Brookfields Private Nursing Home is a care home that provided personal care to 32 people at the time of the inspection.

People’s experience of using this service:

• There were excellent and detailed systems in place to monitor the quality and safety of the service being provided. People’s views of the service were sought through regular meetings, surveys and informal chats. A complaints process was in place and people knew what to do if they had a concern of any kind.

• The provider and management team worked diligently to provide people excellent levels of care and support, and staff a workplace to grow and develop within.

• Staff were not limited from gaining employment due to restrictions such as age or intellectual differences and the provider engaged a culturally diverse staff group that reflected the people in the home.

• The registered manager understood their roles and responsibilities as a registered person. They worked in partnership with the management team and other agencies to ensure people received excellent levels of care and support that was consistent with their assessed needs.

• People told us they felt safe living at Brookfields Private Nursing Home.

• The risks to people had been assessed and people and where appropriate some relatives had been involved in reviewing care plans. Staff were knowledgeable about the range of needs people had.

• People were supported with their medicines in a safe way.

• Training relevant to people’s support needs and staffs scope of duties had been undertaken by staff. The staff team felt involved in the running of the home and were supported by the registered manager and wider management team.

• Staff confirmed a safe recruitment process continued to ensure staff were suitable to work at the service.

• People accessed healthcare services when they needed them, and they were supported to eat and drink enough to remain healthy.

• People were involved in making decisions about their care and support and their consent about the care and services offered was obtained. People were supported by a staff team who were kind and caring and treated them in a considerate and respectful manner.

More information can be found in the detailed findings below.

Rating at last inspection: The home was rated Good at the last inspection in May 2016.

Why we inspected: This inspection was planned in line with our regulatory framework and took place within the specified period since the last inspection.

Follow up: We will continue to provide ongoing monitoring of this service.

We inspected this service on 14 March 2016. The inspection was unannounced. At our previous inspection on 22 October 2013 the provider was not meeting all the regulations we checked. At this inspection improvements had been made in medicines management and recruitment procedures.

Brookfields Private Nursing Home provides nursing and residential care for up to 36 older people who may have a physical disability. There were 33 people living at the home at the time of our inspection visit. Accommodation is provided over two floors with access via a stairwell and two passenger lifts. Communal living areas are located on the ground floor. All bedrooms have ensuite facilities. There are landscaped garden areas with seating.

There were two registered managers in post. One registered manager took a clinical lead whilst the other registered manager was the business lead. 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.

The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005. However mental capacity assessments had not been completed. Deprivation of Liberty Safeguards (DoLS) applications had been made to ensure people’s rights were protected. Staff gained people’s verbal consent before supporting them with any care tasks and promoted people to make decisions.

People we spoke with said they felt safe at Brookfields Private Nursing Home. Staff were knowledgeable as to whom they should report information to should they believe someone was at risk of abuse.

Systems were in place to manage people’s medicines and medicines were stored safely. Risk assessments and care plans were kept up to date. Staff had the relevant information on how to minimise identified risks to ensure people were supported in a safe way.

Staffing levels were monitored to ensure people’s needs were met. The provider's recruitment procedures ensured suitable staff were employed to work with people who used the service. Staff received training to meet the needs of people living at the service and received supervision, to support and develop their skills.

People’s needs and preferences were met when they were supported with their dietary needs. People were supported to maintain good health and to access health care services as required

Staff were caring in their approach and had a good understanding of people’s likes, dislikes and preferences. Staff supported people to maintain their dignity. People were supported to maintain and develop their social interests. People felt confident that they could raise any concerns with the managers.

There were processes in place for people and their relatives to express their views and opinions about the service provided. There were systems in place to monitor the quality of the service to enable the registered manager's and provider to drive improvement.

Staff felt supported by the management team. The leadership and management of the service and its governance systems ensured consistency and quality in the care being provided.

There were 32 people using the service at the time of our inspection visit. We spoke with four people using the service, three staff, and three family members.

People told us they were happy with the care and treatment they received at the service. They felt staff treated them with dignity and respect. One person who used the service told us “I am happy here, you can move freely around the home and the routines are flexible.” Another person told us “The staff look after us well” and “I feel safe here.”

Family members we spoke with were positive about the care provided by the staff.

People told us they liked the staff that supported them and that the staff understood their needs.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicine.

We found that the recruitment procedures were not robust. The necessary pre-employment checks were not in place prior to staff commencing employment.

We spoke with five people who use the service. We also spoke with three staff members and five relatives at the inspection visit.

People we spoke with were positive about the care and support provided to them, comments included "the staff are very nice,” “I have no complaints, it’s very nice here” and I’m quite happy and the staff are friendly."

Comments from visitors were generally positive regarding the care and support provided. Such as, “staff do a good job, I cannot fault them,” ”they (staff) do their best” and “we have no concerns about the staff, they are helpful.”

We saw that people's needs were assessed, and care plans were in place. This meant they received support in a way they prefer.

During the inspection visit we observed staff supporting people to make choices, for example when the refreshments trolley was going round people were asked what they would like.

People that we spoke with confirmed that they felt safe and that staff supported them in a safe way. People told us that if they had any concerns they would talk to staff or the managers.

Visitors we spoke with also confirmed that staff were kind and treated people well.

We found that there were systems in place to monitor the quality of the services, and make improvements where required.

One person using the service told us “the staff always respect my wishes. Staff are wonderful, they respect me and treat me with dignity”.

Another person told us “I was very poorly when I came here, but I’m much better now”. A relative commented “if we need help we use the call button, we do have to wait sometimes but it is acceptable”.

A relative who was visiting the service during our visit commented “I think that my relative enjoys the food and eats well. The staff are all aware of their allergy, I have seen it written down”.