Braemar Care Home

Braemar Care Home is a care home providing accommodation for up to 35 people, some of whom are living with dementia. At the time of our inspection, there were 31 people living in the service. Braemar Care Home provides single and shared bedrooms with ensuite WC’s and a range of suitable communal facilities.

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

People were happy living at Braemar Care Home and spoke positively about the care they received. They told us they felt safe.

People received their prescribed medicines as required. There were safe arrangements in place for obtaining, storing and disposing of medicines.

Recruitment practices were effective and there were always sufficient numbers of staff available to meet people's needs in a safe and unhurried way.

People were protected from avoidable harm. Risks posed to and by people had been assessed and measures were in place and followed by staff, to manage individual people’s risks. Environmental and infection control risks were also managed appropriately.

People's care plans and risk assessments contained detailed information about them and their care and support needs, to help staff deliver care that was individual to each person. Staff had received appropriate training and support to enable them to carry out their role safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service had a very positive person-centred culture. People and staff told us the registered manager and other members of the management team were approachable. Staff, external health and social care professionals, people and their relatives all felt the registered manager was open, approachable and supportive. Everyone was confident actions would be taken to address any concerns promptly.

The service worked in partnership with other agencies to aid joined up, person centred care

provision. There were effective governance systems in place to identify any concerns in the service and drive improvement.

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

Rating at last inspection

The last rating for this service was Requires Improvement (Published 4 July 2019).

At this inspection we found improvements had been made.

Why we inspected

This was a planned inspection based on the previous rating.

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.

We reviewed the information we held about the service and looked at the management systems under the Well-led key question. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Braemar Care Home on our website at www.cqc.org.uk.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

Medicines were not always managed in line with best practice guidance. We recommend that the provider seek advice and guidance on adopting the latest best practice in respect of the safe management of medicines.

At the inspection we observed housekeeping staff did not always follow best practice guidance when managing soiled laundry. We informed the registered manager who took immediate action to ensure staff were aware of the appropriate policies and procedures in place.

Oversight of the quality of service delivery was not always robust. For example, care records and daily recordings were not always effective to ensure people’s care plans were up to date and accurate. However, the provider took immediate steps following our feedback to address this.

There were clear systems and processes in place to protect people from the risk of abuse.

People and their relatives told us they felt safe with the care provided at Braemar Care Home.

We received positive feedback from people that they enjoyed the range of food on offer and we saw people appropriate support to meet their nutritional needs.

The environment was clean and homely, however the decoration and signage was not always supportive of people living with dementia.

People’s rights and freedoms were protected. We saw people were supported to make their own decisions where possible.

Where people required additional support to make decisions about their care, staff consistently followed the principles of the Mental Capacity Act 2005.

People and relatives told us they were happy with the care and support provided. We also received positive feedback from healthcare professionals that people were treated with care and compassion.

Staff told us they felt supported by the provider and had access to a range of training and learning opportunities to promote good outcomes for people they support.

People were encouraged to access a range of activities to meet their interests both in the home and local community.

There was a clear management structure in place, and the registered manager had established positive relationships with people and their relatives.

Rating at last inspection: This service was previously rated as Good at the last comprehensive inspection. That report was published on 13 December 2016.

Why we inspected: This was a planned inspection based on the previous inspection rating.

Follow up: There is no required follow up to this inspection. However, we will continue to monitor the service and will inspect the service again based on the information we receive.

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

Braemar Care Home provides personal care and support to older people with both physical and dementia care needs. The home is registered with CQC (Care Quality Commission) to provide care for up to 26 people. The bedrooms are located on two floors with dining rooms and lounge areas located on the ground floor. The home is situated in Southsea, Hampshire and is within walking distance of the local shops and amenities. At the time of the inspection there were 24 people living at the home.

People living at the home told us they felt safe living at the home. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

We found that medication was given to people safely, with staff receiving appropriate training. Management also undertook audits to ensure there were no shortfalls in practice.

Staff were recruited safely with references from previous employers being sought and DBS (Disclosure Barring Service) checks undertaken.

There were sufficient staff working at the home to meet people’s needs. Feedback from people living at the home, visitors and staff was that staffing levels were sufficient.

Staff received an induction when they started working at the home, as well as receiving appropriate training and supervision to support then in their role.

The home worked within the requirements of the MCA (Mental Capacity Act), with the manager completing appropriate assessments if there were concerns about a person’s capacity. The home also worked within the requirements of DoLS (Deprivation of Liberty Safeguards) and made referrals as necessary.

We saw people received enough to eat and drink, with people also making positive comments about the food provided at the home.

All of the people we spoke with during the inspection including people living at the home, visitors and health professionals made positive comments about the care provided.

People told us they felt staff treated them with dignity and respect and promoted their independence where possible.

People felt the home was responsive to their needs and we saw examples of staff doing this during the inspection.

Each person living at the home had their own care plan, which was person centred and detailed people’s choices and personal preferences.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they received. There were no active complaints at the time of the inspection.

All of the people we spoke with told us they felt the service was well-led and that they felt listened to and could approach management with concerns.

There were systems in place to monitor the quality of service such as audits, resident meetings, staff meetings and accident/incident monitoring.

Staff told us they enjoyed their work and liked working at the home and told us they felt there was an open positive culture.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff. We spent one hour observing at lunchtime and found that people had positive experiences. Staff were observed assisting people in a calm, friendly and polite manner. People were given choices about the food they would like to eat.

We saw that each person's needs was assessed and a care plan devised so that staff had guidance on how to support people. People and their relatives told us they were satisfied with the standard of care provided by the home.

It was not clear that equipment was being used correctly to prevent injuries to people at risk of falling out of bed.

People and their relatives told us the home was a safe place for people to live. The home had procedures for the safeguarding of vulnerable people. Staff were aware of these and who they should report any concerns to.

We saw the home was clean and well maintained. People had personalised their rooms with their own possessions including their own furniture.

We spent time observing people going about their day and we saw that people were relaxed with the staff that supported them. Staff were seen to be responsive to the needs of the people who used the service.

We looked at six care plans and these showed that people's needs were assessed prior to their admission into the service. The life history of each person, family contacts, health needs and end of life wishes had been recorded.