Archived: Bruno's Cottage

Bruno's Cottage is a residential care home registered to provide accommodation with personal care for up to six people with a range of needs including people with learning disabilities and people on the autism spectrum. There were seven people living at the service at the time of inspection.

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

The service rarely applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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

The leadership and the management of the service was ineffective. The provider and registered manager did not have sufficient oversight of the service to ensure people received the best possible care.

Audits had not identified issues regarding medicine recording, care plans and risk assessments not being up to date and relevant to the person. This put people at risk of serious harm.

Audits had not been completed for infection control and water temperatures.

Not all staff working with people had the necessary training to support them safety. Care plans and risk assessments were not kept up to date and relevant. When incidents or accidents occurred, these had not always been reviewed and any lessons learnt had not been identified or acted on. This put people at risk of harm that could have been avoided.

Medicine records were not always completed with all the information required. People had not been consistently safeguarded from abuse.

People were subject to high levels of control and restrictions from staff. This resulted in people not always being treated in a dignified manner. Their privacy was also affected by some of the control measures in place.

The environment had not been kept in a clean and hygienic state. We found issues relating to infection control.

The provider and registered manager had not kept the Commission informed of any changes to their registration or of notifying us of events they are required to by law.

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 Good (published 8 August 2017). The overall rating for the service has changed from Good to Inadequate. This is based on the findings at this inspection.

Why we inspected

We received concerns in relation to the number of people living at the service, and how the provider met the needs of people with complex behaviours. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led.

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

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

Enforcement

We have identified breaches in relation to keeping people safe, protecting people from unsafe or improper treatment, cleanliness of the environment and systems and procedures at this inspection.

We have also identified breaches relating to the providers registration with the Commission.

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

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 the 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.

Bruno’s Cottage provides accommodation with personal care for up to six people with a range of needs including, for example, people with learning disabilities and people on the autism spectrum. There were five people in residence when we inspected.

A registered manager was in not post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were safe. Their needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. Risks to people’s safety had been assessed and reviewed as people’s needs and dependencies changed. Care plans reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe.

People benefitted from receiving care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. People were treated equally and shown respect as individuals that came together from a range of diverse backgrounds and cultures. There were sufficient numbers of experienced and trained staff to meet people’s assessed needs.

People were protected by robust recruitment procedures from receiving unsafe care from staff that were unsuited to the job. They were safeguarded from abuse and poor practice by staff that knew what action they needed to take if they suspected this was happening.

People’s individual preferences for the way they liked to receive their care and support were respected. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive them. They had insight into people’s capabilities and aspirations. People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.

People had enough to eat and drink. People who needed support with eating and drinking received the help they required. Their individual nutritional needs were assessed, monitored and met with appropriate guidance from healthcare professionals that was acted upon.

People that required support with taking medicines received the help they needed. Medicines were appropriately and safely managed and staff had received the training they needed in the safe administration of medicines. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups.

People, and where appropriate, their family or other representatives were assured that if they were unhappy with the care provided they would be listened to and that appropriate action would be taken to resolve matters.