About the service:

Brenalwood 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. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. This service does not provide nursing care. Brenalwood Care Home accommodates up to 38 older people in one adapted building. During our comprehensive unannounced inspection, there were 30 people using the service, some living with dementia.

People’s experience of using this service:

¿ At our last inspection of 17 February 2016, the service was rated requires good. At this inspection of 6 March 2019, 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. The rating has not changed.

¿ People told us that they were happy with the service they received. One person commented, “I like being here.” One person’s relative said, “I would not want [family member] anywhere else, this is home.”

¿ There were systems designed to keep people safe, including from abuse. Risks to people in their daily lives were assessed and plans in place to reduce these. People’s medicines were managed safely.

¿ There were enough trained and skilled staff to meet people’s needs. Recruitment processes were safe.

¿ There was an ongoing programme of improvement in the environment. Infection control procedures to help protect people from the risks of cross infection.

¿ People had access to health care professionals when needed. People were supported to maintain a healthy diet.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

¿ People shared positive relationships with staff. People’s privacy, independence and dignity was respected. People were listened to in relation to their choices about how they wanted to be cared for.

¿ There was a complaints procedure in place and people’s complaints were addressed. People were asked for their views about the service and these were valued and listened to.

¿ The service had systems in place to monitor and assess the service provided.

Rating at last inspection:

At our last inspection of 17 February 2016, which was published 16 September 2016, the service was rated good.

Why we inspected:

This inspection took place as part of our planned programme of inspections, based on the rating of good made at our last inspection.

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

Follow up: We will continue to monitor this service according to our inspection schedule.

The inspection took place on 16 February 2016 and was unannounced.

Brenalwood provides accommodation and personal care for up to 38 older people and people who may be living with dementia. The service does not provide nursing care. At the time of our inspection there were 28 people using the service, four of whom were receiving respite care.

There was a registered manager in post at the service. 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.

People were safe because the manager and staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

There were sufficient staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

People’s health and social needs were managed effectively with input from relevant health care professionals and people had sufficient food and drink that met their individual needs.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

People were treated with kindness and respect by staff who understood their needs.

Staff respected people’s choices and took their preferences into account when providing support. People were encouraged to enjoy pastimes and interests of their choice and were supported to maintain relationships with friends and family so that they were not socially isolated.

There was an open culture and the registered manager encouraged staff to provide care that met people’s needs.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

As part of the inspection we checked on standards that were not met at our last inspection. These related to care and welfare, assessing and monitoring the quality of the service and safety and suitability of the premises. At this inspection we found that the provider had made considerable improvements in these standards and we found that they were now met. The service had appointed a deputy manager since our last inspection and this had strengthened the management team and improved the monitoring of standards in the home.

During our inspection we spoke with five people living in the home. People were very complimentary about the staff and told us that the food was “very good”. One told us: “I’m very happy here. The staff are very good. They’re always helpful. I’m satisfied with everything.” People looked well cared for and there was a happy and relaxed atmosphere in the home.

We had conversations with six people living in the home during our inspection. People we spoke with were complimentary about the staff and the care provided. One person was very appreciative of the fact that staff helped them to maintain their independence and said that this helped them to retain their pride.

Some care plans were of a good standard but others did not reflect people’s current medical condition and needs. This could result in a lack of consistent care. Staff were not consistently attending to people’s basic care needs, for example nail care and shaving, when they could not do this for themselves.

The premises where people lived were in need of considerable redecoration and refurbishment. A number of potential hazards were also identified during our inspection. This was of particular concern as all the people in the home had some form of mental disorder and might not have been able to avoid the risks by themselves. Audits of care, services and the environment were being carried out but were not always identifying concerns within the home.

There was wide range of activities that provided stimulation for people, helped them to retain their abilities and improved their quality of life. People were happy with the standard of the food and the choices available. One person who told us that they were “very fussy” about their food said, “The cook is very good and if you don’t like anything they’ll give you an alternative. They know what I like.”