We visited the service on 11 July 2017. The visit was unannounced. Brookfield Nursing Home provides care and support to people living in their own homes in West Kirby and surrounding areas. At the time of our visit, the agency was providing support for 80 people and 20 staff were employed. We last inspected the service on 10 June 2015 when we found that the agency was providing a good service in all areas. At this inspection we found the service remained Good.

Not all of the people who used the service required help with personal care. Some people had support with household tasks which may be once or twice or week, while others had support when going out, for example on shopping trips.

The service 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.

People who spoke with the expert by experience were very positive about the service they received. People told us they were very happy with the staff and felt that the staff were reliable and kind. They were able to speak with the manager when needed and they had no complaints about the service.

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 supported this practice.

The provider had systems to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and all of the staff team were up to date with training..

Good recruitment practices were followed which included the completion of pre-employment checks prior to new members of staff working at the service. Staff received regular supervision and training to enable them to work safely and effectively.

Care records showed that people were involved in decisions about their care and support and contained good information about the support people required and how they liked things done.

The service had a small and stable management team who have ensured that people receive a consistently good service over a number of years. All of the records we looked at were complete and up to date.

Further information is in the detailed findings below.

We visited the service on 10 June 2015. The visit was unannounced. Brookfield Nursing Home provides care and support to people living in their own homes in West Kirby and surrounding areas. At the time of our visit, the agency was providing support for 81 people, and 16 support staff were employed. Not all of the people who used the service required help with personal care. Some people had support with household tasks which may be once or twice or week, while others had support when going out, for example on shopping trips.

The service 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.

The overwhelming response from people who spoke with the expert by experience was that the service was either very good or excellent. People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff stayed for the length of time allocated and arrived on time. People also confirmed that calls were rarely missed and that an on-call system was always available. People we spoke with had no complaints about the service.

We found that people were involved in decisions about their care and support. The care records we looked at contained good information about the support people required and were written in a way that recognised people’s needs. All records we saw were complete and up to date.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults.

We found that good recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. Staff received regular training to enable them to work safely and effectively.

Comments received from people who used the service were overwhelmingly positive and included:

“We are happy that we have the same carer every week and she has come to know us well and she is aware of our needs without us asking and we feel very comfortable in her company which means a lot.”

“I cannot speak too highly of the service.”

“I find the service outstanding. The carers help me in every way possible.”

“Since having Brookfield carers I have always been satisfied with the help and support I have received.”

“I have the same team of carers who visit me regularly.”

A full review of the service provided was recorded at least annually and a senior carer told us that in between the annual reviews she did home visits, checked the files and asked people if they were happy with the service. People we spoke with confirmed that this happened.

The service had a low turnover of staff and satisfactory recruitment procedures had been followed when a new member of staff started working for the agency.

We spoke with five people who received a care service from the agency. They were very satisfied with the service and told us:

“ I couldn’t have better. My main carer has been with me for 16 years.”

“They are all nice and have time to talk.”

“I don’t think you could find any better carers. I’m so lucky.”

“They have looked after me very well for ten years.”

We saw a number of letters that had been sent to the agency in 2012. Below are extracts taken from the letters:

‘I would like to thank you for the excellent care package that has been instituted by yourselves. Since Brookfield have taken over [they] are able to relax, relying on the morning and evening carers calling at a reasonable agreed time.’

‘We would like to thank you all so much for the care, kindness and companionship you gave to our mother over so many years.’

‘Many thanks for coming to my aid so quickly. It was a wonderful response and just what was required at the time.’

A customer satisfaction survey was last carried out in October 2011. There was a good response and replies showed a high level of satisfaction. One person completing the form responded that they were dissatisfied, but they did not give their name so manager was unable to contact them. People who completed the survey indicated that they knew who to contact if they had a complaint. Comments written on the survey forms included:

‘Carers are always concerned to help with any problems sometimes as I tell them ‘beyond the call of duty’.’

‘My carer is very kind and considerate and a very able person. If I have any problems, she will answer them.’

People we spoke with told us that they could contact the office at any time, there was always a senior member of staff on call.