Archived: Bronte Park Residential Home

Updated 8 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 April and 8 May 2017. The inspection was carried out, on the first day, by two adult social care inspectors and one 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. Two adult social care inspectors returned on the second day to conclude the inspection.

Before the inspection we reviewed the information we held about the service. This included notifications from the provider and speaking with the local authority contracts and safeguarding teams. We also asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The registered provider returned the PIR and we took this into account when we made judgements in this report.

We spent time observing care in the lounges and dining rooms and used the Short Observational Framework for Inspections (SOFI), which is a way of observing care to help us understand the experience of people using the service who could not express their views to us. We looked around some areas of the building including bedrooms, bathrooms and communal areas. We also spent time looking at records, which included eight people’s care records, three staff files and records relating to the management of the service.

We spoke with 10 people who lived at Bronte Park Residential Home, five relatives, three care workers (days), two care workers (nights), the cook, the registered manager, the providers, one community matron, two district nurses and one mental health community liaison nurse.

Updated 8 July 2017

We inspected Bronte Park Residential Home on 27 April and 8 May 2017 and the visits were unannounced.

Bronte Park Residential Home is a large detached converted property. It provides accommodation and personal care to a maximum of 28 people. Accommodation is provided in double and single rooms on two floors. There is a lounge and dining room on the ground floor, car parking to the front and a garden.

At the time of the inspection there were 24 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.

When we inspected the service in February 2016 we identified one breach of regulation in relation to staff training and the overall quality rating for the service was requires improvement. On this inspection found the service had declined significantly.

Staff were not being recruited safely and there were not enough care staff on duty to keep people safe or to meet their needs in a timely way. We saw staff had received training, however, some of the poor practices we saw regarding moving and handling and privacy and dignity made us question the quality of this training.

In their direct dealings with people we saw staff were kind and caring. However, we found practices in the home which showed a lack of respect for the people who lived there. People were not receiving person centred care which met their needs or preferences and there was a lack of activities to keep people occupied.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

Although staff were able to describe how they would keep people safe, they were not always following their safeguarding policy and reporting incidents to CQC or the safeguarding team. The registered manager was holding money for safekeeping, however, the finance policy was not being followed which left people at risk of financial abuse.

People’s healthcare needs were mostly being met, however, there were some concerns about the management of people’s nutrition and hydration needs. Medicines were being managed safely.

People’s views about the meals were mixed and the meal time experience was very poor for some people.

Risks associated with the building were poorly managed, leaving people at risk. Repairs were not being completed in a timely way and information which would be required in an emergency was not readily available. We also saw not enough was being done to mitigate risks to people who used the service who were at risk of falling or had swallowing difficulties.

A complaints procedure was in place, however, concerns were not always fully investigated and no analysis was being done to look at any common themes or trends so further complaints of the same nature could be eliminated.

We did not find an open and honest culture at the service. Staff found it difficult to answer direct questions or were not honest in their answers.

We found there was a lack of effective management and leadership which coupled with ineffective quality assurance systems meant issues were not identified or resolved. We found shortfalls in the care and service provided to people.

We identified eight breaches in regulations – regulation 18 (staffing), regulation 19 (fit and proper persons employed), regulation 12 (safe care and treatment), regulation 13 (safeguarding), regulation 10 (dignity and respect), regulation 9 (person-centred care), regulation 11 (Need for consent), and regulation 17 (good governance). The Care Quality Commission is considering the appropriate regulatory response to resolve the problems we found. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.