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Inspection Summary


Overall summary & rating

Good

Updated 18 October 2017

This inspection took place on 18 and 21 September and was unannounced, which meant the provider did not know we were going to visit. We last inspected this service in May 2016. At that inspection we found the provider was in breach of Regulations 17 and 18 in connection with staffing and good governance.

Burn Brae is a residential care home situated in a rural location on the outskirts of Corbridge. The service is able to provide accommodation to 31 people, some of whom have physical and/or mental health conditions, including people who live with dementia. At the time of our inspection 29 people lived at the service.

The registered provider was also the registered manager. 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.

There were policies and procedures in place to support the smooth running of the service. These included a safeguarding policy which staff told us they understood along with their responsibilities towards protecting people from harm. They told us they would report any concerns without hesitation.

People told us they felt safe. Everyone we spoke with told us they had no major concerns about staffing levels, although people, relatives and staff all told us that at times it was busy.

Checks on the safety of the home were routinely carried out by maintenance staff and by external contractors when required. Personal emergency evacuation plans (PEEPS) were in place and the provider had an emergency contingency plan which would be used in any crisis.

We observed medicines being administered to people during the inspection. People received their medicines in a timely manner, and were treated with dignity and respect during the process. Records were well maintained. We found on occasions the medicines trolley was left unsecure while medicines were given to people. Staff were nearby but when we spoke to the registered manager and deputy about this they recognised that this should not have happened.

Risks to individuals had been identified and assessments to reduce the hazards to people put in place. Accidents and incidents were recorded and monitored to identify trends. Where people needed additional advice or support, they were referred to external healthcare professionals as necessary.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. We found that the registered manager had an understanding of the principles and had acted in accordance with the law. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes.

Staff received an induction and had received suitable training with a staff member dedicated to monitor this. Staff supervisions and appraisals had been undertaken although we have made a recommendation to the provider in connection with this. Staff told us they felt supported by the manager and senior staff. Meeting for staff had taken place but not regularly, we therefore made a recommendation regarding this.

People were supported by staff to maintain a well-balanced, healthy diet and their comments were positive about the food and refreshments they received. We have however, made a recommendation that the provider incorporates the use of various menu formats to support people during meal experiences.

We observed staff respected people, and their privacy and dignity was maintained. Staff displayed caring and kind attitudes and treated people as individuals. We saw staff offered people choi

Inspection areas

Safe

Good

Updated 18 October 2017

The service was safe.

People told us they felt safe living at the service and relatives confirmed this. The registered manager and staff displayed a good understanding of safeguarding people from harm.

Medicines were managed well and people received theirs in an appropriate and timely manner.

Staff were recruited safely and there was enough staff employed to meet the needs of people who lived at the service.

Effective

Good

Updated 18 October 2017

The service was effective.

Staff received training relevant to their role and was regularly updated. Staff were inducted, supervised and monitored and competency checks were carried out by senior staff.

People were supported to maintain healthy nutrition in line with their dietary needs.

People’s consent was sought. The provider followed the law in relation to the Mental Capacity Act 2005.

External healthcare professionals were involved with people’s care as required.

Caring

Good

Updated 18 October 2017

The service was caring.

Staff displayed positive and caring attitudes and interacted well with people. Staff knew people well, including their backgrounds.

Staff involved people in making decisions about their care and support where they could.

Staff had an understanding of equality and diversity and treated people with dignity and respect.

Responsive

Good

Updated 18 October 2017

The service was responsive.

Care records were person-centred and documented how staff were to meet people’s individual needs.

Activities took place and the service continued to develop the programme to ensure they meet the needs of everyone.

There was a complaints procedure in place and people told us they knew how to complain if they needed to.

Well-led

Good

Updated 18 October 2017

The service was well-led.

The service had a homely atmosphere. Staff told us they felt supported by the registered manager.

We saw that people who used the service were consulted to obtain feedback.

Audits and checks were carried out to ensure people received appropriate care and support.

The registered manager had improved governance. Records were kept to monitor the quality and safety of the service.