Bryn Haven

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People and their relatives mostly told us staff were kind and caring and we observed some kind interactions between people and staff. However, we also made some observations of care which did not promote people’s dignity. We found concerns around people’s cleanliness and the timeliness of their support. People told us they made choices around their care and there were no visiting restrictions in place at the home.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People generally told us staff treated them with kindness and respect. One person told us, “I like the staff they are nice to me and they listen to me. I like the fact I can walk around and my friends can visit me.” Another person told us, “The staff are lovely they listen to me and I feel I can talk to them. When they come to my room they knock on the door before they enter.” However, one person told us, “Some of the staff can be a little heavy handed; they don’t hurt me, but sometimes they rush.” We received mostly positive feedback from visitors about how kind and caring staff were to them and their loved one. One visitor told us, “The staff are respectful and easy to chat to; they are affectionate and show compassion.” However, one visitor told us, “Sometimes when we visit, their [Relative] nails are not clean, one of the family will mention it to the care staff and they will clean them.” This reflected some of the observations and concerns noted during our onsite assessment.

Staff explained how they would ensure people’s dignity whilst assisting them with personal care. One staff member told us they had a lot of respect for people at the home. They told us, “In my eyes, they [people] have worked all their life and it is now their time to rest and relax.” Staff told us they sometimes found it difficult to ensure people received timely personal care due to staffing levels. This included baths, showers, and oral care. One staff member told us the home had a keyworker system in place for people to receive baths and showers, but this did not get followed due to low staffing levels. One staff member told us, “We’ve not got the staff to keep people clean as they should be.” Another staff told us, “Sometimes it is shocking – people’s presentation; people sometimes have an unclean smell and food spilled down them. It is to do with not enough time for staff to do it. If there are only 3 staff upstairs, and many people are doubles, this only leaves one staff covering the whole floor.”

Visiting professionals did not have significant concerns about the care delivery at the home and staff were always willing to engage with them. They told us they worked mainly with senior staff, who were mostly long standing at the home. However, they did raise some concerns about non-permanent staff. One professional commented, “There are a lot of agency workers and this is difficult when working with vulnerable people; care plans do not always get followed.”

People did not always have clean fingernails and did not always look well kempt or appropriately dressed. We were not assured people were receiving regular showers and baths. On the first site visit one staff member confirmed that no-one had received a bath or shower that day. We saw people’s clothes were not always clean and had food spilled down them for long periods of time. One lady had unwashed hair, unclean teeth and nails, and unclean clothes. We also saw that some people were not dressed in a dignified manner with appropriate clothing. We observed some staff were kind and attentive to people with a gentle manner. However, we also observed one member of staff being loud and giving people kisses without prompting or asking permission. This staff member incorrectly told people with dementia that they were being served wine (blackcurrant juice) and ice cream (yogurt). We observed some lovely interactions between staff and people; however, we also saw where staff did not ask consent or explain what was happening. We observed one staff member telling people to “sit down”. We also saw where people were disregarded when they required assistance. We observed one person bent over the side of their wheelchair for a long period and another person was visibly upset whilst sat at a dining table for a period of time and was not attended to by staff. We fed back our concerns about people’s cleanliness and presentation on day one of the site visit and the registered manager told us on day 2 they had implemented ‘must do’ actions on the electronic system to ensure people were offered a bath or a shower every day and to document refusals.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us that staff knew them well and felt well treated by staff. People were able to make decisions about their daily lives and were supported to have visits from friends and family. One person told us, “The staff are brilliant; they are very caring and make time for you, they are supportive but not over the top; they allow me to be independent and I prefer it that way. My family visit when they can, and they are made to feel welcome.” Another person told us, “I feel I do have control over my life. I have the remote control [TV] and watch what I want to. I go to bed when I like and get up when I want to.”

Staff told us there was very little in the way of activities as the home’s activities and lifestyle co-ordinator had been absent for several months. Staff told us they were taken off their usual role to provide activities, but they did not have the time to do this. One staff member told us, “We can’t split ourselves in two as the management expect us to do it.” Another staff member told us, “No activities at all going on really. We had a singer last week and that was it.” The registered manager told us they were in the process of recruiting an activities and lifestyle co-ordinator and in the meantime they had additional staff come in to the home to provide activities. The registered manager told us they regularly have community group involvement at the home. The told us, “A few months ago we did afternoon tea for Brinnington community.” They service was in the process of joining an established organisation that provides support for veterans in care homes.

During our observations we did not see any one to one activity. However, on the first site visit a relative was providing a gardening activity and on the second site visit, we saw that a singer was performing at the home and people were enjoying the entertainment. We saw some instances where people were given choice; however, we also observed people having support done to them without their consent. For example, we saw people being moved in wheelchairs without comment or explanation and people having food put in their mouth without first being asked.

The registered manager told us they were in the process of improving the involvement of people and relatives in care plans and care reviews as this was not currently evidenced in documentation. Staff had received training in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). However, when talking with staff, we received mixed responses about their understanding and knowledge about mental capacity and people’s decision making. There were no restrictions on visiting and people could have visitors whenever they chose. People's choices and preferences were included in their care plans. These were regularly reviewed and updated as people's needs changed.

People and their visitors felt staff knew them and were aware of their preferences and choices for care. One visitor told us, “The staff know our relative well and they are well trained and understand their health condition.” One person told us, “If I feel unwell, I tell the staff and the doctor visits. Staff check on you during the night to see if you are okay.” However, feedback indicated non-permanent staff did not always know people well and we saw occasions where people were not being provided with the correct care.

Staff told us they were not always able to respond to people’s immediate needs in a timely manner due to the low staffing levels. We asked staff about call bell response times; one staff member told us, “There are only two care staff on duty today so if attending to a person who needs two then we cannot respond, but the housekeepers are asked to help.” Another staff member told us, “We take a long time to answer them [call bells]. [person] said yesterday that they “never answer them buzzers.” Staff told us they knew people, but they did not get time to read people’s care plans. The registered manager told us they are able to monitor call bell response times and staff had received training in call bell times. On our tour of the building in the early morning of the first site visit, we found many people did not have access to a call bell. The registered manager told us this was because people did not have the capacity to use them and periodic checks were in place as an alternative. The registered manager told us they asked ancillary staff and seniors to help out during mealtimes to ensure people received their meals in a timely way.

We observed attentive staff in the ground floor dining room lunch time on day 1. However, we found people in another lounge on the first floor did not receive the same level of care and attention during their afternoon and mealtime.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.