Archived: Bradmere Residential Care Home

This unannounced inspection was carried out on the 02 June 2015.

Bradmere Residential Care Home provides rehabilitation and continuing care for up to 16 people who have experience of mental ill health. The home is situated in the Eccles area of Salford, close to local shops, pubs and public transport routes. The home is a large modern style house with car parking at the front and a small garden at the rear.

There was a registered manager in place. 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.

At the last inspection carried out in August 2014, we did not identify any concerns with the care provided to people who lived at the home.

Each person we spoke with who either used the service or was a relative of someone who used the service told us the service was safe. One relative told us; “I do think she is safe, better than at other places she was at. I don’t worry about here, I trust them and I have peace of mind.”

As part of our inspection we checked to see how people who lived at the home were protected against abuse. We looked at the service safeguarding adult’s policy and procedure. Safeguarding leaflets and posters were on display in the home with detachable telephone numbers, which people could tear off and use to report concerns directly to the local authority. Staff we spoke to were able to confirm they had received training in safeguarding adults, which we verified by looking at training records. We reviewed a sample of six recruitment records, which demonstrated that staff had been safely and effectively recruited.

We found the service had suitable arrangements in place to manage risks and supported people’s freedom and choices. We found the service operated an open front door policy where residents were allowed to leave the premises when they wanted. The service encouraged people to report when they were leaving the premises and what time they would return.

We looked at how the service ensured there were sufficient numbers of suitably qualified staff on duty to meet people’s needs. One person who used the service told us; “Always enough staff on duty.” Staff told us they had no concerns about staffing levels and that they found management responsive to any concerns including staffing.

We found medicines were managed safely.

All staff confirmed they had undertaken an induction programme when they started with the service, which we verified from looking at personnel files. They also confirmed they believed they had received suitable training to undertake their roles.

We looked at supervision and annual appraisal records and spoke to staff about the supervision they received. Supervision and appraisals enabled managers to assess the development needs of their support staff and to address training and personal needs in a timely manner. Staff told us they received regular supervision and felt supported in their role.

The Care Quality Commission has a duty to monitor activity under the Deprivation of Liberty Safeguards (DoLS). The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. We spoke to the manager and staff who demonstrated an understanding of the principals of the MCA. The manager told us that it was not the company’s policy to accept people subject of any DoLS restrictions as they maintained an open door policy at all times, with people coming and going when they chose.

During our inspection we checked to see how people’s nutritional needs were met. Staff prepared meals for people with choices available. A menu was displayed in the dining room with the main meal being provided at tea time. During our visit bowls of fruit were available in the dining room for people to have. We saw tea and coffee making facilities were available in the kitchen and in the smoking room, where people were free to make their own drinks throughout the day and a water cooler was also available. Staff told us that people were able to make their own snacks throughout the day such as sandwiches. We found the kitchen area was clean and that staff members wore gloves whilst preparing food.

Both people who used the service and relatives we spoke with told us they or their loved one were well cared for at the home. Throughout the inspection we observed staff providing support and care in a kind and sensitive manner.

We observed instances where staff demonstrated a thorough understanding of respecting people’s privacy, dignity and choices. We observed staff knocking on doors before entering bedrooms and asking whether they could enter. One visitor told us; “I have seen staff knocking on doors and they appear to respect everyone’s privacy and dignity.”

On the whole, people told us that the home was responsive to people’s needs. However, one visitor told us; “My only concern is that I asked to make a referral and it still doesn’t appear to have been done. However, they tell me if my client has medical appointments and will often take them.”

During our inspection we noticed a number of people who used the service sat around in the main lounge area smoking. One relative told us about the pungent smoking odours that existed. We were told by a member of staff that people who smoked were offered non-smoking sessions or patches by the GP and practice nurse who attended the home on a weekly basis. We did not identify records to confirm that this had taken place.

During our inspection we saw a lack of stimulus and rehabilitation care being delivered. We saw that a number of people were simply sat around smoking for considerable periods of time with limited interaction and pro-active person centred care. One visitor told us; “I haven’t seen much in the way of activities or stimulation, but I have seen evidence of crafts and baking that they have been involved in.”

We found the service did listen to people’s concerns and experiences about the service. We found that questionnaires were sent to people who used the service, relatives, stakeholders and staff.

People we spoke with and staff told us they believed the home was well run. One private support worker said “Initially I didn’t feel it was the right place for X, but since getting to know staff and the manager, I feel they support her needs very well.” Other comments included; “The manager’s door is always open and very friendly.”

One member of staff said “I am valued and do feel appreciated here. There is always someone to support you. If you have any issues, concerns or complaints, I’m confident management will sort it straight away.” Another member of staff said “We are a small team and all feel valued and supported by the manager who is really approachable.”

The service undertook a range of audits of the service to ensure different aspects of the service were meeting the required standards. These included medication audits, infection control checks, water temperature monitoring.

We found the service had been accredited with Investors in People recognition. Investors in People is a management framework for high performance through people.