Browns Field House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Browns Field House is registered to accommodate up to 29 older people, younger adults and people living with dementia. The home is located on the edge of the city of Cambridge. The home is on two floors accessible by stairs or lift. Shops and other amenities are a short walk from the home.

At our last inspection in June 2016 we rated the home ‘good’. During this inspection, we found the home is now Requires Improvement.

This unannounced inspection was completed by one inspector on 10 and 16 January 2019 and there were 27 people living in the home at the time of the inspection.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager understood their responsibilities in relation to notifying CQC of certain events that happened at the home.

People did not receive a service that was well led. Staff did not feel supported by management during the day or out of hours. People, relatives and staff meetings were not held regularly to enable concerns or issues to be discussed.

People were supported to have choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the home support this practice. However, people were not always provided or supported with choices about their food or drinks. People’s nutritional needs were however met because of staff who knew each person's needs well. People’s health and wellbeing was maintained and they had access to a range of health and social care professionals.

People continued to be kept as safe as possible because staff understood their roles and responsibilities in relation to keeping people safe from harm and abuse. Potential risks to people had been recognised and information on how to minimise risks had been recorded as guidance for staff to follow. People received their prescribed medicines, which were managed safely. There were enough staff on duty with the right mix of skills to meet people’s support needs.

People continued to receive good care because staff treated people with kindness, compassion, dignity and respect. People and their relatives were involved in decisions about their care and thought staff were caring. Staff knew people well and understood their care needs.

People continued to receive a service that was responsive. People and their relatives were involved in their personalised support plans and reviews. The information about them in relation to their care needs was up to date. People were encouraged to take part in a range of activities that they enjoyed and were the choice of the person at that time. This helped promote social inclusion. Information was in place to support people with end of life care.

Further information is in the detailed findings below.

Browns Field House is a care home that provides accommodation and personal care for up to 29 older people, some of whom are living with dementia. There were 25 people living at the home at the time of this visit. There are internal and external communal areas, including a lounge / dining area, a garden including a play area for visiting children, two kitchenettes, two small shops, smaller lounges, a library and conservatory for people and their visitors to use. The home is made up of two floors which can be accessed by stairs or a lift. Seven bedrooms have a hand wash basin and toilet and one of these rooms also has a shower. There are four communal bath/shower rooms for people to use.

This unannounced inspection took place on 17 June 2016.

There was a registered manager in place during this inspection. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Where people had been assessed as lacking capacity to make day-to-day decisions, decisions were made in their best interest. Applications had been made to the local authorising agencies to lawfully restrict people’s liberty where appropriate. Staff demonstrated to us that they respected people’s choices about how they wished to be supported. Staff were able to demonstrate a sufficient understanding of the MCA and DoLS to ensure that people would not have their freedom restricted in an unlawful manner.

Plans were in place to minimise people’s identified risks, to assist people to live as safe and independent a life as possible. Records were in place for staff to monitor people’s assessed risks, and their care and support needs.

Arrangements were in place to ensure that people were supported with their prescribed medicines safely. People’s medicines were managed, stored and disposed of appropriately. People’s nutritional and hydration needs were met.

When needed, people were referred and assisted to access a range of external healthcare professionals. People were supported to maintain their health and well-being. Staff supported people with their interests and promoted social inclusion. People’s friends and families were encouraged to visit the home and staff made them feel welcome.

People were supported by staff in a kind and respectful manner. People’s care and support plans gave guidance to staff on any individual assistance a person may have required. This included how person wished to be supported and what was important to them.

Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions, competency checks and appraisals. This was to make sure that staff were deemed competent and confident by the management team to deliver people’s support and care needs.

Staff understood their responsibility to report any poor care practice or suspicions of harm. There were pre-employment safety checks in place to ensure that all new staff were deemed suitable and safe to work with the people they supported. There was a sufficient number of staff to provide people with safe care and support.

The registered manager sought feedback about the quality of the service provided from people, their relatives and visiting stakeholders. People who used the service and their relatives were able to raise any suggestions or concerns that they had with the registered manager and staff and they felt listened to.

Staff meetings took place and staff were encouraged to raise any suggestions or concerns that they may have

An adult social care inspector carried out this this inspection on 24 June 2014. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at

Is the service safe?

Risk assessments regarding people’s individual needs and activities were carried out and arrangements were in place to minimise any potential dangers as much as possible. Staff understood their roles and responsibilities in making sure people were protected from the risk of abuse and were up to date with safeguarding training and accompanying reporting procedures. There were effective infection control procedures in the home to ensure that people were protected from the risk of infection as much as possible. The premises were well maintained and the communal areas and private bedroom space met the personal preferences and needs of people living in the home.

Is the service effective?

The care staff we met were knowledgeable about people’s individual care and support needs and especially the needs of those people living with dementia. Observations we made during our inspection confirmed that the care staff provided friendly and attentive support when assisting people during the day. People were assisted to make choices regarding how they wished to spend time during the day either at home, or going to local facilities in the community. Staff had also received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and we saw that appropriate assessments were in place so that people who could not make decisions for themselves were protected.

Is the service caring?

Observations made during our inspection showed that people received warm, consistent and respectful support from care staff and that they were enabled to make choices and decisions when required. One person told us that, “I am happy living here and I have no concerns.” Staff told us that they were well supported and supervised by the manager and senior staff so that they could provide safe care and support to people.

Is the service responsive?

We saw that people’s personal care and social support needs were assessed and met by staff. This also included people’s individual choices and preferences as to how they liked to be supported. We observed and saw that people could make changes to their support and were treated in a very ‘person centred’ way by staff at all times. People and, or, their relatives had been involved in the reviews of their support plans as much as possible.

Is the service well led?

The home was effectively managed and staff told us that they felt supported and were regularly trained to safely provide support to people. Observations made during our inspection showed that staff were keen and enthusiastic about their work and provided friendly and attentive support to people living in the home. Health and safety checks were in place to monitor the services provided. The service gathered opinions from people who used the service, healthcare professionals and staff to identify any improvements that could be made to the service.

People that we met with during our inspection visit on 23 April 2013, were not able to tell us about the care and support they received whilst living in the home, due to their complex needs. However, observations made during our visit showed that people were satisfied and happy with the care and the attention they received from care staff. One relative told us that “It’s lovely here and feels like one big family”.

Care and support was being regularly reviewed and updated to ensure that peoples’ care and support needs were being met. There was evidence that people’s relatives had been involved in the planning of the person’s care and support and had supplied background information which enhanced the staff’s understanding of the person.

Staff were trained in the safe administration of medication and records of administration were accurately completed.

Ongoing training sessions were in place that ensured staff delivered safe care and support to people. Staff told us that they felt supported by the management in the home. However, it was noted that improvements were needed to the frequency of formal recorded supervision sessions that staff received.

The home had an effective system to regularly assess and monitor the quality of the service that was provided to people.

People told us what it was like to live at this home and described how they were

treated by staff and their involvement in making choices about their care. They

also told us about the quality and choice of food and drink available. This was

because this inspection was part of a themed inspection programme to assess

whether older people living in care homes were treated with dignity and respect

and whether their nutritional needs were met.

The inspection team was led by a Care Quality Commission (CQC) inspector

joined by an Expert by Experience who has personal experience of using or

caring for someone who uses this type of service, and a practising professional.

During our inspection of Browns Field House on 10 July 2012 we used a number of different methods to help us understand the experience of people living in the home. This was because some people living there had dementia, which meant that they were not able to tell us their experiences. For part of the inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People we spoke with were very positive about the home and the way they were treated by the staff. A family member completed a form on the CQC website to tell us about their experience of this service. They wrote, “The staff are respectful and treat people as individuals”. People were as involved in planning their care and making choices about how they wanted to live their lives as they were able to be.

Lunchtime was a very relaxed, sociable time, with lots of conversation and people clearly enjoying their meal. One person said, “The food is wonderful”. Staff ate lunch with people so that they could assist people who needed help with their food, and could also help to make it a pleasant experience for everyone. Staff were fully aware of people’s food preferences, and snacks and drinks were provided throughout the day to ensure that people had plenty to eat and drink.

A visitor told us that they had no worries about their relative’s safety, and people said they knew how to raise concerns should they need to. There were sufficient staff on duty to meet people’s needs, and to be able to spend time with people. A relative said, “The staff have been very caring and kind”. Records were individualised, gave good information about people’s care needs, in particular their nutritional needs, and were stored securely.