Brookfield

Updated 12 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by three inspectors, and one 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.

Service and service type

Brookfield is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service short notice of the inspection. This was because the service is small, and people are often out. We wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

During the inspection visits we talked with the three people who used the service and observed their interaction with the staff supporting them. People used a range of communication methods to tell us about their experience of using the service, including verbal communication and Makaton.

We spoke with the registered manager and four members of care staff. We reviewed a range of records. This included assessments, care plans and care records for the three people using the service.

We reviewed the medicines administration records and care plans for two people and recent medicines audits. We reviewed medicine error incident forms and subsequent learning from these. We spoke with the registered manager, service manager and one staff member who administers medicines. We looked at three staff files in relation to recruitment and staff supervision.

We spoke with four relatives on the telephone about their experience of the care provided to their loved ones.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with the registered manager by telephone and reviewed a range of records in relation to the management of the service, which were provided to us via e-mail. This included quality and safety systems processes, quality and safety records and audits, meeting minutes and staff training and supervision records. We also undertook on-line meeting with the registered manager to discuss our findings.

Following up breaches of regulation

During our last inspection in April 2019 we found that the service was in breach of regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014, good governance. Systems and processes were not established and operated effectively to assess, monitor and improve the quality and safety of the service or to mitigate the risks relating to the health, safety and welfare of people who used the service and others.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17. There had been improvements made in the way the provider

Updated 12 October 2021

We expect Health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 or autistic people

People’s experience of using this service and what we found

The service was able to show how they met the principles of Right support, right care, right culture.

Right support:

The model of care and setting maximised people’s choice, control and independence.

People were encouraged and empowered to make their own decisions. Care staff ensured that people were supported and gave people daily choices which were appropriate to their needs and level of understanding and ability. People lived in an ordinary, semi-detached family home which integrated well within the community.

Right care:

Care was person-centred and promoted people’s dignity, privacy and human rights.

Staff knew people well and established positive relationships with them. People’s dignity, privacy and human rights were maintained. People were treated and supported as an individual, and we saw that the service had made improvements around providing individual stimulating activities.

Right culture:

The ethos, values, attitudes and behaviour of leaders and care staff ensure people using the service lead confident, inclusive and empowered lives.

People were involved in the community and taking part in a wide range of community-based activities. People were put first, and the service had made good progress with building activities and facilities around people, following lockdown.

The new leadership team were open, honest and easy to talk to. They listened to people, staff and visitors to discuss concerns and improve the service for people.

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.¿

• People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs. People told us they loved their home. A lot of resources had been put into making sure the decoration reflected people’s tastes and was comfortable and safe.

• People were protected from abuse and poor care. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

• People were supported to be independent and had control over their own lives. Their human rights were upheld.

• People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that enabled them to understand and engage.

• People’s risks were assessed regularly in a person-centred way; people had opportunities for positive risk taking. People were involved in managing their own risks whenever possible.

• People who expressed distress in ways that could challenge others had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where restrictive practices were used.

• People made choices and took part in meaningful activities which were part of their planned care and support. Staff supported them to achieve their aspirations and goals. The service had started to design and build a sensory garden together with people and sought activities which were of specific interest for them.

• People’s care, treatment and support plans, reflected their sensory, cognitive and functioning needs.

• People received support that met their needs and aspirations. Support focused on people’s quality of life and followed best practice. Staff regularly evaluated the quality of support given involving the person, their families, and other professionals as appropriate.

• People received care, support and treatment from trained staff and specialists able to meet their needs and wishes. Managers ensured that staff had relevant training, regular supervision and appraisal.

• People and those important to them, including advocates, were actively involved in planning their care. Where needed a multidisciplinary team worked well together to provide the planned care.

• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.

• People were supported by staff who understood best practice in relation to learning disability and/or autism. Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. People and those important to them worked with leaders to develop and improve the service.

Why we inspected

This was a planned inspection based on the previous rating.

We undertook this inspection to provide assurance that the service is applying the principles of Right support ,right care, right culture.

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.

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