Brook House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified 1 breach of the legal regulations. The provider’s governance processes were not effective in identifying and addressing concerns in the quality and safety of people’s care. The provider had not embedded a culture of learning to ensure improvements in the service were sustained. The provider had not fully explored how to gather feedback from people and the culture of the service did not always promote respectful care. Despite these concerns, people, relatives and staff were generally positive about the improvements being made by the management team. Staff felt supported and able to speak up if they had any concerns.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and managers told us they felt positive about the culture of the service and their role in supporting people to achieve good outcomes. However, we found the language used to describe the complexities of some people’s care needs was not always respectful. This meant there was a risk the culture of the service may not promote compassionate care which respected people’s diverse needs. Following our feedback the registered manager told us they were sourcing additional support and training for the whole team to better understand the impact of communication and language on promoting a positive culture.

The provider did not always have robust processes in place to engage with people, relatives and staff to evidence how they were listening and collaborating with others to develop the service. The management team had not always fully explored different options to promote people and relatives feedback and involvement. At the time of the assessment, the registered manager told us they were implementing more robust systems to gather feedback and improve communication. However, these processes were not yet embedded.

Staff spoke positively about the leadership of the service. Staff told us the management team were a visible presence and were always willing to provide direct support alongside staff where required. The management team told us working alongside staff enabled them to better understand any issues and provide additional support.

The management team had clearly established roles and responsibilities which ensured people, relatives and staff understood who to contact and how to raise any issues or concerns.

Staff told us they felt supported and were able to raise concerns with the management team. Staff knew how to access information about whistleblowing and speaking up if needed. Managers were able to tell us how they responded to concerns and followed the appropriate processes to ensure concerns were listened to and addressed.

The provider had a whistleblowing policy and process in place for staff to follow. Information was available to staff about how and where to raise concerns anonymously if required.

Staff told us they had access to relevant training and development opportunities and were able to request any additional support required. The management team told us they used support systems such as supervisions, team meetings and training opportunities to promote an inclusive culture for all.

The provider had policies in place to support fair and inclusive recruitment, induction and training for all staff.

The management team were open in acknowledging improvements were needed in their governance processes and told us they were implementing a new governance system which would enable them clearer oversight. The registered manager told us the new system would allow them to pull through actions more easily, creating an action plan and enabling them to monitor progress. However, at the time of the assessment, these systems were not yet in place.

The provider's governance processes were not robust. Areas of concern identified at the last inspection remained an issue at this assessment. For example, the provider’s oversight of fire safety and infection prevention and control. We also found additional concerns in relation to the provider’s oversight of key areas such as medicines management and recruitment. Where the management team were able to evidence some concerns had been identified through their governance processes, action had not always been taken promptly to address these concerns.

People were supported by a range of different health professionals who worked alongside staff to support their needs. People enjoyed visits from local community groups and were encouraged to take part in local events and activities.

Staff and managers told us they engaged with other healthcare professionals and community groups to meet people’s needs and promote their wellbeing and engagement.

We received generally positive feedback from health and social care professionals about the service's partnership working. However, we received mixed feedback about how promptly and effectively the provider communicated health concerns.

The provider had processes in place to seek support from other health professionals and work in partnership to improve people's care. However, some feedback suggested these processes had not always worked effectively to ensure prompt and appropriate communication.

The management team were not always able to demonstrate how people, relatives and staff were involved in making decisions about improvements in the service. Processes for gathering feedback from people and relatives were not robust. Staff meeting records did not demonstrate a two-way dialogue which encouraged staff to feedback; however, staff told us they felt listened to.

The provider's processes were not effective in driving continuous improvements and learning. During our assessment, we identified a number of concerns which had been raised previously. This demonstrated a poor culture of learning and improvement in the service.