Brookfield Support Centre

Brookfield Support Centre is a residential care home providing personal care for up to 39 people. The service provides support to people by providing intermediate care services. Intermediate care is for people who are ready to be discharged from hospital but may not be fit enough to go home straight away, or for those who may have difficulties managing at home due to illness or reduced mobility. They may require a further period of recovery and/or rehabilitation. Accommodation is provided on the ground floor with full access to adapted facilities.

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; the policies and systems in the service supported did not support this practice. At the time of this inspection there were no people being supported under the Mental Capacity Act.

Medicines were managed safely within the service. People told us they felt safe staying at Brookfield Support Centre. Procedures were in place for the reporting of incidents, accidents, and safeguarding concerns to prevent further occurrences.

Effective procedures were in place for the safe recruitment of staff. Risks to people's health and wellbeing had been assessed and guidance was available for staff to support people safely.

The service had a clear ethos of ensuring that people maintained, and where possible improved their independence whilst using the service.

Regular checks and maintenance of the service took place to provide a safe environment for people to live. Governance systems were in place to monitor and assess the quality of care people were provided with. The registered manager and staff worked in partnership with other external agencies and professionals to meet the needs of people using at the service.

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 21 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed and remains good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brookfield Support Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

A designated unit within the home had been identified for use to admit people to the service. This meant the risk of cross infection was mitigated.

Staff were provided with current infection prevention and control (IPC) guidance. There was a designated infection control lead who worked effectively with other staff to ensure they followed correct IPC procedures.

Well stocked and clearly signed personal protective equipment (PPE) stations were located around the service. Staff were observed using correct PPE equipment when carrying out their duties. People told us staff always wore the correct PPE.

The service was clean and well maintained. Cleaning schedules were in place and regularly monitored.

We found the following examples of good practice.

A designated unit within the home had been identified for use in response to the Winter Plan for people discharged from hospital with a positive Covid-19 status. The service was compliant with all infection prevention control measures and managers ensured the safety of people and staff both within the unit and across the whole service.

Staff were provided with current infection prevention and control (IPC) guidance and the provider kept them up to date through regular meetings, newsletters and emails. Staff completed IPC training and regular competency checks to ensure they followed correct procedures and knew how to keep people safe during the COVID-19 pandemic.

Well stocked and clearly signed personal protective equipment (PPE) stations were located around the service. Staff were observed using correct PPE equipment when carrying out their duties. People told us staff always wore the correct PPE and they felt safe whilst staying at Brookfield Support Centre. Staff were observed social distancing whilst supporting people.

There was a designated infection control lead who worked effectively with other staff to ensure they followed correct IPC procedures. Risk assessments and cleaning schedules related to Covid-19 were in place and regularly monitored. Increased cleaning schedules were in place.

Staff told us they felt safe at work and well supported by the registered manager and senior staff. Staff were provided with details of appropriate services should they wish to access independent support with their wellbeing.

People were supported with their wellbeing through regular one-to-one contact with staff and therapeutic programmes. Safe measures were in place to facilitate family visitors in exceptional circumstances. Where visitors were not permitted, alternative methods of communication were supported.

Further information is in the detailed findings below.

The service is owned and managed by St. Helens Local Authority and has recently had a substantial refurbishment. The service is registered to provide care to 39 people, at the time of inspection 22 people were receiving support.

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.

At this inspection we found the service Good.

The service has a registered manager who was supported by five assistant managers and the provider. 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.

Medications were safely managed. People who lived in the home and relatives we spoke with all gave positive feedback about the home and the staff who worked in it. The service had a relaxed feel and people could move freely around the service as they chose. People were able to have control over their lives and participate in activities they enjoyed. People were supported to retain and regain their independence.

Staff worked together with nurses, social workers, physiotherapists and occupational therapists to ensure the support being delivered was person centred and this was evidenced in the success of people being supported back into the community. However, information in care plans did not always reflect the care being delivered. This was brought to the managers attention who immediately actioned it. We saw the service had responded promptly when people had experienced health problems.

The registered manager and provider used different methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. The staff team were consistent and the providers were also involved in the running of the service.

Staff were recruited safely, received a robust induction and suitable training to do their job role effectively. All staff had been supervised in their role.

The home had carried out various checks to ensure the environment was safe and infection control processes were in place. As the service had recently undergone a refurbishment the building was in need of an up to date fire risk assessment, the registered manager was able to show actions following inspection to ensure this was to take place.

People are 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 support this practice.

As Brookfield Support Centre is specifically to provide intermediate care, this meant that no end of life care would be delivered. However, processes were put in place following this unexpectedly occurring and lessons learnt to support people who might need this service in the future.

Further information is in the detailed findings below

At the time of the inspection the service was providing support to 17 people. The service offers temporary care and support to people for a period of up to six weeks. Assistance is offered to people who require an assessment of their future care needs, or who require therapy support to improve their confidence and levels of independence with day to day tasks.

There was a registered manager in post within the service. 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.

Staff had completed training in a number of areas including safeguarding, manual handling and infection control. However staff had not completed training in the Mental Capacity Act 2005 (MCA), which the registered provider was working to rectify. Despite this, people’s rights and personal wishes were respected in line with the MCA.

New staff were supported through a programme of induction. They were required to complete training and to familiarise themselves with the registered provider’s policies and procedures. This helped ensure that new starters had the necessary skills and knowledge to carry out their role effectively.

People were protected from the risk of abuse. Staff had a good understanding of the different kinds of abuse that could occur and how to report their concerns. The registered provider had an up-to-date safeguarding policy in place which was accessible to staff, and staff were also familiar with the whistle blowing policy.

Recruitment processes were robust and ensured that staff were suitable to work within the service. Prospective staff were required to complete an application form, outlining their previous experience and qualifications, and also went through an interview process. New staff were subject to a check by the disclosure and barring service (DBS). The DBS carry out checks to ensure staff are suitable to work with vulnerable people.

Staff received supervision on a regular basis which enabled them to discuss development opportunities and any training needs. They also allowed the registered manager to discuss any performance related issues. This helped ensure that any performance or development needs were addressed.

People were supported to take their medication as prescribed. Staff appropriately completed the medication administration record when medication was given to people. People’s medicines were securely stored in their own rooms in locked cabinets. These were accessed by staff who had received appropriate training in the administration and management of medicines.

People’s care records were personalised and contained relevant information around their likes, dislikes and any preferences. People also had an individualised therapy plan which was updated to reflect any changes or developments in their abilities. This helped ensure that staff had access to up-to-date information on people’s needs.

People were provided with appropriate dietary options. Their care records contained information around their dietary needs and kitchen staff kept a record of people with special dietary requirements. During meal times people received appropriate levels of support from staff. People made positive comments about the quality of the food available.

People told us that they would feel confident in being able to make a complaint. The registered provider had an up-to-date complaints policy in place, which was on display at the entrance to the building. People also received a copy of the complaints procedure on admission into the service.

People and staff spoke positively about the service and the management team. People told us that the registered manager was approachable and they felt confident in approaching her with any issues. The registered provider carried out audits of the service to ensure the quality of the service was maintained. These focussed on areas such as medication, care records, and people’s experiences.

The registered provider had sought feedback from people on their experiences of using the service. People had provided positive feedback about the standard of the service they had received. The staff and management teams had also received a number of ‘thankyou’ cards from people and their relatives.

We looked at care planning, complaint systems and staffing levels. We also talked with residents about the home. Comments were positive and included, 'I have no complaints the management and staff are all caring people.'

We found care plan records were up to date and people were happy with the service they were receiving. We found sufficient staff around to meet the needs of people staying and living at the home. One resident we spoke with said, 'Always plenty of staff around to talk to, which is what I like.'

We spoke with people living at the home and staff throughout the inspection. We observed the quality of care and support provided by staff during the inspection.

We found people were supported by staff who had been trained and appropriate support arrangements were in place for them. A relative we spoke with said, "All the staff are competent and are around when you need them."

The home had a complaints procedure which was available to residents and families. This was confirmed through talking with residents. It explained how to make a complaint and how this would be handled.

There were a range of audits and systems in place to monitor the quality of the service being provided.

On a tour of the building we observed that the centre was warm and clean and people were encouraged to join in with the activities on offer. We saw that the staff members on duty were respectful and polite to people who used the service and were mindful of people's dignity and privacy at all times.

We spoke with four people who use the service, and one told us that the staff members were 'always respectful', whilst another said that they felt that the centre was 'homely' and 'not like a hospital'.

We examined documentation for four people using the service whilst on our visit. The files were updated and reviewed on a monthly basis and were up to date on inspection.

Managers were clear about their role within safeguarding and the staff members we spoke with had a good understanding of the Mental Capacity Act and its application in day to day care.

During our visit we looked at records of complaints and concerns and found that they were logged appropriately and had been dealt with correctly. There were a large number of thank you cards around the units, and on our visit we saw a large bouquet of flowers which had been sent by an appreciative family.