Archived: Bromfield House Residential Home

Bromfield House Residential home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Bromfield House Residential Home accommodates up to 10 older people. There were two floors, the first floor was accessible by passenger lift. There were nine people living at the service when we inspected.

At our last inspection on 12 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service had 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.

Risks were appropriately assessed and mitigated to ensure people were safe. Medicines were managed safely. Records evidenced that people had received their medicines as prescribed.

Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. Accident and incident records were closely monitored, actions were taken in a timely manner to ensure lessons were learnt.

People were happy with their care and support. Staff had built up good relationships with people. Relatives confirmed that their family members were happy living at the service.

The service provided good quality care and support to people enabling them to live as fulfilled and meaningful lives as possible.

Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the service was calm and relaxed. Staff treated people with dignity and respect. People’s privacy was respected. The service was homely, clean and tidy.

People were supported to maintain their relationships with people who mattered to them. Relatives told us they were able to visit at any time.

There were enough staff deployed to meet people’s needs. The provider continued to operate a safe and robust recruitment and selection procedure to make sure staff were suitable and safe to work with people. Staff received training, support and supervision to enable them to carry out their roles safely.

Staff knew what they should do to identify and raise safeguarding concerns. The registered manager knew their responsibilities in relation to keeping people safe from harm.

People were encouraged to make their own choices about everyday matters. People’s decisions and choices were respected.

People's care plans clearly detailed their care and support needs. People and their relatives were fully involved with the care planning process. The service had developed care plans which clearly detailed people’s likes, dislikes and preferences. Care had been delivered in line with people’s choices. The registered manager reviewed each person’s care with each person on a monthly basis. People were encouraged and supported to engage with activities that met their needs.

People had choices of food at each meal time. People were supported and encouraged to have a varied and healthy diet which met their health needs.

People were supported and helped to maintain their health and to access health services when they needed them. The registered manager and staff maintained good communication with other organisations such as the community nursing service, GP and other healthcare services. Relatives were kept well informed about their family member’s health needs.

People and their relatives were given information about how to complain. People and their relatives were actively involved in improving the service, they completed feedback surveys and had meetings.

Staff were positive about the support they received from the management team. They felt they could raise concerns and they would be listened to.

The registered manager had built strong links with other local registered managers and providers who they gained support and advice from. The registered manager had signed up to conferences and events in the local area to help them continuously learn and improve.

Bromfield House is a care home providing accommodation and support for up to 10 older people who require some assistance with personal care. It is over two floors and there is lift available to access the first floor.

The registered provider is also so the 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 were given individual and group support to take part in their preferred hobbies and interests. However there were no planned trips out of the home. The staff were looking into facilities of different locations locally where people may like to visit

Medicines were stored, administered and disposed of safely. Only trained staff administered medicine. Staff had received training and their competency to administer medicine this had been checked. Audits of medicines made sure people received the medicines they had been prescribed.

The environment was suitable for the people who lived there and looked well maintained.

People spoken with all said that they were very pleased with the care and support that they received at the home.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings with people using the service and their families and annual surveys.

There was a complaints procedure on the homes notice board. People told us that they would know how to complain but that they had no need to. They were confident that any complaint would be taken seriously by the provider.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. As the people living in this home have mental capacity and there was no deprivation of liberty there had been no reason to make an application. The provider and staff understood why and when an application should be made. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

Staff had received safeguarding training and knew how to protect people. They knew the action to take in the event of any suspicion of abuse towards people. Staff also understood the whistle blowing policy. They were confident raising any concerns with the provider or outside agencies if this was needed.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. The provider and staff contacted other health professionals for support and advice when necessary.

People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the meals offered and that each week they were asked for suggestion for the menu. Staff made sure that people had plenty of drinks offered through the day. We observed lunch being served and people were happy with their choice.

Staff were recruited using procedures designed to protect people from unsuitable staff. Staff were trained to meet people’s needs and their performance was discussed during one to one supervision and their annual appraisal. Staff were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how any risks could be minimised. There were systems in place to review accidents and incidents and make any relevant changes to reduce further harm.

There were quality assurance processes were in place to make sure people received a service which maintained their health and wellbeing. People and their family’s views were sought through surveys and meetings to monitor and improve the service being offered.

The staff were fully aware and used in practice the home’s ethos for putting people at ease so that they feel happy and comfortable, whilst maintaining peoples independence, respect and dignity

During our inspection we spoke with several of the ten people who were using the service, together with speaking with the staff and management.

We found that the service obtained suitably detailed information about people and their needs to enable staff to provide effective care.

Care records showed that the people were supported with their care in a way that was individual and in accordance with their wishes. The care records reflected the health and personal care that people needed, and were appropriately checked and agreed with people or their next of kin.

People told us that they were happy with the support they received, and that the staff looked after them well. People said that they liked the food, there was a choice of menu and that they chose where to eat.

We found that care staff were appropriately trained and supervised so that they could meet people’s individual care needs.

People said that they were happy with the service provided. Their comments included “Very caring and kind”, “Very good they are angels”, “A good co-operative atmosphere always, and happy”. “I like it here” and “You look after us well”.