Brookthorpe Hall Care Centre provides accommodation and personal care for up to 32 older people aged 65 and over. At the time of our inspection 25 people were using the service.

This inspection was unannounced and took place on 17 and 18 May 2017. The service was last inspected in September 2016.

There were two breaches of legal requirements at the last inspection in September 2016. At our comprehensive inspection on 17 and 18 May 2017 the provider had followed their action plan with regard to meeting the requirements of the regulations.

There was a registered manager in post. 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 service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. The registered manager had carried out the relevant checks to ensure they were employing suitable people at Brookthorpe Hall.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at Brookthorpe Hall. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained people’s dignity.

The service was responsive to people’s needs. Care plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. Quality checks were in place and where issues had been identified, there was evidence these had been addressed. People, relatives and staff spoke highly of the registered manager. Staff morale was good and reflected the positive support from management. The registered manager had informed CQC of the relevant notifications as required by the law.

Brookthorpe Hall Care Centre provides accommodation and personal care for up to 32 older people aged 65 and over. At the time of our inspection 25 people were using the service.

This inspection was unannounced and took place on 28 and 29 September 2016.

There was a registered manager in post. 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 service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. The registered manager had carried out the relevant checks to ensure they were employing suitable people at Brookthorpe Hall.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at Brookthorpe Hall. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was not always responsive to people’s needs. Daily records were not completed thoroughly and immediately following care being given. Care plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was not always well-led. Quality checks were in place and the registered manager was planning to ensure these were better used to improve the service provided. However, these audits had not identified shortfalls in areas such as record keeping. The registered manager was well liked and respected.

We found one breach of the 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. This was a repeated breach from the last inspection. We found at this inspection that there had not been sufficient improvements to meet the requirements of the regulations and the service remained in breach of the regulation.

Brookthorpe Hall Care Centre provides accommodation and personal care for up to 32 older people aged 65 and over. At the time of our inspection 27 people were using the service.

This inspection was unannounced and took place on 13 and 14 January 2016.

There was a registered manager in post. 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 did not always receive a service that was safe. Risk assessments were not always in place and those that were often lacked sufficient detail to safely provide care. Staffing levels were not regularly reviewed. People did not always receive their medicines as prescribed. The registered manager and staff team understood their role and responsibilities to keep people safe from harm. Staff knew how to raise any concerns regarding people’s safety. Employment checks were carried out on staff before they started work to assess their suitability to work with vulnerable people.

The service did not always provide effective care and support. Some staff had not received training on caring for people living with dementia. The service was not adhering to the principles or requirements of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS).

People seemed to enjoy the food and menus were planned in advance. People did not always have easy access to drinks. Arrangements were made for people to see their GP and other healthcare professionals when they needed to do so. The service had made some adaptations to the environment to meet the needs of people living with dementia.

People did not always receive a caring service. Staff did not always give people the care and attention they wanted or needed. Staff did not always treat people with dignity and respect. People generally spoke positively about the staff caring for them.

The service was not responsive to people’s needs. Care plans were not person centred and lacked the detail required to provide consistent, high quality care and support. Daily records were not completed thoroughly and immediately following care being given. There were not enough activities for people. Comments and complaints from people, relatives and others were not recorded. People’s views and opinions had not always been acted upon.

The service was not consistently well-led. The registered manager had not always submitted notifications to the Care Quality Commission (CQC) as required by law. The registered manager was well liked and respected. Quality checks were in place and the registered manager was planning to ensure these were better used to improve the service provided. However, these audits had not identified shortfalls in areas such as medicines management and record keeping.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of the Care Quality Commission (Registration) Regulations 2009.

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

We looked at the care files for six people who used the service. We also spoke to one person. We were unable to speak to more people because they were unable to tell us about their experience. During our inspection we were also not able to speak to any relatives. We observed excellent communication and interaction between staff and people who used the service. Encouragement was given for people to do as much for themselves as possible.

We spoke to one person who used the service and saw some of the returned questionnaires in the latest satisfaction survey set out by the provider just before our visit. The comments we heard and saw included "the home is comfortable and the staff are good". "I would not change a thing, I'm very happy". "I am very happy here and the staff look after me very well".

During our visit we saw all the bedrooms and communal areas and all appeared to be clean. We observed that medicines were also given safely and by appropriately trained staff. The home is well staffed with a consistent and stable workforce. The manager also confirmed that they had not received a complaint in over a year because staff do their best to resolve any concerns when they occur.

Due to the nature of the service we were only able to speak to four people who use the service. We also spoke to three relatives of people who use the service and saw a wide range of feedback held by the provider. We also inspected records and documents held by the provider.

One person told us "The staff always ask me what I want to do and what I would like to eat".

A relative also told us "Staff always work with me to provide care to my mother and that gives me confidence".

Other people commented that the food was excellent, the staff are very helpful and that the home is lovely.