This inspection took place on 10 December 2018. This was unannounced.At our last inspection on 1 and 2 May 2018 we rated the service as ‘Inadequate’ and identified five breaches of regulation which related to person centred care, staffing, safeguarding people from abuse and improper treatment, safe care and treatment and good governance. This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and are ongoing and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. Newbrook provides care for up to three people who have learning disabilities. At the time of inspection there was two people using the service. People in care homes receive accommodation and personal care as a single care 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 in place who had started working at the service two weeks prior to the inspection but they had not registered to manage this service yet. They told us they were planning to submit their application soon. It is a legal requirement that this service has 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 is run.
We found the manager, regional manager and staff had worked hard to make improvements in the areas of concern found at the last inspection. At this inspection, we found improvements in all areas. However, we discussed with the manager and regional manager more work was needed to ensure a robust and sustained service moving forward. The management agreed with this and told us they had been focusing on ensuring the home was safe and people received the right support.
We found the care and support plans now being completed for people were centred around their needs and preferences. The manager had discussed the changes in care planning with staff at the last staff meeting.
We found improvements in relation to how people’s risks were managed in the care plans. We also saw the manager had re written one person’s care plan with the support from family and staff. The manager told us this would be ready to implement to the service over the next few days. We have made a recommendation about care plans in the report.
We found fire safety had improved and the home had actioned maintenance issues since the last inspection.
We found improvements to how incidents and accidents were recorded.
At the last inspection people were not receiving their personal financial allowance. We found the management team had placed robust financial records in place for people living at Newbrook.
We found staff were receiving regular supervisions and training and these were clearly recorded on an action plan for the upcoming year. At the last inspection we also found limited members of staff on duty. We found this had improved and the rota clearly stated where someone received a one to one support.
We spoke to a relative who told us they were happy with the staff, however had lost faith in the provider due to changes in management throughout the last year
We saw medicines were managed safely.
People lived in a pleasant environment. People had nicely decorated bedrooms with personal pictures in their rooms. We saw improvements in relation to how people’s health needs were managed and we saw evidence to support people were attending appointments from health professionals. We also found improvements to meal time experience. We saw the menu showed choices of meals and support with setting the table.
We observed staff supporting one person to bake, however the person was reluctant to engage in the activity. The staff member was calm and gave an alternative. We observed both staff and the person completing a jigsaw in the lounge. We found staff did know the person well and gave time for them to engage in activities and tasks.
We found the manager had completed a staff meeting as soon as they were appointed. Discussions included, where the service was, the changes they wanted to implement at the service for people and what was expected of staff. Staff could share their views in relation to this. Staff felt these now would be acted on and felt the manager was good.
We saw the provider had completed a complaints log and this was up to date on the system.