We carried out a review of the data available to us about Brook Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Brook Lodge, you can give feedback on this service.
People's experience of using this service and what we found
The provider had a dysphagia management policy in place. This was developed in line with current national good practice guidance.
An assessment of each person's needs was carried out regularly, this included the support they needed with eating and drinking. When people were known to have difficulty with swallowing, a choking risk assessment was completed and kept under review.
People were referred to a speech and language therapist (SLT) if their needs had changed and following any choking incident.
Risks to people living with dysphagia were understood by the registered manager and staff team. Staff were careful in following people's eating and drinking support plans which included SLT guidance.
Staff were familiar with people's food preferences and people living with dysphagia were supported to have the choice of a balanced diet.
The provider and registered manager were committed to making improvements to the service in response to specific incidents. An investigation and staff de-brief had been carried out and additional training in dysphagia was provided for the whole staff team.
The service had appropriate infection control policies and procedures in place. These were developed in line with current government guidance. We were assured the service were following safe infection prevention and control procedures to keep people safe.
Rating at the last inspection
The last rating for this service was Good (published 27 June 2019).
Why we inspected
This targeted inspection was prompted by notifications of two specific incidents. While no serious injuries were sustained, the level of risk to people was significant. These incidents are being examined through our serious incident process. As a result, this inspection did not examine the circumstances of these incidents.
The information CQC received about the two incidents indicated concerns about the management of people's swallowing difficulties (dysphagia) and choking risks. This inspection examined those risks.
We found no evidence during this inspection that people were at risk of harm from this concern.
We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections, even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
The care service had been developed and designed in line with 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.
People’s experience of using this service:
People using the service were safe. The service had reflected on an incident and put measures in place to ensure any further risks were minimised. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. There were sufficient staff with the proper skill mix on duty to support people with their needs and keep them safe. Effective and safe recruitment processes were consistently followed by the provider. Medicines were managed safely.
Staff had the right skills, experience and support to meet the needs of people who used the service. People were assisted to have a healthy and balanced diet with a choice of meals that they had chosen. 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.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of people’s care and support. People were treated with dignity and respect and their independence was promoted.
Relatives and social and health care professionals gave feedback that evidenced people received responsive and person-centred care and support in all areas of their lives. A relative commented, “Overall, [person] has the best care he has ever received within the system, it is my fervent wish that he retains this high level of care.”
Staff had ensured people could maintain their interests and arranged activities in line with this. This ensured that individual preferences were explored and acted upon so people could live as full a life as possible.
Where people could not easily verbalise their needs, management and staff involved people’s family, friends and others that knew them well, so that care and support plans reflected people’s needs and aspirations. Care and support plans were reviewed and updated as people’s needs changed.
Staff respected people’s beliefs such as religion. People and family were encouraged to explore and record their wishes as part of their end of life care plan, including how their religious beliefs would be met.
People and staff felt supported by the registered manager. The provider had effective systems and processes in place to ensure the quality and safety of service.
Rating at last inspection: Good (Report published 20 December 2018)
Why we inspected: This was a planned inspection based on the previous rating. A focused inspection took place in November 2018 following concerns raised regarding the safety of people. We looked at two areas during that inspection, Safe and Well Led and found the registered manager had taken all appropriate action following the concerns raised and therefore people were protected, and the rating remained as Good.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
We carried out this inspection following concerns raised regarding the service in November 2018, these concerns were focused on the safety of people. As a result, we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Brook Lodge on our website at www.cqc.org.uk.
At the time of our inspection, eight people were living at Brook Lodge. Brook Lodge has accommodation for people over two floors. The home has an enclosed garden which people could enjoy, as well as a lounge diner, and a communal lounge. This was an unannounced inspection.
We previously inspected the home on 8 September 2016. The service was meeting all the requirements and we rated the service as “Good” overall. At this inspection in November 2018, we only looked at ‘Is the service safe?’ and ‘Is the service well led?’ questions. At this inspection the service was rated ‘Good’ overall.
There was a registered manager in place at Brook Lodge. 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 told us they were safe living at Brook Lodge. Where staff had identified risks to people’s health and wellbeing, the risk assessments and guidance around these were detailed and contained sufficient information for staff to support people to minimise risk. Staff we spoke with could tell us how they assisted people to reduce their risks and prevent them from avoidable harm.
People’s prescribed medicines were managed well and people were supported to take their medicines as prescribed.
There were enough staff deployed to ensure people’s health needs were being met. The registered manager had systems in place to learn from incidents and accidents. They shared this learning with staff to reduce the likelihood of future safety incidents and prevent harm to people.
The registered manager and provider had systems to monitor the quality of care people received at Brook Lodge. Quality assurance checks and audits were completed regularly and identified actions required to improve the service. People, relatives and staff spoke positively about the leadership offered by the registered manager.
The service is registered to provide accommodation for up to 8 people and cares for people who predominantly have a learning disability. At the time of this inspection, there were 6 people using the service.
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. Staff had a good understanding of safeguarding processes to minimise the risk of abuse or neglect. There were sufficient staffing levels to ensure safe care and treatment. The administration, recording and storage of medicine was safe. The registered manager took appropriate steps to ensure suitable people were employed to support the people using the service.
People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS). The accommodation was suitable for the people who were living at Brook Lodge. People had opportunities to personalise their living space.
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 promoted this. Plans had been developed to reflect people’s wishes in relation to end of life care.
The service was responsive. Care plans were person centred and provided sufficient detail to provide safe, high quality care to people. Care plans were reviewed and people were involved in the planning of their care. There was a robust 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 assurance checks and audits were completed regularly and identified actions required to improve the service. Staff, people and their relatives spoke positively about the registered manager.