This inspection was carried out over two days on the 25 and 26 January 2016. Our visit on 25 January was unannounced.
We last inspected Bryn Haven in September 2013. At that inspection we found that the service was meeting all the regulations we assessed.
Bryn Haven is a residential care home located on the outskirts of a large housing estate, in Brinnington, Stockport. It looks out onto a main road and bus route; provide direct access into Stockport town centre. The home is one of a group of eleven homes managed by a 'not for profit' organisation; Borough Care Limited.
Bryn Haven is registered to provide care and accommodation for up to 42 older people although currently they are providing care for up to 41 people.
The home has 41 single bedrooms, including 18 with en-suite facilities. Accommodation is provided over two floors. There is a small garden to the front of the property and a reasonably sized, enclosed garden to the rear which has a summerhouse.
At the time of this inspection the manager was not registered with the Care Quality Commission (CQC). The acting deputy manager was due to take up permeant post on 1 February 2016. The home had been without a registered manager since September 2015. 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.
During this inspection we identified seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Medicines were not managed safely. We found there was no accurate, documented evidence that a drink thickener required by a person who uses the service with swallowing difficulties, to prevent the risk of choking had been used, which could put the person at risk of choking. We saw there were gaps in the recording of prescribed creams which meant there was a risk that creams had not been applied when required, which could have resulted in unnecessary discomfort to the person.
We saw some sterile dressings and an eye pad in two first aid boxes were out of date. If dressings are used beyond the expiry date it cannot be guaranteed that the dressing inside remains sterile and therefore should not be used.
We saw that some areas of the home were not visibly clean and there were no detailed cleaning schedules in place to indicate exactly what cleaning had been undertaken.
Building work was being undertaken on the first floor of the home and risk assessments had not been undertaken by the home to ensure people were kept safe.
Not all staff had received regular formal one to one supervision and none of the care staff had received an annual appraisal which meant that some staff were not being appropriately guided and supported to fulfil their job role effectively.
Consent to care had not in all cases been appropriately obtained from people using the service. This meant that some care plans did not demonstrate that decisions had been made in the person’s best interest.
The Care Quality Commission had not been sent all the required statutory notifications relating to the outcome of some the Deprivation of Liberty Safeguards (DoLS) that had been made to the authorising authority. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.
Systems were in place to monitor the quality of service people received. However due to the shortfalls we found during our inspection they require improvements.
Visitors we spoke to whose relatives used the service told us they thought Bryn Haven was a safe and caring place to live and they thought people were happy and well looked after.
Relatives spoken with told us they had never made a complaint but told us that any issues they had raised had been dealt with to their satisfaction.
Staff we spoke with had a clear understanding of their role in protecting people and making sure people remained safe.
Staff working in the home understood the individual needs of the people who lived there and we saw that care was provided with kindness and dignity. We saw that people who used the service looked clean, well dressed, relaxed and comfortable.
Staff completed induction training when they commenced working at the home, including familiarisation with the policies and procedures for the service.
We saw that activities were provided by staff on duty and outside entertainers.
Members of staff we spoke with told us that the management team were very approachable and supportive.
We saw that there were sufficient numbers of suitably qualified staff on duty at any one time to provide safe care.
We saw people could make choices about their food and drink and were supported by staff where needed to ensure adequate diet and fluids were taken.
We saw staff had good relationships with people and had a understanding of the individual needs and personal preferences of the people they were caring for.
We saw that staff asked people’s permission before any care was undertaken.
A GP we spoke told us that Bryn Haven gave people a high standard of care.