Archived: Bracken Ridge Manor

Updated 15 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One adult social care inspector carried out this inspection.

Service and service type

Bracken Ridge Manor 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.

An interim manager was in post from 12 April 2019 until 1 July 2019. A new manager started on 1 July 2019. They had started the process to become a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from Redcar and Cleveland, Middlesbrough and Newcastle local authorities and professionals who work with the service. This included South Tees infection prevention and control team, Cleveland fire authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with five people using the service. We also spoke with the nominated individual, a director, interim manager, manager, two nurses, a carer, the chef and a domestic member of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed four people’s care records and six people’s medicine records. We also reviewed three staff recruitment records, two staff induction records, four staff supervision and appraisal records and training matrix of all staff.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We shared our inspection findings with stakeholders. Not all stakeholders provided a response.

Updated 15 October 2019

About the service

Bracken Ridge Manor is a care home for up to 17 people with mental health needs. The service provides assistance with personal and nursing care. At the time of inspection 12 people were using the service. Bracken Ridge Manor accommodates people in one adapted building.

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

Staff were not responsive to risk. Where risk was in place, staff did not recognise or take appropriate action to reduce the risks. The safety of the building had not been maintained. Records for ‘when required’ medicines needed to be improved. There were enough staff on duty at all times. We made a recommendation about infection prevention and control.

People’s general needs were met because staff knew people so well. No effective action had been taken to address the inaccurate care records. This increased the risk of harm to new staff and students on placement. Activities needed to be improved. People knew how to make a complaint and felt confident they would be listened to.

There was continued lack of oversight by the provider. Leadership was not effective and had not resulted in improvements to the service. Staff did not understand regulatory requirements. Feedback was not used to drive improvement. Staff did work well with professionals.

Staff training was not up to date. Staff did receive supervision and appraisal. People were supported with their nutritional and healthcare needs. Improvements to the environment had started to take place.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support good practice.

People were not supported with their independence. There were missed opportunities with medicines, cooking and activities of daily living. Staff knew people well and understood their needs. Support was given when needed. Staff were caring, kind and compassionate.

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 this service was requires improvement (Published 18 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. This was updated each month.

At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We brought forward this planned inspection because concerns had been raised by stakeholders involved in the service. There were concerns about the lack of improvements at the service since the previous inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

The overall rating for the service has changed from requires improvement to inadequate. 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 Bracken Ridge Manor on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to supporting people with their independence, the management of risk, medicine records, staff training, care records, quality assurance systems and oversight of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.