Bromham House

Updated 21 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

good practice

Inspection team

This inspection was undertaken one inspector.

Service and service type

Bromham House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Bromham House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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 safeguarding team and commissioners of the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the service location on 7 October 2022, and again in the evening on 11 October. We spoke with three people and three relatives. We also spoke with seven staff including the area manager, registered manager, senior support workers and support workers.

We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were also reviewed, including training records, incident records, compliments, quality assurance processes and various policies and procedures.

What we did after the inspection

We sought assurance about infection and prevention control practices and incidents.

Updated 21 October 2022

About the service

Bromham House is a residential care home providing accommodation and personal care for up to four people. At the time of the inspection there were four people using the service. Each person had their own room, shared kitchen and other communal areas with a large garden area.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 and autistic people and providers must have regard to it.

Based on our review of is the service safe, effective, caring, responsive and well-led questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

The service gave people care and support in a safe environment that was clean and suitably equipped to meet people's physical and emotional needs. Most staff complied with measures designed to reduce the risk of COVID-19 spreading within the service.

Staff supported people to actively pursue their interests, work, hobbies and pastimes inside and outside the home, and to achieve their aspirations and goals. The service worked with people to plan for when they experienced periods of distress; to minimise any restrictions and to ensure people had as much freedom, choice and control over their lives as possible.

Staff received training in the use of restraint and were confident in their ability to deploy this training if it should be needed. At the time of our inspection no person required restraint. Any restraint would be in an emergency, as a last resort, done in a safe way and for the shortest time possible.

Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. 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.

The service and its staff team made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go. People were administered their medicines in a way that respected their independence and achieved positive health outcomes.

Right Care

Staff promoted people's equality and diversity, supporting and responding to their individual needs. People's care plans were detailed and an accurate reflection of the support they needed and what people could do independently.

Staff had training on how to recognise and report abuse, and had the skills to protect people from poor care and abuse, or the risk of this happening. The service worked with other agencies to do so. The service had enough appropriately skilled and safely recruited staff to meet people's needs and keep them safe.

Staff had a thorough understanding of people's individual ways of communicating and this enabled people to be listened to. People received care that supported their needs and aspirations, was focused on their

quality of life, and followed best practice. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture

People were supported by staff who understood best practice in relation to people's strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew people well and responded to their needs and wishes. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

People and those important to them, including advocates, were involved in planning their care. This enabled people to be able work with staff to develop the service. Staff valued and acted upon people's views.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. Staff put people's wishes, needs and rights at the heart of everything they did.

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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.

Rating at last inspection

This service was registered with us on 17 December 2020 and this is the first inspection.

Why we inspected

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bromham House 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.