Background to this inspection
Updated
8 September 2017
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 inspection took place on 22 August 2017, and was unannounced. The inspection team consisted of one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert involved in this inspection had expertise in the care of older people.
Before the inspection, we had asked the provider to complete a Provider Information Return (PIR). This 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 took this into account when we inspected the service and when we made the judgements in this report.
Before the inspection we gained feedback from health and social care professionals who worked together with the service. We also reviewed the information we held about the service and the provider. This included safeguarding alerts and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law.
During the inspection, we used a number of different methods to help us understand the experiences of people who used the service. We reviewed records of care and management systems used by the service for care delivery. We observed the environment and staff supporting people. We spoke to five people who were able to share with us their experiences of living at Brook House. We spoke with two relatives by telephone. We also spoke with the deputy manager of the service, the registered manager, one professional who had visited the service, and four care staff. It was not possible to gather the views of the other five people who lived in the service due to their communication needs. However their relatives were able to share their views with us.
We looked at care records of the five people of which two records were pathway tracked.
Pathway tracking is where we look in detail at how people’s needs are assessed and care planned whilst they use the service. We also looked at a variety of records relating to management of the service. This included staff duty rosters, four recruitment files, the accident and incident records, policies and procedures, service certificates, minutes of staff meetings, reports from safeguarding professionals and also quality assurance reports, audits, and medicine records.
Updated
8 September 2017
This unannounced inspection took place on 21 August 2017.
Brook House is registered to provide personal care and accommodation for up to 10 people with a learning disability. The home is a large semi-detached house situated in a residential area of Burnley. Accommodation is provided in single rooms with en suite facilities. The home has two lounges, a dining kitchen and utility room. There is a garden area to the rear of the home and parking facilities at the front. There were 10 people who lived at the service at the time of our inspection.
The service had 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.
This inspection was the first inspection since the service was registered with the Commission on 16 February 2016.During this inspection we found the service meet all regulations. However we made a recommendation in relation to seeking consent.
There were policies and procedures on how the service protected people against bullying, harassment, avoidable harm and abuse. Staff had received introductory training in safeguarding adults.
Staff had sought advice from other health and social care professionals where necessary. There were risk assessments which had been undertaken. Plans to minimise or remove risks had been drawn up and reviewed in line with the organisation’s policy. These were robust and covered specific risks around people’s care and specific activities they undertook in a person centred manner.
People were protected against the risk of fire. Building fire risk assessments were in place and fire fighting equipment had been maintained.
There was a medicines policy in place and staff who administered medicines had been trained to safely support people with their medicines.
We looked at recruitment processes and found the service had recruitment policies and procedures in place to help ensure safety in the recruitment of staff. These had been followed to ensure staff were recruited safely for the protection and wellbeing of people who used the service. Records we saw and conversations with staff showed the service had adequate care staff to ensure that people's needs were sufficiently met.
We found care planning was done in line with the Mental Capacity Act, 2005. Some of the staff showed awareness of the Mental Capacity Act, 2005 and how to support people who lacked capacity to make particular decisions. They had received mental capacity training. Improvements were required in relation to mental capacity and consent.
People who used the service gave positive feedback on the quality of the service. Some people were unable to give us feedback due to their complex needs. We spoke to their relatives. Feedback from relatives about care standards was positive.
People using the service had access to healthcare professionals as required to meet their needs. Staff had received training deemed necessary for their role. Staff competences had been checked in medicine management. Staff had had also been provided with annual appraisals.
We found that people’s care needs were discussed with care commissioners before they started using the service to ensure the service was able to meet their assessed needs. Care plans showed how people and their relatives were involved in discussion around their care. People were encouraged to share their opinions on the quality of care and service being provided. People’s nutritional needs were met. Where people's health and well-being were at risk, relevant health care advice had been sought so that people received the treatment and support they needed. There were a variety of activities provided to keep people occupied in and out of the service.
We received positive feedback from people, relative and staff regarding management of the service
There were established management systems at the service. The director had been involved in the day to day management of quality at the service. The registered manager had provided oversight on duties they delegated to other staff.
Quality assurance systems were in place and various areas of people’s care been audited regularly to identify areas that needed improvement. We found audits had been undertaken of medicine records, finances and infection control. Further improvements were required to ensure other areas of the service were regularly audited. There was a business contingency plan to demonstrate how the provider had planned for unexpected eventualities which may have an impact on the delivery of regulated activities.
Some of the records in the service had been adapted to an easy format to ensure they were accessible to people who used the service.
Feedback from relatives showed they felt their relatives received a good service and they spoke highly of the staff. Relatives told us the staff were kind, caring and respectful and were considerate in their approach to dealing with some challenging situations. Professionals we spoke to confirmed this.
We found the service had a policy on how people could raise complaints about their care and treatment. Relatives told us they could raise concerns and felt listened to.