Bryony House

Updated 14 March 2020

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 and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Bryony House is a ‘care home’. People in care homes receive accommodation and 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.

The service had a manager registered with the Care Quality Commission however they had left. There was a manager in post who was in the process of registering with us. This means that 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 sought feedback from the local authority and professionals who work with the service. 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 15 people who used the service and six relatives about their experience of the care provided. We spoke with eight members of staff including the manager, assistant manager, senior care workers, care workers, activity coordinator, kitchen staff and the administrator. 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 reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at incident and accidents and information relating to falls. We spoke with one professional.

Updated 14 March 2020

About the service

Bryony House is a residential care home providing personal and accommodation for up to 35 people aged 65 and over. At the time of the inspection 30 people were living at the home.

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

The day to day monitoring of the home was not effective. Incident and accidents weren’t analysed for themes and trends. Systems were not effective for monitoring medicines. The wrong applications had been submitted to deprive people of their liberty, this had not been identified. Records relating to people’s day to day needs were not always completed. The storage and retrieval of documents was not effective.

The registered manager had left in 2017 and CQC had not been notified of this.

Prescribed cream and patched were not always managed in line with best practice (NICE) guidelines. Staff did not always record people had received their medicines as prescribed. Lessons were not always learnt following incidents and accidents.

Moving and handling was carried out safely. People felt safe. There were safe staffing levels. Staff knew how to protect people from abuse.

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

People were treated with kindness and compassion. People felt well supported. People were encouraged to be independent.

People’s and their relatives were involved in the review process. People’s personal preferences were identified in their care plans. People were involved in decisions about their care.

People received person centred care. People, relatives and staff expressed confidence in the manager. People, relatives and staff were given the opportunity to provide feedback.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 February 2019) and there was a breach in relation to the governance of the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.