We carried out an inspection of Brookhaven on 22 and 23 June 2015. The first day of the inspection was unannounced.
Brookhaven provides accommodation and nursing care for up to 22 people with mental health needs. The aim of the service is to provide people with care and support through a recovery and rehabilitation programme. The service is based in a residential setting within walking distance of local amenities. Accommodation is provided on two floors in single bedrooms. At the time of our inspection there were 17 people living in the home.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 last inspected this service on 4 December 2014 and found it to be meeting the regulations in force at the time. This inspection focussed on the management of medication in the home.
During this inspection we found the provider needed to improve the cleanliness of the building, ensure all risks to people’s health and safety were assessed, ensure people received safe care and treatment in respect of their healthcare needs and ensure people were treated with dignity and respect. You can see what action we told the provider to take at the back of the full version of this report.
We also made recommendations about the implementation of the Mental Capacity Act 2005 and making care plans more meaningful to people using the service.
People living in the home made positive comments about the home and told us they felt safe and looked after.
On arrival, we found some parts of the home had a poor level of cleanliness. Prompt action was taken to clean these areas. However, we also noted one person’s bedroom only contained a bed and had no heating or soft furnishings. Whilst there were mitigating factors, this situation had not been risk assessed in order to manage the risks to the person.
Staff knew about safeguarding people from harm and we saw they had received appropriate training on these issues.
We found the arrangements for managing medicines were safe and all records seen were complete and up to date.
We found staff recruitment to be thorough and all relevant checks had been completed before a member of staff started to work in the home. Staff had completed relevant training for their role and they were well supported by the management team.
Whilst people had access to healthcare services, we found there had been a delay in obtaining a medical diagnosis for one person and specialist advice and support had not been sought for another person.
People told us the staff were kind and supportive. However, we noted some practices which did not promote the dignity of people living in the home. For example, there were locks on all external doors and some internal doors and many of the staff had a bunch of keys on a strap attached to their clothing. Although some people had a fob to get out the front door other people had to ask staff every time they wished to go out for fresh air or smoke a cigarette.
The unit manager had made two applications to the local authority for Deprivation of Liberty Safeguards (DoLS). However, we found there was no information in one of the people’s care plan about the DoLS application.
We noted from looking at people’s personal files each person had an individual care plan. However, apart from one person, people were not aware of their care and recovery plan.
People were able to express their views about the service at weekly “Have your say” meetings and they had also been given the opportunity to complete a satisfaction questionnaire.
We saw there were systems in place to monitor the quality of the service, including audits. The registered manager had also devised a detailed operational development plan, which included an action plan to improve the service.