We carried out a review of the data available to us about Brewery House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Brewery House, you can give feedback on this service.
We found the following examples of good practice.
The service has remained free from COVID-19. Staff used various methods to communicate with people about the pandemic, and how to keep safe. This included easy read posters promoting good hand hygiene, and information about the COVID-19 vaccination and what to expect. Where a person was afraid of needles, effective systems have been put in place to support the person and reduce anxiety.
Staff supported people to retain their independence in carrying out household tasks, whilst in the background were carrying out extra cleaning during the day of high touch point areas, such as door handles.
Where applicable, staff kept people’s relatives updated on current visiting guidelines and offered flexibility in accommodating visits. Where relatives, due to their own circumstances could not visit, people were supported to have face to face calls using technology.
One person told us about the recent resident’s video meeting they had joined in with, which linked them up with provider’s other services, enabling them to discuss and raise any issues.
National guidance was being followed to ensure staff and people living in the service were regularly tested for COVID-19. Staff had been trained to carry out, and process the quick 30 minute lateral flow test correctly.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
We identified a lack of risk assessment and management monitoring in relation to the risk of burns and scalds from hot surfaces such as unguarded radiators and the risk of falls from unrestricted windows. In response to our findings the registered manager took immediate action to rectify these shortfalls. Whilst immediate action had been taken, management monitoring systems for auditing the safety of the service needed to be more robust as they had not identified the risk areas prior to this inspection.
People were protected from abuse. Staff understood how to recognise and report any concerns they had about people's safety and well-being. There was enough staff to keep people safe and provide them with support that met their needs.
Staff were trained, and competency assessed to administer people's medicines safely. Staff had access to relevant training, regular supervision and annual appraisal. This equipped staff with the knowledge and skills they needed to fulfil their roles and meet people’s needs.
Nutritional needs were met. People were supported to access healthcare services if they needed them. Health care needs were closely monitored and any changes to people’s health and wellbeing was responded to in a timely manner.
Staff knew people well, provided personalised care and treated people with dignity and respect. 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. We recommended further work to ascertain people’s cultural needs and wishes in the event of sudden death or the need for palliative care support.
Staff demonstrated a good understanding of the people living at the service and created opportunities for maximising their independence and life skills. Staff worked in partnership with other social care and health care professionals to ensure people received the support they needed.
The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was Good (published 30 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At our last inspection in June 2015 this service was rated Good. At this unannounced inspection we found the overall rating for this service remained Good.
The service 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. The manager registered for this service is also registered for two other services local, nearby care services.
People remained safe at the service. There were sufficient staff available to meet people's needs and support them with activities both in and outside of the service. Risk assessments had been completed to enable people to retain their independence and receive care with minimum risk to themselves or others.
People’s medicines were managed safely and people received their medicines as prescribed
There were enough suitably knowledgeable staff to provide people with support and guidance when they needed it. Staff had received appropriate training, support and development to carry out their role effectively.
Care plans were well organised, reviewed regularly and up to date. The plans contained information about what was important to people as well as information regarding their health needs.
The staff were very caring and people had built strong relationships with staff. We observed staff being patient and kind. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received.
Staff understood and promoted people's rights in line with the requirements of the Mental Capacity Act 2005 (MCA). Staff had received training in MCA and had good knowledge of the principles and how to support people to make decisions about their day to day living.
There were systems in place to ensure that staff were trained, regularly competency assessed to ensure that people received their medicines as prescribed. Medicines were stored safely and appropriate records of administration maintained.
Staff were provided with training in Safeguarding Adults from abuse. Staff were provided with training in understanding their roles and responsibilities with regards to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People’s capacity to make decisions about their everyday lives had been assessed and their consent was considered in the planning and provision of their care and support
People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were met. People were supported to maintain good health and had access to external health care professionals when required. This included health screening and access to learning disability nurses, GPs, chiropodists and dentists.
People were provided with the opportunity to participate in personalised, meaningful activities according to their assessed needs, wishes and preferences. People were encouraged to develop as much independence as possible and learn new life skills. People had access to annual holidays and opportunities to be integrated into the local community.
The provider had a system in place to respond to suggestions, concerns and complaints. The service had a number of ways of gathering people’s views including; regular reviews, meetings and satisfaction surveys. The registered manager carried out a number of quality and safety monitoring audits to ensure the service was running effectively and to plan for improvement of the service.
For a more comprehensive report regarding this service you can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk
The inspection took place on 4 June 2015 and was unannounced.
The service provides care and support to two people with learning disabilities.
There was a registered manager in post. 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.
Staff were trained in safeguarding people from abuse and systems were in place to protect people from all forms of abuse including financial. Staff understood their responsibilities to report any safeguarding concerns they may have.
Risks to people and staff were assessed and action taken to minimise these risks. People were encouraged to remain as independent as possible and any risks related to this were assessed.
Staffing levels meant that people’s needs were met. Recruitment procedures were designed to ensure that staff were suitable for this type of work and checks were carried out before people started work to make sure they were safe to work in this setting. New staff were recruited before posts became vacant.
Medicines were administered safely and records related to medicines were accurately completed.
Training was provided for staff to help them carry out their roles and increase their knowledge of the healthcare conditions of the people they were supporting and caring for. Staff were supported by the manager through supervision and appraisal.
People gave their consent before care and treatment was provided. Staff had received training in the Mental Capacity Act (MCA) 2015 and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. Where people’s liberty needs to be restricted for their own safety, this must done in accordance with legal requirements. People’s capacity to give consent had been assessed and decisions had been taken in line with legal requirements.
People were supported with their eating and drinking needs and staff helped people to maintain good health by supporting them with their day to day healthcare needs.
Staff were caring and treated people respectfully making sure their dignity was maintained. Staff were positive about the job they did and enjoyed the relationships they had built with the people they were supporting and caring for.
People were involved in planning and reviewing their care and were encouraged to provide feedback on the service. Care was subject to on-going review and care plans identified people’s particular preferences and choices. People were supported to play an active part in their local community and follow their own interests and hobbies.
No formal complaints had been made but informal issues were dealt with appropriately and to people’s satisfaction.
Staff understood their roles and were well supported by the management of the service. The service had an open culture and people felt comfortable giving feedback and helping to direct the way the service was run.
Quality assurance systems were in place and audits were carried out regularly to monitor the delivery of the service.
We found that care plans were very detailed and were centred on people's needs and preferences and that they assessed and minimised any associated risks. We found that the service provided a variety of fresh food and supported people to eat a balanced diet.
We saw that staff were trained to administer medicines safely and that records related to medicines were organised and well maintained. We spoke with the member of staff on duty and the registered manager and looked at staff records and rotas. We found that staff were appropriately skilled and experienced. Staff told us that they felt they had the support and training they needed to carry out their role safely and effectively.
We viewed the care files for people who used the service and found them to be very person centred and involved the people who used the service and their families.
We spoke with the manager who told us that people get the opportunity to go out regularly with staff as that is their preferred choice. We observed their return to the service and found staff to be kind and caring. We saw that the people were happy on their return.