Brackenlea Care Home

Updated 27 June 2018

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 comprehensive inspection took place on the 2 and 9 May 2018 and was unannounced. One inspector and an expert by experience carried out day one of the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert in this inspection had a background in nursing and working with people living with dementia. One inspector carried out the second day of the inspection.

Before the inspection, the provider completed a Provider Information Return. 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. We reviewed previous inspection reports and notifications we had been sent by the provider. A notification is information about important events which the service is required to send us by law.

We spoke with 11 people and three relatives. We also spoke with the registered manager, the deputy manager, seven care staff and one external healthcare professional.

We looked at care plans and associated records for four people and records relating to the management of the service. These included staff recruitment files, records of complaints, accidents and incidents, and quality assurance records. We observed care and support being delivered in communal areas.

The home was last inspected in March 2017, where the service was rated Requires Improvement.

Updated 27 June 2018

Brackenlea Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Brackenlea Care Home accommodates up to 25 people in one adapted building. There were 21 people at the service at the time of inspection. The accommodation is over two floors, each floor is accessible via stairs or a passenger lift.

The service was rated Requires Improvement at its last inspection in September 2016 and had breached two regulations in relation to safe care and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do to meet the breach and improve the key questions of Safe and Well Led to at least Good. At this inspection, we found that the provider had made sustained improvements by ensuring that were systems in place to ensure people's records were accurate, complete and contemporaneous. The provider had also made improvements to its medicines management system to ensure the safe ordering, storage, administration, recording and disposal of medicines.

Risks to people’s health and wellbeing were assessed and monitored. The registered manager used a range of assessments to determine the appropriate level of care people required. Where people had incidents or suffered falls, the provider investigated and reflected on incidents to reduce the likelihood of recurrence.

Where people had changes in behaviour or health, the provider made appropriate referrals to health professionals and made appropriate changes to care provided in response.

People’s dietary and nutritional needs were fully assessed and monitored. Where people required staff to monitor their fluid or food intake, records were kept accurately and shared with relevant medical professionals to ensure that people were receiving the correct level of support.

Risks associated with the spread of infection were assessed and monitored. The home was a clean environment and staff understood their responsibilities around infection control.

The provider had made adaptions to meet the needs of people living there. This included adapting signage and décor to make the environment more suitable for people living with dementia.

There were systems in place to protect people from the risk of abuse or harm. The provider had an open and transparent culture, which was reflected by the registered manager informing CQC about important events that happened in the home. Where concerns were raised, the registered manager investigated issues thoroughly to ensure that people were as safe as possible and protected from harm.

There was a clear management structure in place. People told us the registered manager was effective in their role. The registered manager monitored the quality and safety of the service through a series of audits, residents meetings, staff meetings and through responses to questionnaires. The registered manager had an ongoing ‘action plan’ in place, which identified where key improvements would be made and the timescales for completion.

There were systems in place to ensure that concerns and complaints were dealt with appropriately.

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 support this practice.

People received personalised care. Staff understood people’s preferred routines around their daily living and personal care. People told us staff were caring and considerate of their needs and that there were plenty of activities available to keep them busy and occupied.

People received support to plan how they wished their care to be delivered during their last days. People were treated with dignity and respect and the provider welcomed relatives and visitors into the home.

There were enough suitably qualified and skilled staff in place to meet people’s needs. The registered manager calculated staffing levels to ensure people did not have to wait for staff to support them. The registered manager frequently worked alongside staff and had a good understanding of people’s needs.

The provider had systems and processes in place when recruiting staff to help ensure they were of good character and had sufficient experience to carry out their role.

Further information is in the detailed findings below.