OSJCT Brookside

Updated 15 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by three inspectors including a pharmacist inspector.

Service and service type

Brookside is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single 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 registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the 6 August 2019. The second day of the inspection was announced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with 12 staff including the area manager, registered manager, senior care workers and care workers. We also spoke with the chef, head housekeeping, handyperson, activities staff and volunteer. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This including seven people’s care records and multiple medication records. We looked at six recruitment files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked additional information provided by the registered manager.

Updated 15 October 2019

About the service

Brookside is a care home registered to support up to 50 people, based in Melksham in Wiltshire. The provider is The Orders of St. John Care Trust.

People’s experience of using this service and what we found

Individual risks were assessed and risk reducing measures devised. Care plans were devised for people who expressed their anxieties and frustrations through behaviours staff found difficult to manage. For some people the care plans were detailed on managing these situations. However, for some people where the levels of anxiety had increased their care plans did not reflect the changes. The actions from staff were not detailed on how staff were to divert or distract the person.

Personal emergency evacuation plans (PEEP) needed detail on how to support people to safely evacuate the premises.

Medicine systems needed to improve in areas of when required protocol and seeking advise from a pharmacist for best method of disguising medicines. We recommended the provider consider current guidance on giving when required medicines as well as taking action to update their practice and procedures accordingly.

While care plans were person centred and staff knew people well some action plans lacked detail. People’s advanced wishes were not gained and for people with diabetes the signs of deterioration were not detailed in the care plan. The registered manager had identified these areas for improvement and appropriate action was being taken to develop care plans for advance decisions.

There was a strong culture where people views were at the centre of the way the home operated. Some staff practices and facilities exceeded standards.

The people we spoke with said they felt safe living at the home and relatives confirmed their family members had a sense of security with the staff. Safeguarding of adults at risk procedures were accessible to staff. Staff were knowledgeable about the expectation on them to report concerns of abuse.

People and staff felt valued. We saw kind and caring interaction. People were supported to follow their preferred routines. People chose how and where they spent their day. Relatives and people said the staff were kind and caring.

People's care needs were assessed before admissions for respite of permanent stays were agreed. There were introductory visits before stays at the home took place. This meant people’s anxieties were reduced because they recognised staff when they arrived for stays.

The staff were supported to meet the responsibilities of their roles. New staff received an induction when they started work at the home. The staff attended a wide range of training which ensured they were able to meet the needs of people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were good relationships within the local community. A healthcare professional told us the home was responsive to their suggestions and recommendations.

The registered manager had good leadership oversight. People and staff felt confident to approach the registered manager. The staff, people and relatives said the registered manager had a good presence in the home.

There were effective quality assurance systems in place and plans on developing the service were also in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Outstanding (published 22 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.