Brookvale- Prestwich 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. Brookvale is a purpose built home set in extensive well maintained grounds close to open countryside. There are also seven cottages within the grounds which can accommodate people who live semi independently. The home is registered to provide accommodation and personal care for up to 80 people with learning disabilities. On the day of our inspection there were 78 people using the service.

At our last inspection on 20 October 2015 we rated the service Good overall. At that inspection we found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because staff did not receive all the training and supervision they needed to carry out their roles effectively. Following the last inspection, we asked the provider to complete an action plan to tell us what they intended to do and by when to improve the key question; is the service effective to at least good. At this inspection, we found that required improvements had been made.

We found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good overall.

Why the service is rated good.

Staff received the training they needed to carry out their roles effectively and were well supported. Staff members had been safely recruited. There was sufficient numbers of staff to provide people with the support they needed.

The service has 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. People were positive about the registered manager and the way the home was run.

Care records were detailed and person centred. They identified what was important to and for the person. People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm.

People’s nutritional and health needs were met and medicines were managed safely.

Health and safety checks had been carried out and there was a programme of regular maintenance to the building and any equipment used. Brookvale–Prestwich was beautifully decorated and furnished. The home was very clean and staff had been trained in infection prevention.

The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people's consent prior to care and support being provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us they liked the staff that worked at the home. Staff treated people with kindness, respect and compassion.

There was a wide range of activities available for people both in the home and in the community. There was a range of sporting facilities on site including: a gym, swimming pool, football and basketball pitch and put golf, tennis and a running track and cycling track. People were supported to maintain friendships outside of the home.

Quality assurance systems were in place to monitor and continually improve the quality of the service provided. Policies and procedures were in plac

Brookvale is a purpose built home set in extensive well maintained grounds close to open countryside. There are also seven cottages within the grounds which can accommodate people who live semi independently. The home is registered to provide accommodation and personal care for up to 80 people with learning disabilities. On the day of our inspection there were 74 people using the service.

This was an unannounced inspection which took place on 20 October 2015. The inspection team comprised of two adult social care inspectors, a specialist advisor and expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. The expert had experience of services for people with learning disabilities.

The home had 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.

We last inspected the home on 22 October 2014. During that inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This resulted in us making two requirement actions. Following our inspection in October 2014 the provider wrote to us to tell us what action they intended to take to ensure they met all the relevant regulations. During this inspection we checked to see if the required improvements had been made.

We found the service had made improvements since our last inspection; however we found a breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Although staff had received an induction when they started work at the service we found staff had not received the necessary training and supervision to enable them to carry out their roles effectively. The provider told us they had started a new system for providing training and supervisions but we found that this had not yet been fully embedded in the service.

People we spoke with felt safe at Brookvale. Policies and procedures were in place to safeguard people from abuse. Although not all staff had received training in safeguarding adults staff we spoke with were able to tell us how to identify and respond to allegations of abuse. Staff were aware of the whistleblowing policy to report poor practice. A safe system of recruitment was in place. We observed there were sufficient numbers of staff to provide people with the support and care they needed.

During our inspection we found there were safe systems in place for the storage, administration and recording of medicines

Care records were detailed and person centred. Care plans and risk assessments reflected people’s individual needs and contained enough information to enable staff to provide safe and appropriate care and support. Care records provided detailed information about people’s social histories, likes, dislikes and hobbies.

People we spoke with were positive about the service and the staff who supported them. We found the atmosphere to be calm and unhurried. There was lots of laughter and gentle banter between people. We saw that managers and staff knew people well, and were caring and compassionate in the support they provided. Staff we spoke with demonstrated a commitment to providing person centred care and promoting people’s independence.

We saw a wide range of activities were provided in the service and the community. People we spoke with told us holidays and trips out were arranged. The service had a hydro therapy pool, gym, football pitch, mini golf course, outdoor gym, football pitch, mini golf course and all weather walkway. People told us they were very happy with the activities on offer.

Managers and staff we spoke with were able to demonstrate a good understanding of the importance of gaining consent from people who used the service before any care or support was provided. We saw managers and staff respected people’s rights and choices and used a variety of ways of ensuring they had involved people in decisions; including use of non-verbal communication, pictures and objects.

The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS provide legal safeguards for people who are unable to make their own decision.

Brookvale is a Jewish organisation and food is provided in line with Jewish kosher food rules. We found there was a choice of suitable, good quality nutritious food. We saw that when needed staff supported people to choose what they wanted to eat and drink.

The home was very clean; all areas were well decorated and furnished. The grounds were well maintained. Records we looked at showed procedures were in place to prevent and control of the spread of infection. Systems were in place to ensure all necessary health and safety checks were completed. There were procedures in place to guide staff in the event of an emergency that could affect the provision of care, such as loss of gas, electricity, heating or breakdown of essential equipment.

We found there was a robust system in place for assessing, monitoring and reviewing the service. Records were kept of any issues or concerns which people had raised and any actions taken to address them. We saw there was a system for gathering people’s views about the service. There was a system in place for dealing with complaints about the service. People told us suggestions were acted upon and they had confidence the manager and staff would deal with any concerns.

People we spoke with were complimentary about the managers of the service. They said the registered manager was approachable and knew what was happening in the service. Staff spoke positively about the leadership of the service, the support they received and the work they did. People told us they were able to speak to a manger whenever they needed to.

Brookvale is a single-storey purpose built home set in extensive well-kept grounds close to farmland and the village of Simister in Prestwich. In addition to the main building and smaller buildings within the grounds there are also four cottages on site. These cottages accommodate people who live fairly independent lives. The home provides accommodation and care for up to 80 younger adults who have a learning disability. On the day of our inspection 75 people were using the service.

This was an unannounced inspection that took place on 22 October 2014. We observed how staff cared for and supported people, looked at people’s care and medicine records and records about the management of the home. We spoke with ten people who used the service, five relatives, six care staff, the cook, the management team, including the registered manager, and a visiting GP. 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.

We last inspected the home on 27 November 2013. At that inspection we found the service was meeting all the regulations that we reviewed.

During this inspection we found the recruitment of staff was not safe. We found that gaps in people’s employment history were not always explored, as required by law. We also found that the correct procedure for requesting criminal record checks had not been followed. This was a breach of Regulation 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The safety of people who used the service was placed at risk as the recruitment system was not robust enough to protect them from being cared for by unsuitable staff.

Although people’s health and social care needs were met, the care records were not always updated to show any changes required to people’s care. The quality of information about people’s needs, wishes and preferences varied in the care records we looked at. This was a breach of Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. People were not protected against the risk of unsafe or inappropriate care because care records were not always updated and did not always reflect people’s needs.

You can see what action we have told the provider to take at the back of the full version of the report.

There was not a lot of evidence in the care plans to show that the people who used the service were involved in compiling them. The care records were not ‘user friendly’. They did not contain ‘easy read’ pictorial information which may have enabled people to be more involved and have a better understanding of what was in their care plan. We have recommended to the provider they refer to the Department of Health Document- Valuing People - A New Strategy for Learning Disability for the 21st Century (2001) (England).

During this inspection we found that people were well cared for by kind and patient staff and the staff understood what care and support people required. The people we spoke with told us they liked the staff and felt safe with them. Relatives spoke positively of the staff’s kindness and attitude.

Brookvale is a Jewish organisation and, with regards to the cultural and dietary laws, is under the supervision of the Manchester Beth-Din which is a religious court. Great emphasis was placed on ensuring the religious and cultural needs of people were met. People of other faiths also lived at the home and they were encouraged to follow their faith and receive their own clergy into the home if they wished to.

People had a choice of meals and they told us they enjoyed the food and they had plenty to eat. Only Kosher food was prepared and served in the home in accordance with Jewish dietary laws.

We found that the medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.

An important aspect of people’s care was making sure they took part in the indoor and outdoor activities they liked doing. Throughout the inspection we saw people taking part in several types of activities that they were clearly enjoying. There was lots of laughter and friendly banter.

All areas of the home were clean, well maintained and accessible; making it a safe environment for people to live and work in. Procedures were in place to deal with any emergency that could affect the provision of care.

People were cared for by sufficient numbers of suitably skilled and experienced staff. Staff received the essential training necessary to enable them to do their job properly and care for people safely. Staff were able to tell us what they would do if an allegation of abuse was made to them or if they suspected that abuse had occurred.

During this inspection we spoke with eight people using the service. People were asked if they liked living at Brookvale and if they felt they were being looked after properly. Comments made included; “I like it here because there is so much to do. I go to the synagogue, do baking and arts and crafts. I am always busy” and “I like it here, it’s great”.

Care records contained enough information to show how people were to be supported and cared for. The care records also showed that systems were in place to protect people who lacked the capacity to make decisions about their own treatment, care and support.

An inspection of the care records showed that people had access to other health and social care services. Staff worked closely with other agencies so that people's social, emotional and physical needs were effectively met. We were also made aware of the systems that were in place to make sure that information was passed on when a person's care was transferred to another service.

We saw that appropriate arrangements were in place to help safeguard people from abuse. Staff had received training in the protection of vulnerable adults and knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.

People were well cared for by staff who were properly trained, supported and supervised.

During our inspection we saw records that provided evidence of people’s complex needs being fully assessed prior to them moving to the home. Care plans were in place to show exactly what support people needed. A full activity programme was in place so people could take part in various activities throughout each day and evening.

The home was run in accordance with the Jewish faith and culture. People from other religions also lived there. They were able to take part in their own religious ceremonies.

The home was very spacious, bight and well decorated. As well as indoor communal areas there were outdoor areas and a hydrotherapy pool.

We saw that a full work history was obtained from staff before their employment was considered. References and a Criminal Record Bureau check were also obtained to ensure staff were suitable to work with vulnerable people.

Although there were few formalised checks on the quality of the service we saw the manager had systems in place that would highlight any issues. She received a daily report from staff and we saw that if any improvements or changes were identified from this report they would be acted upon.

Due to people’s complex needs and communication difficulties we were unable to obtain extensive verbal feedback. However, all the people we saw appeared happy and at ease with the staff. The people we spoke with told us about trips outside the home and about social events they could attend at Brookvale.

The people that we spoke to told us that they were very happy and liked living at Brookvale. They told us they had fun and enjoyed doing all the different activities that were available.

One person who used the service told us they could change their mind “anytime I like”, about what they wanted to do.

People were very complimentary about the staff, the care and the facilities. Some of the comments were:

“You could not find better”.

”The staff are amazing. I trust them with the care of my relative”.

“The place is fantastic”.

“Smashing”.

“The place is fantastic. We moved house to be near here. We heard of its excellent reputation and wanted to be part of it”.

We were also told that it was comforting and pleasing to know that Jewish festivals and traditions were always observed.