Background to this inspection
Updated
24 November 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 comprehensive inspection took place on 5 and 6 November and was unannounced on day one. The inspection team consisted of two adult social care inspectors, one specialist advisor [who was a nurse] and two experts-by-experience on day one and two adult social care inspectors on day two. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we looked at the information we held about the service. This included statutory notifications and a provider information (PIR) sent to us by the provider. A statutory notification is information about important events which the service is required to send us by law. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We contacted the local authority contracts and quality assurance team to gain their views of the service and they shared they current knowledge. We checked whether a Healthwatch visit had taken place and saw that the last visit was in 2015.
During the inspection we used a variety of methods to understand the experience of people who used the service. We spoke with 14 people using the service and eight relatives/visitors to seek their views. We undertook a Short Observational Framework for Inspection (SOFI) observation. SOFI is a way of observing care to help us understand the experience of people who could not talk to us.
We spoke with the regional director, regional support manager, resident experience manager, and 18 members of staff which included department managers; nursing; care; kitchen; hostess, housekeeping and laundry staff. We also looked at documentation which included three staff files, eight care files and other documentation related to the running of the home.
Updated
24 November 2018
Brookview Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 52 people living at Brookview Care Home.
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 that the service remained good.
There had been a change in management since the last inspection. The new manager was not present during the inspection. However, we met with the regional director, regional support manager and regional quality manager who were supporting the service. People, visitors and staff spoke positively about the new manager and that improvements had been made since their arrival.
People felt safe, their needs were regularly assessed and they were protected from harm and abuse. Accidents and incidents were recorded and monitored to identify emerging trends and individual risks were assessed.
People’s care and support needs were regularly assessed and linked to a dependency tool to determine staffing requirements. A review was being undertaken at the time of the inspection.
A medicines policy was in place to guide staff practice. Staff received training and their competency to do so was regularly checked. We raised an issue about a person refusing their medicines and the regional management team took immediate action.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff sought consent before carrying out care support and people told us they were happy with the care they received.
Staff were supported to develop their skills, knowledge and competencies by completing a wide range of developmental training.
There was an extensive refurbishment programme underway which was nearing final stages. The environment was clean, bright and airy and of a high standard. Specialist equipment was readily available.
Food served was nutritious and meal time experience calm and pleasant. Staff supported people who needed assistance in a kind and unobtrusive manner.
The inspection team observed interactions that were extremely kind, caring and patient. Staff clearly knew people’s needs and preferences and warm and trusting relationships had been developed.
Care delivery was extremely person-centred and people were treated as individuals. Some records reviewed did not fully reflect the person-centred care being delivered. We were informed that this would be improved in a programme of transfer to new documentation.
Staff contacted health care professionals promptly when people were unwell and people were supported to access a wide range of services to maintain their health and well-being.
There was a programme of activities and a new activities co-ordinator was being recruited.
There were robust audits used to assess and monitor the quality of the service. We saw that these had identified where the service was not compliant with the provider’s policies and procedures which resulted in action plans being implemented to improve the service.