We carried out this unannounced inspection on the 18th December 2014.
We last inspected Briarfield House on the 30th October 2013 and found the service was not in breach of any regulations at that time.
Briarfield House provides residential care for twelve older people including people who were living with dementia. It is situated within its own grounds and there are twelve bedrooms, which are well appointed to provide comfortable living space.
There was a manager in post who was going through the process of becoming a registered manager with the Care Quality Commission at the time of our inspection. 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. The manager had worked for SSL Healthcare Limited for a number of years and had been in post as manager since September 2014.
People living at the service received good care and support that was tailored to meet their individual needs. Staff ensured they were kept safe from abuse and avoidable harm. People we spoke with were positive about the care they received and said that they felt safe.
Staff were trained and understood the principles and processes of safeguarding.
We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers
We observed interactions between staff and people living in the home and staff were kind and respectful to people when they were supporting them. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity. Independence and choice were encouraged.
We observed a morning medicines round and observed medicines were administered correctly. We did evidence that medicines were being signed for prior to administration. This was incorrect practice. We discussed this with the person administrating the medicines and the manager. The service had no protocols for when required medicines (PRN), these need to be individual to each person, explaining why and how each PRN should be administered. The manager agreed to implement this following our inspection visit.
The manager and staff had been trained and had a good knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager understood when an application should be made, and how to submit one. This meant people were safeguarded and their human rights respected.
People who used the service were encouraged to be as independent as they wanted to be. They often went out with the staff to the local Tesco for a coffee and cake. We saw evidence that people were encouraged to maintain contact with friends and family.
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The support plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. The support plans included risk assessments which were sufficiently detailed.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff or relatives to hospital appointments.
We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were also supported to use equipment they may need to maintain their independence whilst staying at the service such as adapted plates and cutlery.
Appropriate systems were in place for the management of complaints. Relatives told us the manager and staff were approachable. People who used the service and relatives we spoke with did not raise any complaints or concerns about the service.
There were effective systems in place to monitor and improve the quality of the service provided. At the time of our inspection the manager was updating and implementing new paperwork, to enable them to audit the service more effectively.
Staff received training to enable them to perform their roles and the service looked at ways to increase knowledge to ensure people’s individual needs were met. Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the manager.
We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks. The service had a new boiler fitted the day before inspection.
The service was clean and tidy. We observed the cleaning rota, this had just been introduced since the new manager started in September. We saw there was plenty of personal protection equipment (PPE) such as gloves and aprons. Staff we spoke to confirmed they always had enough PPE.