Archived: Brand Homes Limited - 55 Berryscroft Road

People’s experience of using this service:

Learning and improvement had not been implemented when adverse incidents occurred. An ambulance crew had raised concerns about the information available to them about a person’s needs when they responded to a 999 call in May 2019. The crew noted that staff could not provide important information about the person’s healthcare needs and that there was no hospital passport in place. Despite this, hospital passports had not been developed for use in any future hospital admissions.

The provider had not notified CQC of this event, which meant we were unaware of it until this inspection and unable to check that appropriate action had been taken to address the ambulance crew’s concerns.

Although the home was safe, some key aspects of the service, such as medicines and infection control, were not audited to ensure appropriate standards were being maintained. We have made a recommendation about this.

Staff received good support from the registered manager but one-to-one supervisions were not taking place and staff meetings had not been held for some time. We have made a recommendation about this.

People received their care from consistent staff who knew them well.

Staff supported people in a way which maintained their dignity and respected people’s decisions about their care. People had formed positive relationships with the staff who supported them.

People were supported to maintain good health and to access healthcare services when they needed them.

People had access to activities they enjoyed and opportunities to access their local community.

People enjoyed the food at the home. They were encouraged to contribute to the menu and their feedback was listened to.

There were enough staff available to keep people safe and meet their needs. The provider’s recruitment procedures helped ensure only suitable staff were employed.

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 service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that 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

At the last inspection the service was rated Good (published 14 October 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

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 work alongside the provider and 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.

The service is owned and operated by Brand Homes Ltd. The provider owns another small care home nearby and the staff employed by Brand Homes Ltd. work at both homes.

The inspection took place on 13 and 18 September 2017. The first day of the inspection was unannounced. We told the provider we would return on the second day to speak with people who lived at the home.

There was a registered manager in place. 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.

At the last inspection on 30 July 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were safe because staff understood any risks involved in their care and took action to mitigate these risks. There were enough staff available to meet people’s needs and keep them safe. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out appropriate pre-employment checks before staff started work.

Medicines were managed safely. Staff maintained appropriate standards of safety in the home and there were plans in place to ensure that people would continue to receive care in the event of an emergency.

People received their care from experienced staff who knew their needs well. Staff had access to the support they needed to do their jobs. People were supported to have 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.

People were supported to eat food they enjoyed and were involved in planning the menu. Staff were aware of any dietary restrictions involved in people’s care. People’s healthcare needs were monitored and staff supported them to obtain treatment promptly if they needed it.

People enjoyed living at the home and had positive relationships with staff and their housemates. Staff treated people with respect and maintained their privacy and dignity. People were supported to maintain relationships with their friends and families and were able to invite guests whenever they wished. People were encouraged to be independent and were supported by staff to learn and develop new skills.

Care and support was personalised to meet people’s individual needs. People had access to activities they enjoyed and had opportunities to enjoy an active social life. Some people attended day centres and others had paid employment. People were involved in their local community and had the opportunity to take an annual holiday.

There were appropriate procedures for managing complaints, although no complaints had been received since our last inspection. Staff encouraged people to speak up if they had any concerns. The provider sought feedback from people who lived at the home, their relatives and professionals and responded positively to feedback.

The registered manager was involved in the home on a daily basis and provided good support to people and staff. The registered manager monitored the quality of the service to ensure people received safe and effective care. Staff worked co-operatively with other professionals to ensure people received the care they needed.

Records were well organised and people’s personal information was kept confidential. The registered manager had established links with other social care professionals to ensure they kept up to date with changes in legislation and best practice. The registered manager had informed CQC and other relevant agencies about notifiable events when necessary.

Further information is in the detailed findings below.

We found that the provider had taken action to ensure people received appropriate care in a safe environment.

The provider had arranged for training in the management of medicines to be delivered by the home's supplying pharmacist.

An electrical contractor had checked the property's wiring and carried out the work required to ensure that the installation was in a satisfactory condition.

The provider had carried out a fire drill and agreed to review and update the fire risk assessment to address the issue identified during the drill.

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

' Is the service safe?

People were cared for in an environment that was homely, clean and hygienic. There were enough staff on duty to meet the needs of the people living at the home and people told us that a member of staff slept at the home each night. Care plans demonstrated that people's healthcare needs were addressed and that people had access to medical advice and treatment when they needed it.

The provider had written procedures for the ordering, storage and administration of medication. Staff had been made aware of these procedures but had not attended formal medication training. This meant that people could be at risk because staff had not received training from an appropriately qualified professional.

There was no evidence that the electrical installation had been inspected by an appropriately qualified person. This meant that people were potentially at risk because the electrical installation had not been inspected by an appropriate professional.

The provider had written fire evacuation procedures in place and risk assessments had been carried out in relation to fire safety. The home's fire alarm and firefighting equipment had been recently checked by a fire safety contractor. The records we checked during our inspection showed us that fire drills had not been carried out often enough. The provider agreed to hold a fire drill the day after our inspection and to ensure that evacuation drills were carried out at least twice a year. On the day after our visit, we received confirmation from the provider that the fire drill had taken place.

' Is the service effective?

People told us that they were happy living at the home. They said that they had plenty of opportunities to go out with friends and to take part in activities they enjoyed. One person told us, 'I'm very happy in this house. I'm with friends and we get on very well.' We found that people had access to a range of social activities, some of which were arranged by local clubs and groups and others planned by staff from the home. We also found that people were supported to maintain relationships with their friends and families.

' Is the service caring?

People told us that staff were kind and helpful and that they provided good care. One person told us, 'I like all the staff here, they're very kind. They help me make dinner for everyone when it's my turn to cook.' All the staff we spoke with had worked at the home for a long time and clearly understood people's needs well. We observed that staff engaged positively with people and treated them with respect.

' Is the service responsive?

People's needs had been assessed before they began to use the service to ensure that the home was suitable for them. One person had recently moved to the home. We found that the provider had met with the person, their family, their advocate and their care manager to find out whether the home could meet their needs. The provider had also enabled the person to visit the home several times before deciding to move in.

A care plan had been drawn up for each person which identified individual goals and aspirations. We found that care plans were reviewed each month to assess progress towards the goals identified at previous meetings and to discuss goals for the future. People said that they were encouraged give their views at residents' meetings and that they knew how to complain if they were unhappy about something.

' Is the service well-led?

Staff had a good understanding of the ethos of the home and said that they had access to support from the provider when they needed it. The provider was also the registered manager of the home and had held this post for a number of years.

We found that the provider had developed systems to monitor the quality of the service, including seeking the views of people living at the home. People told us that they had opportunities to have their say about the care and support they received and how the home was run. They said that staff listened to their views and that changes had been made as a result of their feedback.

Residents told us that they were supported to make choices about their lives. We found that residents played an active role in the life of the home, which promoted their independence and developed daily living skills. Residents were supported to take part in activities that they enjoyed, to lead active social lives and to maintain relationships with their families and friends.

At our last inspection, we found that some staff had not attended training in safeguarding vulnerable adults. At this visit we found that the provider had arranged training in this area for all staff. We also found that the provider had obtained the documents required to demonstrate that there were effective recruitment and selection processes in place, some of which had not been in place at our last inspection.

Staff told us that they had access to the training they needed to do their jobs. They said that they were encouraged to suggest ways in which the support residents received could be improved. We found that there were systems to monitor the quality of service people received and opportunities for residents to have their say.

People told us that they enjoyed living at the home and that staff were available when they needed them. They said that staff were polite and treated them with respect. We observed that staff encouraged people to make choices about how they wanted to spend their time and what they wanted to do.

People told us that they were involved in the routines of the home and that they had opportunities to take part in activities that they enjoyed. We found that people had opportunities to give their views about the service they received. People told us that any comments they made or improvements they suggested were acted upon by staff.

The people we spoke with said they felt safe and well cared for at the home and that they were confident that any concerns they raised about their care would be taken seriously. Whilst we identified no concerns about safeguarding, we found that some staff had not attended safeguarding training and were therefore not aware of the correct procedures to follow in the event of an allegation of abuse.

We found that there were effective recruitment and selection procedures in place but the provider had not obtained all necessary information in respect of all the staff employed at the home.