could improve; we discussed this with the provider who was able to evidence this was consistently under review. People were able to personalise their rooms with personal items important to them. The provider was able to evidence the approach staff took in supporting people during times of anxiety and distress was consistently reviewed and reflected on to inform continuous improvement.
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; the policies and systems in the service supported this practice.
Right Care: People received robust support relating to their diet and when support from external professionals was needed, this was requested in a timely manner. Feedback from people and some relatives was mixed in relation to how safe people felt at the service. Staff’s presence within the home was consistently raised as needing improvement particularly comments relating to staff spending significant periods of time in the office. We also observed during our visit to the service staff spent long periods of time based in the office; however, we also noted there was generally one member of staff based in the areas of the home most frequently used by people. We discussed feedback with the provider who provided evidence of reflective work around this issue; we have made a recommendation the provider carries out further work to respond effectively to people’s feedback around feeling safe.
Right Culture: The provider ensured a person centred approach to care planning, support and care was promoted throughout the service. People’s protected characteristics were considered at all times. The provider had robust quality assurance systems in place which ensured checks within the service were robust and accurate. The provider had worked proactively with local safeguarding professionals to ensure they were meeting the requirements to share safeguarding incidents in line with local and national guidance and legislation. We observed evidence of reflective work being carried out. However, in some cases this was not always recorded in relevant records; for example, management reflection on accidents and incidents needed additional detail to evidence why staffs approach to supporting people, during periods of anxiety and distress, reflected best practice particularly in relation to people’s therapeutic plans. We have made recommendation relating to reflection in accidents and incident and in relation to people feeling included in decisions made about their support.
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 good (published 28 May 2023).
Why we inspected
We received information which highlighted a review of risk management and service governance was needed. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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 remained the same.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Edge Brook on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.