This unannounced inspection took place on 10 October 2018.

Brook House Residential 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. Both were looked at during this inspection. The care home accommodates up to 10 people living with a learning disability. At the time of the inspection, there were 10 people who received support with personal care as nursing care is not provided at this home.

The care service is aware of the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. We found on this inspection that the service was delivering these values.

The home was managed by 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.

This inspection was the first inspection since the service was registered with the Commission on 23 October 2017. The service was previously registered under a different provider.

During this inspection we found shortfalls in relation to the safe management of medicines and the systems for monitoring the quality of the care delivered. This was because records of people’s medicines had not been effectively managed, and staff did not always have guidance on how to use ‘as and when’ (PRN) medicines and medicine audits were not robust. Action was taken to rectify the shortfalls immediately after our inspection.

We found there was one breach of the Regulations. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.

People and their relatives told us they felt safe living at Brook House Residential Home. Feedback from people regarding the care quality was positive. There was a safeguarding policy and staff had received safeguarding training.

There were systems and processes for monitoring and assessing quality in the home to ensure people's safety and compliance with regulations. However, improvements were required to ensure the audits could identity shortfalls in care provided. Medicines audits had not been effective to identify the shortfalls we found and systems for analysing accidents and incidents were not robust to ensure trends and patterns were identified and lessons were learnt. Internal audit and quality assurance systems required further improvements to ensure they could effectively assess and improve the quality of the service. The registered manager took immediate action to address all the shortfalls immediately after our inspection.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. Additional improvements were required to cover risks associated with use of topical creams and smoking. The registered manager took immediate action to address this after our inspection visit.

The staff who worked in this service made sure that people had choice and control over their lives and supported them in the least restrictive way possible. People’s consent to various aspects of their care was considered and where required, Deprivation of Liberty Safeguards (DoLS) authorisations had been sought from the local authority.

Recruitment checks were carried out to ensure suitable people were employed to work at the home.

Care plans were in place detailing how people wished to be supported. Peop