Background to this inspection
Updated
30 October 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.
This unannounced comprehensive inspection took place on the 13 September 2018. The inspection team consisted of one inspector.
We reviewed information supplied by us by the provider in their Provider Information Return (PIR). A PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this information into account when we made the judgements in this report. We also reviewed the information we held about the service. We looked at information received from the statutory notifications the registered manager had sent us. A notification is information about important events which the provider is required to send us by law. We used this information to plan the areas of focus for our inspection visit.
During our inspection visit we met all the people who live at the home. People living at Brookfield’s have learning disabilities. Verbal communication is not always their preferred method of communication, so we spent time observing people’s care in the communal areas of the home. We used the Short Observational Framework for Inspection(SOFI). SOFI is a way of observing care to help us understand how people experience the support they are given.
During our inspection we spoke with the registered manager, two registered nurses, two care staff the operational manager, three relatives, and a health care professional.
We reviewed two people's care plans and daily records to see how their care and treatment was planned and delivered. We looked at how medicines were managed by checking the Medicine Administration Record (MAR) charts. We checked whether staff were recruited safely and trained to deliver care and support appropriate to each person's needs. We reviewed the results of the provider's quality monitoring system to see what actions were taken and planned to improve the quality of the service.
Updated
30 October 2018
This inspection took place on the 13 September 2018 and was unannounced. Brookfields is a ‘nursing 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. Brookfield’s is registered for six people with learning difficulties and physical disabilities. On the day of our inspection, six people were living at the service.
At the last inspection on 20 January 2016 this service was rated good in all five key questions, and before that the home has a history of compliance with legal requirements. At this inspection we found the service remained Good.
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. People living at Brookfields could live a life as fully as they were able in a domestic styled homely environment that had been created to meet their needs.
On the day of our inspection visit 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 was run.
The service was well led. There was a person-centred ethos which meant that people were empowered to have some choice and control over their lives. The registered manager provided stable leadership and clear direction to the staff team and staff felt supported.
There were effective systems to monitor the quality and safety of the service provided that placed an emphasis on the quality of people’s lives. These systems were used to continue to drive improvements in the service and the care people received.
Brookfield’s provided person-centred care. We saw that people and relatives were treated with kindness by a staff team. Staff supported people with dignity, and had developed some positive relationships with people that were based on respect and trust.
People could maintain relationships with people who were important to them. Relatives we spoke with felt their views and opinions about their loved one’s care were listened to so that they felt involved in their loved one’s care.
Staff sought consent from people before caring for them and they clearly understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Where people were deprived of their liberty, processes had been followed to ensure that this was done lawfully. Where medicines were given covertly the best interests processes hadn’t been followed. Staff understood people’s unique communication styles and ensured that the views of people with communication difficulties were listened to and acted upon.
People were protected from the risk of harm because there were robust processes to ensure their safety. Staff all knew and understood their responsibilities in relation to protecting people from abuse and had received the training they needed to do this. People were protected from harm because the risks to their safety were clearly identified and measures in place to reduce these risks.
People were supported by enough well trained and competent staff who knew people well. The registered manager followed robust recruitment checks to ensure that staff employed were suitable to support people using the service with all aspects of their care. People’s medicines were managed safely and people were protected from the risk of infection.
People were supported to have enough to eat and drink, to manage their health needs and saw health professionals regularly as needed. Staff implemented the guidance that was provided by health care professionals to support people to meet their health needs and stay well.