Brookvale is a purpose built home set in extensive well maintained grounds close to open countryside. There are also seven cottages within the grounds which can accommodate people who live semi independently. The home is registered to provide accommodation and personal care for up to 80 people with learning disabilities. On the day of our inspection there were 74 people using the service.
This was an unannounced inspection which took place on 20 October 2015. The inspection team comprised of two adult social care inspectors, a specialist advisor and expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. The expert had experience of services for people with learning disabilities.
The home had a registered manager. 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.
We last inspected the home on 22 October 2014. During that inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This resulted in us making two requirement actions. Following our inspection in October 2014 the provider wrote to us to tell us what action they intended to take to ensure they met all the relevant regulations. During this inspection we checked to see if the required improvements had been made.
We found the service had made improvements since our last inspection; however we found a breach of 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 this report.
Although staff had received an induction when they started work at the service we found staff had not received the necessary training and supervision to enable them to carry out their roles effectively. The provider told us they had started a new system for providing training and supervisions but we found that this had not yet been fully embedded in the service.
People we spoke with felt safe at Brookvale. Policies and procedures were in place to safeguard people from abuse. Although not all staff had received training in safeguarding adults staff we spoke with were able to tell us how to identify and respond to allegations of abuse. Staff were aware of the whistleblowing policy to report poor practice. A safe system of recruitment was in place. We observed there were sufficient numbers of staff to provide people with the support and care they needed.
During our inspection we found there were safe systems in place for the storage, administration and recording of medicines
Care records were detailed and person centred. Care plans and risk assessments reflected people’s individual needs and contained enough information to enable staff to provide safe and appropriate care and support. Care records provided detailed information about people’s social histories, likes, dislikes and hobbies.
People we spoke with were positive about the service and the staff who supported them. We found the atmosphere to be calm and unhurried. There was lots of laughter and gentle banter between people. We saw that managers and staff knew people well, and were caring and compassionate in the support they provided. Staff we spoke with demonstrated a commitment to providing person centred care and promoting people’s independence.
We saw a wide range of activities were provided in the service and the community. People we spoke with told us holidays and trips out were arranged. The service had a hydro therapy pool, gym, football pitch, mini golf course, outdoor gym, football pitch, mini golf course and all weather walkway. People told us they were very happy with the activities on offer.
Managers and staff we spoke with were able to demonstrate a good understanding of the importance of gaining consent from people who used the service before any care or support was provided. We saw managers and staff respected people’s rights and choices and used a variety of ways of ensuring they had involved people in decisions; including use of non-verbal communication, pictures and objects.
The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS provide legal safeguards for people who are unable to make their own decision.
Brookvale is a Jewish organisation and food is provided in line with Jewish kosher food rules. We found there was a choice of suitable, good quality nutritious food. We saw that when needed staff supported people to choose what they wanted to eat and drink.
The home was very clean; all areas were well decorated and furnished. The grounds were well maintained. Records we looked at showed procedures were in place to prevent and control of the spread of infection. Systems were in place to ensure all necessary health and safety checks were completed. There were procedures in place to guide staff in the event of an emergency that could affect the provision of care, such as loss of gas, electricity, heating or breakdown of essential equipment.
We found there was a robust system in place for assessing, monitoring and reviewing the service. Records were kept of any issues or concerns which people had raised and any actions taken to address them. We saw there was a system for gathering people’s views about the service. There was a system in place for dealing with complaints about the service. People told us suggestions were acted upon and they had confidence the manager and staff would deal with any concerns.
People we spoke with were complimentary about the managers of the service. They said the registered manager was approachable and knew what was happening in the service. Staff spoke positively about the leadership of the service, the support they received and the work they did. People told us they were able to speak to a manger whenever they needed to.