We carried out a review of the data available to us about Brookfield 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 Brookfield, you can give feedback on this service.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People were protected from the risk of abuse. Staff had received training in safeguarding vulnerable people and low level concerns had been reported to the local authority.
Recruitment practices were safe and people which helped protect people from the risk of abuse.
Staffing levels were sufficient to meet the needs of people using the service.
Training was in place for staff to ensure they had the correct skills in place to meet people's needs.
People were supported to have a nutritious diet, and where appropriate special diets were prepared in line with people's needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff were kind and caring towards people and positive relationships had been developed.
Care records clearly outlined people's needs and provided instruction around how staff needed to support people.
Activities were available for people which helped protected them from the risk of social isolation.
Audit systems were in place to monitor the quality of the service being provided .
Brookfield is registered to provide accommodation and personal care within a residential setting to a maximum of six people. There were six people using the service at the time of our inspection. This included people with a learning disability and autism.
The service consists of three units. Four people lived in the main unit where the registered manager’s office was situated. The other two units consisted of two separate bungalows where people were supported by staff to live as independently as possible.
A requirement of the provider’s registration is that they have 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. At the time of our inspection there was a registered manager at the service. A new manager had recently been employed at Brookfield in September 2015 and was working alongside the registered manager. They were planning to register with us in the new year and the current registered manager would then be responsible for managing one of the provider’s other homes. The provider had acknowledged the need to employ a full time manager for the home following feedback from relatives and staff.
Relatives told us they felt people were safe at Brookfield and security at the home had been improved over the last year following an incident involving a person living at the home. The registered manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. Staff had a good understanding of risks associated with people’s care needs and how to support them.
There were enough staff at Brookfield to support people safely and at the times they preferred. Recruitment procedures made sure staff were of a suitable character to care for people at the home.
Medicines were stored and administered safely, and people received their medicines as prescribed. Regular audits were carried out of medicines. People were supported to attend health care appointments when they needed to maintain their health and wellbeing.
We observed, and relatives told us, staff were kind and supportive to people’s needs, and people’s privacy and dignity was respected. We saw people were encouraged to be independent.
The management and staff teams understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and supported people in line with these principles. People were supported to make everyday decisions themselves, which helped them to maintain their independence.
Where people were not able to make decisions, relatives and healthcare professionals were consulted for their advice and input.
People were supported to pursue their hobbies and interests both within and outside of the home. Activities were arranged according to people’s individual preferences, needs and abilities but some relatives felt people were not consistently able to access them if they required additional support outside of the home. Audits by the provider identified some people needed to access more activities within the community; the provider had identified this and was taking steps to address this. People who lived at Brookfield were encouraged to maintain links with friends and family who visited them at the home. They were also supported to visit their relatives.
Staff felt the registered manager and new manager were supportive and promoted an open culture within the home; however some relatives expressed concerns that communication from the management team was not always consistent. The provider acknowledged this needed to be improved and the new manager had met relatives individually to discuss their concerns.
Some relatives told us they did not know how to make a formal complaint but were able to discuss concerns they had with staff; however some felt communication and feedback could be improved. The provider monitored complaints to identify any trends and patterns and made changes to the service in response to complaints.
Staff were supported by the registered manager, and new manager, through regular team meetings and observation. Staff were also supported through supervision sessions; however these had not been consistently carried out prior to the start of the new manager. Staff felt their training and induction supported them to meet the needs of people they cared for and relatives felt staff had the skills and knowledge to meet people’s needs.
The registered manager and new manager felt well supported by the provider who visited regularly.
The provider carried out audits to check the quality of care people received however they acknowledged these had not been carried out consistently over the last year and improvements were being made to address this.
This inspection was completed by one inspector. Due to their complex health conditions and communication difficulties, we were unable to speak with people who used the service. We observed their experiences to support our inspection. We spoke with the registered manager and three care staff.
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what staff told us. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.
Staff knew about risk management plans and we saw people were supported in line with those plans. This meant people were cared for in a way that protected them from harm.
The provider worked well with health care providers to ensure people's health needs were met and they were protected against harm.
Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people and helped the service to continually improve.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We found an application had been submitted and authorisation had been granted for one person. Appropriate policies and procedures were in place and relevant staff had been trained to understand when an application should be made and how to submit one.
Is the service effective?
People's care needs were assessed with them. We saw evidence that people were involved in their care planning and reviews by using communication methods that met their needs. We saw care plans were regularly updated.
Where people had complex needs that required the input of specialist health care services, assessments had been made by the appropriate professionals. Their recommendations were carried out by staff. This meant the provider worked well with other services to ensure people's health care needs were met.
Staff were appropriately supported and trained to ensure they effectively met people's needs.
Is the service caring?
People were supported by kind and caring staff. We saw staff were patient and encouraged people to be independent.
People's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes.
People's behaviour was managed in a calm and dignified way.
Is the service responsive?
People had the opportunity to plan and engage in a range of different activities each day.
People were asked their views about the service using appropriate communication methods and the provider acted on comments that people made.
Where care staff had noticed people's changing needs, their care plans were updated to reflect this. We found staff discussed people's care needs with them on a regular basis.
Is the service well led?
The provider had quality assurance and risk management systems in place. We found the registered manager checked that risks were managed effectively.
The provider sought the views of people who used the service. Records seen by us indicated that shortfalls in the service were addressed where they had been identified.
Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure people received a good quality of care. Staff told us the service was well organised and they felt supported by their manager.
There were five people living at Brookfield when we visited. Three of the people living at the home were unable to communicate with us verbally. Two people were able to speak with us during our visit. We spent time observing how staff supported people within the home.
During our visit we saw staff supporting people with care and consideration. Staff respected people's decisions as to where they wanted to be and what they wanted to do. One person we saw turned on the television and said "I want to watch TV now!"
Care plans were clear and contained details of the support staff needed to provide. Staff we spoke with were knowledgeable about the care needs of each person. We saw that the service referred people to other health care professionals as and when necessary.
There were sufficient numbers of staff to provide individual care and support to people who used the service.
We saw systems were in place to assess the quality of the service provided.