Our inspection of Brookfield Care Home took place on 21 December 2016 and was unannounced. At the previous inspection in November 2015 the service had been in breach of regulations relating to staffing, safe care and treatment and good governance. During this inspection, we saw the service had made significant improvements within these areas and found it no longer in breach of regulations.

Brookfield Care Home is located in Nabwood, Shipley on the outskirts of Bradford and is registered to provide personal care for up to 40 people, although the service had made two double rooms into single rooms which reduced the maximum occupancy to 38. At the time of our inspection there were 36 people living at the service. Accommodation was arranged over two floors and all bedrooms were en-suite with toilets, baths or showers. There were a number of communal lounges on both floors, two dining rooms on the ground floor and a passenger lift in place. Outside the property were gardens and a car parking area.

A registered manager was in position. 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 told us they felt safe living at the home and the care provided was good. Staff understood how to keep people safe and safeguarding training was in place. Staffing levels were sufficient to keep people safe although increased levels would allow more interactions with people at busy times.

A robust recruitment process was in place and staff received a range of training to enable them to care and support people living at the home.

Appropriate risk assessments were in place in people's care records and these were updated as care and support needs changed. People's needs were assessed and plans of care put in place which were updated appropriately.

The premises were well maintained with no malodours. People were encouraged to have personal possessions such as ornaments, pictures and toiletries in their bedrooms.

Medicines were well managed with appropriate safe systems in place to ensure people received their medicines at the right times.

People had access to a range of health care professionals and referrals were made where required.

The home was working within the legal requirements of the Mental Capacity Act 2005 and people's consent was sought wherever possible. People's preferences were respected and people were treated with dignity and kindness.

People told us the food was of a high standard and menus were formulated with people's input and feedback. People were provided with nutritious and varied diets with plenty of fluids encouraged and dietary supplements were given to those nutritionally at risk.

Any complaints were treated seriously with actions and outcomes documented. People told us they felt able to approach staff and management with any concerns they had.

A range of audits and processes were in place to ensure the quality of the service was maintained.

The management team were highly visible and people knew the registered manager by name. All staff worked together as a team and morale was good.

Resident and staff meetings took place as well as quality questionnaires sent to gauge service satisfaction.

During the inspection we had the opportunity to speak with four people who used the service. They told us they were looked after in an appropriate manner and felt safe and comfortable with the care and treatment provided.

Their comments included: "The girls are very nice here", “They look after us” and “I like my bedroom and wardrobes”.

We found the home had appropriate systems in place to ensure consent was gained before staff proceeded with personal care.

We saw evidence there was an appropriate system in place for listening to and acting on people’s comments and concerns.

We spent time observing the lounges and dining areas during the day of our inspection. We looked closely at how people spent their time and how staff interacted with people.

All the interactions we saw between carers and people who used the service were respectful. We saw some people engaged in activities with members of staff such as singing and watching TV. The Registered Manager told us that various activities were delivered on a daily basis.

During our visit we spoke with six of the 33 people who lived at the home. They told us they enjoyed living at Brookfield Care Home. One person said, "It is absolutely beautiful here."

People we spoke with told us staff were kind to them. One person said, “They are brilliant staff here."

We were able to speak with a relative during our visit; they commented "I come most days, I am made very welcome, it’s a welcoming place."

During our visit the lounge on the ground floor was well occupied. The residents were given a choice of hot and cold drinks with biscuits. The television was on and some people were chatting in a cheerful manner. The residents and looked smart, the gentlemen were clean shaven. There was a pleasant atmosphere throughout the home and we were made to feel welcome by staff and the people using the service.

We inspected Brookfield Care Home on 10 & 20 November 2015 and the visit was unannounced.

Our last inspection took place on 2 July 2013 and, at that time, we found the regulations we looked at were being met.

Brookfield Care Home is located in Nabwood, Shipley on the outskirts of Bradford and is registered to personal care for up to 40 people. However, as the two double bedrooms were being used as single bedrooms this had reduced the number to 38. At the time of or visit there were 37 people using the service. Nursing care is not provided.

Brookfield Care Home is an extended building and the accommodation is arranged over two floors. All of the bedrooms have either an en-suite toilet and shower or en-suite bath and toilet. There are communal sitting areas on both floors and a passenger lift is available. Outside there is car parking to the side and gardens.

There is a registered manager. 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.

Recruitment processes were robust and thorough checks were always completed before staff started work to make sure they were safe and suitable to work in the care sector. Staff told us they felt supported by the registered manager and that training was on offer. People told us they liked the staff and found them kind and caring. On the day of our visit we saw people looked well cared for. We saw staff speaking calmly and respectfully to people who used the service.

There were not always enough staff on duty to meet people’s needs. The registered manager had identified they needed an additional care worker on duty during the day as there were 18 people using the service who required two staff to assist them with their moving and handling needs. The provider agreed to increase the staffing levels in the evening but not during the morning.

We found nurse call bells could be sounding for up to 12 minutes before staff attended to assist people. This delay meant people’s needs were not being met in a timely way.

We found the lack of response by the provider to some issues was leaving people using the service at risk. We found the hot water to some bedrooms and en-suite bathrooms was excessively hot and could have caused a burn or scald. We saw this had been reported but no action had been taken to resolve the problem. We found the loft was being used to store combustible materials, we asked the fire officer to visit because we were concerned about this.

People told us they felt safe at Brookfield Care Home. We saw there were policies and procedures in place to safeguard adults at risk.

We found people had access to healthcare services and these were accessed in a timely way to make sure people’s health care needs were met. The medication system was well managed and people received their medicines at the right times.

We found the service was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

People told us meals at the home were good offering choice and variety.

We found there were quality assurance systems in place, however, these were not always up to date and were not effective in ensuring the provider addressed the issues identified in a timely way. Some of people’s personal care and treatment records were not up to date.

We found three breaches of regulations and you can see what action we told the provider to take at the back of the full version of the report.