Brook House Care Home

Brook House Care Home is a two-storey residential care home providing accommodation and personal care for up to 35 older people and people living with dementia. At the time of our inspection there were 31 people using the service.

We found the following examples of good practice.

Staff had up-to-date training about infection prevention and control (IPC), they had enough personal protective equipment (PPE) and we saw they wore this correctly. Visits to people in the home were facilitated through 'window' visits or visits in person such as for end of life care.

Systems were in place that promoted people's and staff's safety such as regular tests for COVID-19, completing a health questionnaire and being symptom free. The service had an IPC lead who provided staff with the latest guidance and trained them how to put on and take off PPE, and how to dispose of this safely.

Various changes relating to COVID-19 and the way people kept in touch with family members had been implemented including facilities for video and telephone calls and the use of social media.

The registered manager ensured that staff adhered to good IPC practise such as regular cleaning of frequently touched items including hand rails and door handles. Individual sealed containers were used to transport any potentially infectious items such as bedding and crockery to separate areas in the laundry or kitchen. People and staff were supported with their wellbeing such as, St Valentine’s day homemade cards.

The service looked clean and furniture had been positioned to enable people to socialise but in a socially distanced way. There were plans and facilities in place to manage any future potential COVID-19 outbreaks. This included separate units within the home and having dedicated groups of staff who would only work in one part of the home.

Brook House Care Home is a residential care home providing personal care and accommodation to 30 older people at the time of the inspection. The service can support up to 35 people in one adapted building over two floors. One area of the service specialises in providing care to people living with dementia.

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

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.

Staff knew their duty to report any incidents of harm or poor care. Staff used people’s risk assessments as guidance on how to monitor people’s identified risks whilst supporting people’s right to independence. Staff worked in conjunction with legislation, best practice guidance and information from health professionals across different organisations. This helped promote people's well-being.

Staffing levels were adequate to meet the care and support needs of the people living at the service. Medicines were safely managed. Staff knew the people they supported well. To develop their skills and knowledge staff received training, competency checks, supervisions and appraisals.

Staff encouraged people's food and drink intake. Staff promoted and maintained people's privacy and dignity. Staff had a good relationship with people and understood their individual needs and preferences.

We have made a recommendation about staff’s practices in promoting good infection control.

Trained staff were aware of infection control practices to reduce the risk of contamination but did not always follow these practices.

People and their relatives told us staff were caring. Staff kept people’s personal information confidential. People and their relatives told us they were involved in discussions about the care and that their preferences were respected. Staff were trained to support people on end of life care.

People told us if they had to raise any concerns they knew how to do so. Staff had positive comments about how approachable the registered manager was. Audits including organisational audits were carried out to monitor the service and address any improvements required. The registered manager notified the CQC of incidents that they were legally obliged to.

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 9 September 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.

This unannounced inspection was carried out on 8 August 2017. At the last inspection on 14 July 2015 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was 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.

People were supported to be safely cared for whilst living at the home. Staff were knowledgeable about the procedures to ensure that people were protected from harm. Staff were also aware of whistleblowing procedures and would have no hesitation in reporting any poor care. People’s medicines were safely administered by trained and competent staff.

There were sufficient numbers of suitably qualified staff employed at the home. The provider’s recruitment process ensured that only staff deemed suitable to work at the home were employed. Staff did not commence working in the home until all pre-employment checks had been satisfactorily completed.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that the registered manager and all staff were knowledgeable about when a request for a DoLS would be required. The registered manager had submitted DoLS applications to ensure a person was only deprived of their liberty to ensure their safety. People who had limited capacity to make decisions were supported with their care and support needs in their best interests. 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 respected and maintained people’s privacy. People were provided with care and support as required and people only had to wait a short period of time before having their care needs met. This meant that people’s dignity was respected and met in a timely manner.

People’s care and support needs were planned, detailed and reviewed regularly. Staff had a good understanding of how and when to provide people’s care. Staff respected people’s independence and choices.

People were supported to access a range of health care professionals. This included a GP, hospital appointments and visits from district nurses and community psychiatric nurses. People were consistently supported with their health care needs in a timely manner. Risk assessments were in place to ensure that people were safely supported with potential health risks.

People were provided with a varied menu and had a range of meals to choose from including those who required a specialist diet. There was a sufficient quantity of food and drinks available and whenever people required these.

People’s care was provided by staff in a kind, caring and compassionate way. Staff were proactive in arranging activities and they supported people with their hobbies and interests to prevent them from becoming socially isolated. There was a wide range of activities for people to be involved with.

The home had an effective complaints procedure in place. Prompt action was taken to address any concerns that had been raised.

People were provided with several ways they could comment on the quality of their care. This included regular contact with the registered manager staff and by completing quality assurance surveys.

As part of this inspection we spoke with eight people who used the service, four relatives, a healthcare professional who had regular contact with the home, the registered manager and members of care staff. We reviewed records relating to the management of the service which included five care plans, daily records, safeguarding procedures, training records and quality assurance monitoring records.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time

We have contacted the provider about this and we are in the process of removing the person's name from the home's registration.

Is the service safe?

Risk assessments were in place to minimise any potential harm to people using the service. Care staff understood their roles and responsibilities in making sure people were protected from harm. There were effective safeguarding procedures in place to ensure that people were protected from abuse and harm. We saw that Deprivation of Liberty (DoLs) assessments were carried out where necessary to ensure that people who could not make decisions for themselves were protected

Is the service effective?

We found that care staff were knowledgeable about people's individual care and support needs. People that we spoke with confirmed that care staff provided consistent and kind support. Care planning documentation was well coordinated and reviewed to ensure that individual people's care and support needs were being met. The manager confirmed that care planning documentation was regularly audited as part of the home's quality assurance procedures to ensure they were being accurately recorded.

Is the service caring?

People told us that they received consistent and respectful support from care staff and felt able to make choices and changes when required. Care staff told us that they were well supported and supervised so that they could provide safe care and support to people. We observed that care staff spoke to people in a friendly and attentive manner and responded quickly to people's care needs.

Is the service responsive?

We saw that people's personal care and social support needs were assessed and met. This also included people's individual choices and preferences as to how they liked to be supported. People we spoke with told us that they felt well cared for and observations we made during the inspection confirmed this to be the case.

Is the service well led ?

Care staff that we spoke with told us that they felt well supported by the manager and senior care team and were regularly trained to safely provide care and support. People that we spoke with told us that they felt they were listened to and support was consistently and safely provided. Quality assurance systems were in place to regularly audit the care and services provided to people. Surveys were carried out to gather opinions from people using the service, relatives and healthcare professionals to ensure that ongoing improvements could be made.

People that we spoke with were positive and complimentary about the care and support they received and commented that, 'The staff are kind and go out of their way to help me'. People told us that their views and concerns were listened to and properly dealt with. Care and support was well coordinated and care planning documentation was detailed and showed peoples' preferences and details of how their care should be delivered.

Staff were trained in the safe administration of medication and records of administration were accurately completed.

There were induction programmes and mandatory training in place to ensure that staff were competent to deliver care. Supervision was regularly provided to staff to monitor their work performance and development needs.

Complaints were responded to appropriately and people using the service, and their relatives, told us that they knew who to contact if they had any concerns about the care and services being provided.