Archived: Showley Brook Residential Home for the Elderly

Showley Brook Residential Home for the Elderly is registered to provide accommodation and personal care for up to 15 people. Accommodation is provided in single bedrooms on two floors. The home is situated in a quiet residential area of Wilpshire Blackburn. At the time of inspection there were 13 people accommodated in the home.

The service was managed by a registered manager. 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.

People living in the home told us they felt safe and well cared for. They considered there was enough staff to support them when they needed any help. Good recruitment procedures were followed to ensure new staff were suitable to work with vulnerable people. People using the service told us there were enough staff deployed to support and help them when they needed help.

The staff we spoke with were knowledgeable about the individual needs of the people and knew how to recognise signs of abuse. Arrangements were in place to make sure staff were trained and supervised at all times.

Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained to do this safely.

Risks to people’s health and safety had been identified, assessed and managed safely. The registered manager followed up to date guidance on safety issues such as falls prevention and pressure ulcer prevention.

We found the premises to be clean and hygienic and appropriately maintained. Regular health and safety checks were carried out and equipment used was appropriately maintained. The service held a maximum five star rating award for food hygiene from Environmental Health.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.

People told us they had their privacy respected by all staff. Each person had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. Care files contained a profile of people’s needs that set out what was important to each person, for example how they were dressed, personal care and how they could best be supported.

People’s care and support was kept under review, and people were given additional support when they required this. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs had changed. This meant people received prompt, co-ordinated and effective care.

We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. Staff had been trained in End of Life care. This meant staff could approach people’s end of life care with confidence and ensure their dignity, comfort and respect was considered.

Activities were varied and people were given opportunities to take part in routine household tasks such as baking, washing up and folding laundry to enhance a sense of well being and worth. Visiting arrangements were good.

People were provided with a nutritionally balanced diet. All of the people we spoke with said that the food served in the home was very good.

People told us they were confident to raise any issue of concern with the provider and staff and that it would be taken seriously. They were regularly encouraged to express their views and opinions and also had opportunities to give feedback about the service, the staff and their environment in quality assurance surveys and at their meetings.

All people, their relatives and staff spoken with said the management of the service was very good and they had confidence in the registered manager. There were systems in place to monitor the quality of the service and evidence to show improvements were made as a result of this.

This is a summary of what we found:

Is the service safe?

Before people were admitted to the home arrangements were in place to make sure they would be safe in the environment and there was enough skilled and qualified staff to meet their needs.

We found people had been given a contract of residence outlining the terms and conditions of residency therefore protecting their legal rights.

The manager and staff had been trained and understood their obligation to apply the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). This is a legal framework designed to protect the best interests of people who are unable to make their own decisions. One person had been assessed as needing this safeguard in place. The correct procedures had been followed and the safeguard in place was being kept under review.

People told us they were treated with respect and dignity by the staff. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Risk assessments were completed and staff had been made aware of who may be at risk of falling, developing pressure ulcers or may not eat enough.

People’s care and treatment was planned and delivered in a way to protect them from any unlawful discrimination within the home and wider community.

Staff were trained in emergency procedures such as fire and first aid. All staff had been trained in safe moving and handling people and this was up to date.

Care had been taken to make sure people were kept safe by good recruitment procedures. Staff contractual arrangements prevented them from gaining financially from people they cared for.

We found the provider has taken steps to provide care in an environment that was adequately maintained. Health and safety checks were carried out at regular intervals and all essential services such as fire, gas, electric and water were certified as being safe. Safety locks were fitted as standard on bedroom doors and automatic door closures were fitted to doors as a safety precaution. Security arrangements at the home were good.

Sufficient staff were employed to meet the needs of people using the service. One person commented, "It’s not like living in my own home, but I wasn’t safe living alone. At least here there are always staff around if you need help.”

Systems were in place to make sure the provider continually checked the service was safe. This reduced the risks to people and helped the service to continually improve.

Is the service caring?

People told us they were happy with the care they received and the staff team. They said, “I do need help having a bath. I enjoy these. They (the staff) are really very nice and helpful and give me time to have a soak. It’s very nice here and the food is good.” And, “They don’t just give you things or just do something. They always call you by your name first, they will say (Anonymised) would you like... It’s important they speak to you right, its good manners. They are very kind and will come to see that you are all right.”

We saw staff treating people with respect and kindness while delivering appropriate levels of care and support.

Staff worked to care plans that were person centred, well written and sufficiently detailed on how best to meet individual needs. Daily records showed staff responded to people's needs as required day and night. Staff gave a good account of and showed an understanding of the varying needs of different people we had discussed with them.

Within the constraints of a DOLS order, the person involved was able to make choices regarding their lifestyle. They had the opportunity and scope to express their wishes for daily living and social activity, and this was respected. This helped to make sure that the person admitted was looked after in a way that did not inappropriately restrict their freedom.

Surveys carried out showed people considered the service they received was very good.

Is the service responsive?

People were given plenty of opportunities to say what they wanted. People’s assessment of needs and care plans were reviewed regularly and professional help and support was sought from health and social care professionals when needed.

A person admitted in an emergency situation was given the same consideration as a planned admission. A continuing assessment of need was ongoing, including mental capacity assessment to support a continuing placement at the home or transfer to another service.

People using the service and their relatives had completed a satisfaction survey. Residents meetings were held and people could say what they wanted and they felt listened to. A system was in place for receiving comments, compliments and complaints. People told us that they would know how to make a complaint, should they need to do so.

Is the service effective?

People told us they were happy with their care. They had their own preferred routines, likes and dislikes staff knew about. One person told us “I don’t need much help but when I do I get it. My problem is standing up. I use a frame for walking and that keeps me steady, so when I want to get up and move about I just ask.” People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care. People told us if they were not well staff arranged a doctor’s visit.

Staff worked to a key worker system to oversee people’s care. Staff had been trained in dealing with health conditions people presented such as diabetes, dementia, Parkinsons disease and in wound care.

People told us they were consulted with and listened to. Quality monitoring showed an action plan was drafted to respond to any issue raised such as preference for meal choices and activities.

There were no institutional practices imposed on people and staff were flexible in their work to accommodate individual needs and preferences.

Is the service well led?

People told us the management of the service was very good. They said, “The manager works here. She knows what is going on. I’m very happy no complaints. All the staff are very good.”

Staff were clear about their responsibilities and duty of care and were able to raise their views and concerns. Staff were encouraged to develop their skills and knowledge. Training was provided and staff were given opportunity to put their new skills into practice. Meetings were held for staff and residents.

There were systems in place to regularly assess and monitor how the home was managed and to monitor the quality of the service. We saw evidence the service knew when to consult with health and social care professionals when required. This meant any decision about people’s care and support was made by the appropriate staff at the appropriate level.

The service had achieved Investors In People (IIP) award. This is an external accredited award for providers who strive for excellence, which recognises achievement and values people.

We reviewed the care files of four people who used the service and found evidence that there were procedures in place to ensure their consent was gained in relation to the care provided for them. We found there were processes in place to ensure, where people did not have the capacity to make particular decisions, staff had the necessary information to be able to act in their best interest.

We saw that care plans clearly identified the needs of the person and included information on how they wished their care to be delivered.

People we spoke with told us they received appropriate support with their medication. We found evidence that there were effective systems in place for the safe administration of medicines.

We saw evidence that there were effective recruitment procedures in place to ensure that people who used the service were protected from inappropriate staff.

We found that suitable arrangements were in place to manage an effective complaints process for identifying, receiving and handling complaints for people in Showley Brook.