Brimley

Updated 2 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service. Not all were able to verbalise their views of the service, so we observed their nonverbal communication and interaction with staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with two relatives and five members of staff including the registered manager, area manager and team leader. We spoke to two visiting therapists, for art and massage.

We reviewed a range of records. This included three people’s care records and medication records. We looked at staff recruitment, induction, supervision, and staff training records. We also looked at records related to the management of the service such as quality monitoring and policies and procedures. After the inspection we sought feedback from commissioners, and health and social care professionals who worked with the service; four responded.

Updated 2 August 2019

About the service.

Brimley provides accommodation and personal care for up to six adults who require personal care. The service specialises in providing care for both younger and older adults with a learning disability and/or autism. The home is a large bungalow in a quiet cul-de-sac in a residential area of the seaside town Exmouth in Devon.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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People’s experience of using this service and what we found

The management team and staff genuinely cared for the people they were supporting. They offered a truly caring approach and were proactive in addressing inequalities and prejudices which impacted on the people they were supporting. For example, they had gone the extra mile to advocate for a person to remain at Brimley when their physical and mental health had deteriorated, arguing the person was still able to enjoy a good quality of life with people and staff who knew them well.

The service was well led. The provider’s ethos was promoted by the staff team. This was a commitment to a society where “everyone has equal access to the same rights and opportunities.” The management team demonstrated an open and transparent management style and were fully engaged with people and staff at the service. The registered manager had steered the service through a significant period of upheaval, including a change of provider, policies and processes. Improvements were ongoing and informed by best practice. Quality assurance systems were being reviewed to ensure the continued quality and safety of the service and continued to drive improvement. Environmental improvements were in progress to enhance people’s quality of life.

We identified an issue with documentation, related to recommended fluid intake for one person. This had no impact on the support provided to the person and feedback from health professionals was overwhelmingly positive. The registered manager acted immediately to address this issue ensuring the persons health needs were reviewed and met, and the documentation was accurate.

Staff promoted people’s privacy and dignity, enabling them to make choices and have as much control and independence as possible. They worked hard to facilitate communication, supporting people to identify goals, express their views and take an active role in their community.

Staff knew people exceptionally well and were skilled at responding to their needs as they changed. Feedback from a visiting health professional stated, “People are supported to live their own lifestyle within the home and accommodations and adjustments are made according to the residents changing needs.”

Staff received training and an induction which gave them the skills and knowledge they needed to support people safely and effectively. They worked closely with external health professionals, seeking out more specialist training to allow them to meet people’s needs as they became more complex. The management team were proactive in their own continued professional development, using their learning to improve their leadership skills and develop the staff team.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 26 September 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.