Brook House Care Centre

Updated 27 November 2018

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.

The inspection site visit activity started on 25 September and ended on 26 September 2018. It included a visit to the home on both days to meet with people, the manager and other staff; to review care records and policies and procedures.

Before the inspection we looked at all the information we had about the service. This information included statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law. The provider had also completed a Provider Information Return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We contacted the local authorities that commission services from the provider to gain their views about the home. We used this information to help inform our inspection planning.

The inspection site visit team on 25 September 2018 consisted of three inspectors, a specialist nurse advisor and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On 26 September 2018 a single inspector returned to the home.

During the inspection we spoke with six people and five relatives to seek their views about the home. We also spoke with the manager, the regional support manager, the clinical lead, the HR personnel, a chef, three activities coordinators, four registered nurses and eight care workers. We looked at eight care plans and 11 staff records including records relating to staff recruitment, training, supervision and appraisal. We also looked at records used in managing the service including policies and procedures, health and safety checks, audits, surveys, complaints logs, accident and incident records and minutes of relatives and staff meetings. We spoke with two visiting healthcare professionals to seek their views about the home.

Updated 27 November 2018

This inspection took place on 25 and 26 September 2018 and was unannounced. Brook House Care Centre is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Brook House Care Centre is registered to provide accommodation and nursing care for up to 74 adults. The service is provided over three floors and within three units. People using the service include adults with a range of disabilities including brain injury, older adults with nursing needs and people living with dementia. At the time of this inspection there were 48 people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was no registered manager in post. The home manager had applied to CQC to become the registered manager of the home. 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.

This is the first inspection of the home under the new provider Bond Care.

Records were not always complete, consistent, signed and legible as some care plans had been handwritten. However, the provider knew of this and was still in the process of updating their records since taking over the service in October 2017. There were systems in place for assessing and monitoring the quality of the service. The provider had values and an organisational structure in place and staff upheld these values when performing their roles. People, their relatives, other professionals and staff were encouraged to be involved in service improvements through regular feedback and meetings. There were systems in place to promote continuous learning and improve the quality of the service. The provider worked in partnership with key organisations such as the local authorities that commissioned services from them to ensure people’s needs were met effectively.

The provider had policies and procedures in place to safeguard people from abuse and staff knew of the reporting and recording procedures if they had any concerns of abuse. There were safe recruitment practices in place to ensure staff employed at the home were suitable to work in social care. Checks had also been carried out on the registration of qualified nurses with their professional bodies to ensure they were suitable for the role. There were sufficient numbers of staff available on each shift to support people’s needs and meet them in a timely manner. The provider had safe systems for acquiring, storing, administering and disposing medicines and monitoring controlled drugs. Risks to people had been identified and assessed; risk assessments were person centred and included appropriate management plans to ensure risks to people were managed safely. There were systems in place to deal with foreseeable emergencies and each person had a personal emergency evacuation plan in place. The provider carried out checks on the environment and equipment to ensure they were safe for use. Appropriate infection control protocols were maintained to minimise and prevent the spread of diseases. Accidents and incidents were recorded, managed and monitored regularly to prevent future occurrences.

Staff assessed the needs of people before they moved into the home to ensure their needs would be met. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice. People were provided freshly cooked and nutritious food daily and in sufficient amounts for their health and wellbeing. Where required people were supported to use health care services including attending hospital appointments. The staff teams work in partnership with other health and social care professionals to provide joined-up care. The design, decoration and adaptation of the home was suitable and met people’s needs. Staff were supported through induction, training, supervision and appraisals to ensure they had appropriate knowledge and skills required to perform their roles.

People were supported by staff who were kind and compassionate towards them. Staff respected people’s privacy and dignity and promoted their independence. People and their relatives had been consulted and were involved in making decisions to the care delivery. People were provided with information before they started using the service to ensure they knew of the standard of care to expect.

Each person had a care plan in place which outlined their needs and provided staff with guidance of how these needs should be met. Staff understood people’s diversities and supported them without any discrimination. People’s communication needs had been assessed and information was provided in formats that supported their understanding. People were supported to maintain relationships that were important to them and their family and friends could visit them without any restrictions. People were supported to participate in activities that stimulated them. People and their relatives knew how to make a complaint and the provider acted to ensure they were satisfied with the service provided. Where required people were supported to have a peaceful, comfortable and dignified end of life care.