Braydeston Court

Braydeston Court is a residential care home providing personal care to up to a maximum of 43 older people, most of whom live with dementia. At the time of our inspection there were 33 people using the service. The home is a converted period building over three floors with gardens.

People’s experience of using this service and what we found

The provider’s quality assurance system had been effective at identifying concerns although timely and sufficient improvements had not been made. However, an action plan was in place to address these concerns and it was felt with the appointment of a new manager that progress would now be made after a period of instability.

The individual risks to people had not always been identified, recorded, mitigated or reviewed and this placed people at risk of harm. Whilst permanent staff delivered caring, patient and respectful care that gave people choice, dignity and independence, care assessments had either not taken place, were incorrect, lacked detailed information or had not been reviewed; this risked people receiving inappropriate care particularly as agency staff were being used to fulfil shifts. We also found concerns with the medicine management within the home.

We could not be assured that people were supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way and in their best interests; the systems in the service did not support this practice. Where Deprivation of Liberty Safeguards (DoLS) had been authorised, we could not be assured that attached conditions had been met.

Staff had not received the consistent training, support or supervision required to ensure they met their roles and the needs of the people who used the service. We also had concerns that the staffing levels at night would not be adequate to keep people safe in the event of an emergency such as a fire. There was some evidence to suggest there were not consistently enough staff to always meet people’s needs in a person-centred and timely manner.

The culture within the service was positive and caring. Staff told us they worked well as a team. However, the provider needs to ensure they fully engage with staff, the people who use the service and their relatives as they told us communication and support wasn’t consistently reliable in relation to the service being delivered. Relatives did, however, confirm staff were good at keeping them informed in relation to the health and wellbeing of their family member.

People’s nutritional needs were met and there were activities available. Visiting was in line with Government guidance and the infection prevention and control systems in place were good. The premises and equipment were clean, and staff used personal protective equipment (PPE) appropriately.

The provider had made improvements to the environment including redecoration, new furniture and fixtures and the introduction of a café. Plans were in place for further improvements. People told us they were happy living in the home and their relatives told us that whilst further improvements were needed, they would recommend the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for the service under the previous provider was requires improvement, published on 01 April 2019, and there were breaches of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk and medicines management, adherence to the Mental Capacity Act 2005 (MCA), staff training and support, person-centered care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.